PARENTAL PERMISSION FORM
I am the parent or legal guardian of ___________________________________________________________ (name of student), and, by signing this permission form, I hereby give my consent and permission for my student to go on the trip described on the Trip Information Sheet ( See other side and/or any attached event schedules). I have reviewed the Trip Information Sheet and any attachments, and I have placed my initials at the bottom of the sheet to indicate my approval of the trip details. Although some of the anticipated details of the trip are set forth on the attached Trip Information Sheet, I fully understand that any or all of the details of the trip may change due to unforeseen circumstances, of which I may or may not have advance notice. I have fully discussed the trip with my student, and I have asked the person in charge of the trip any questions which I may have about the trip or the activities in which my student may participate during the trip. I understand, and have been fully advised of all activities scheduled in connection with the trip, and I know of no restrictions on my student's ability to participate in such activities except as follows: ( If "NONE", then so state. )
By signing this Permission Form, I waive any and all liability to the Board of Education of Coweta County, or its agents, servants or employees, for any injury to my student(s) during the course of the tri p .I also relieve the Board, its agents, servants or employees, and any chaperons on the trip, from any and all liability arising out of injuries to my student, or actions of my student, while on the trip. I understand that during the trip my student will be subject to the policies, rules and regulations of the Board of Education.
By signing this Permission Form, I acknowledge that the Board of Education is not obligated to provide automobile insurance coverage on any vehicle in which my student may be transported. I further understand that no automobile insurance coverage may be provided by the Board for the vehicle transporting my student on this trip and that the extent of such coverage, if any, may depend upon the mode of transportation.
In the event of any emergency, please get in touch with me at one of the following phone numbers:
If I am not available, please contact_________________________________________________ at the following phone numbers:
____________________________________________________________________________________________________
I have read, and I fully understand, the contents of this permission form. I have signed this form on the_______ day of________________20___
(SEAL)S
PARENT OR GUARDIAN (Signature)
TRIP INFORMATION SHEET
Name of Group:_______________________________________________________________________________________________
Purpose of Trip:_______________________________________________________________________________________________
Destination:___________________________________________________________________________________________________
Other Stops in Route (if applicable):_________________________________________________________________________________
Date and Approximate Time of Departure:________________________________ at ________________o'clock_______.M.
Date and Approximate Time of Return:___________________________________at ________________o'clock________.M.
Teacher/Administrator in Charge:________________________________________________________________________
Mode of Travel (Check One):
_____ School Bus or Other School Owned Vehicle
_____ Privately Owned Vehicle To Be Drive By:__________________________________________(Name of Teacher or Administrator)
_____ Privately Owned Vehicle To Be Driven By Parent
_____ Privately Owned Vehicle To Be Driven By Another Student
_____ Other:_____________________________________________________________________(Descnbe Other Mode)
Parent or Guardian Initial Here: ______________________