New Bedford Public Schools

New Bedford, MA

Permission Form Day Trips

School: Abraham Lincoln Elementary School	Today’s Date: _________________

Destination:________________________	Location: _____________________

Departure: __________	Return: _____________

Date of Trip: ______________________	Teacher(s): ___________________

Grade: ___________________________	Transportation: ________________

I hereby give my son/daughter ________________________________________ permission to participate in the field trip to the destination indicated above during the date as noted. I fully understand that the proper school officials have approved this trip and that my son/daughter shall abide by the rules and regulations as set forth by the school administration relative to this trip.

Should an emergency arise, I hereby give the supervisors in charge to arrange immediate treatment. Parents will be notified immediately.

Information for Emergency Use:

Student Name: ________________________________ Room: ________________________

Parent/Guardian Name: ________________________________________________________

Home Address: _______________________________________________________________

Telephone (Home): ______________________ Cell Phone: __________________________

Is your child on medication? ________________

Does your child need to take medication on the trip: ____________________

Emergency Contact Name and Number: ___________________________________________

Parent/Guardian Signature: _____________________________________________________