Bay District Schools

BAY DISTRICT SCHOOLS

STUDENT PERMISSION FORM FOR SCHOOL SPONSORED FIELD TRIP

Name ______Grade______School______

Sponsor______Organization______

Origination of Destination of Departure Return Method of

Trip Trip Date & Time Date & Time Transportation:

Circle the Correct One

1. / Date:
Time: / Date:
Time: / School Bus
Commercial Bus
Private Vehicle**
Rental Vehicle*
2. / Date:
Time: / Date:
Time: / School Bus
Commercial Bus
Private Vehicle**
Rental Vehicle*

Trip Costs: Transportation $______

Tickets/Admittance Fees $______

Lodging $______

Meals $______

Misc.______$______

TOTAL Cost per Student $______

Parent Permission & Deposit due by ______

Total Payment due by ______

If my child cannot participate for any reason, I understand that refunds, total or partial, may not be possible due to shared cost of some services which must be prepaid. Refunds must be requested through the School Principal and there is no guarantee of reimbursement.

I hereby give my son/daughter consent to engage in activities as a representative of school and to accompany the activity group as a member on the above trips. I recognize that participation in these trips is beneficial for my child. I understand that in giving my permission, adequate supervision will be provided. I hereby agree to hold the Bay County School Board, its employees, agents, representatives, and certified volunteers harmless from any an all liability.

I AGREE TO ABIDE BY THE REGULATIONS SET ______

FORTH BY THE FHSAA, SCHOOL BOARD, AND THE Signature of Parent/Guardian

CHAPERONES WHILE ON THIS TRIP

Date Signed:______

______

Signature of Student

Date Signed:______STUDENTS ARE NOT ALLOWED TO DRIVE.

*RESTRICTIONS APPLY ON VAN CAPACITIES

RISK MANAGEMENT APPROVAL REQUIRED.**If a

private vehicle is used please list the driver on the back

of this form.

Private Drivers

Vehicle to be driven:______

Authorized Drivers: ______

______

______

______

______

______