Field Trip Permission Form
HOSA Fall Leadership Rally
Perry, GA October 13, 2017
I am the parent or legal guardian of , and by signing this statement I give permission for my child to travel with Effingham College and Career Academy to the Fall Leadership Rally in Perry, GA on October 13, 2017. I understand that this trip is provided by the Effingham College & Career Academy for my child to learn about HOSA. I understand that the students will leave from Effingham College and Career Academy and travel by ECBOE bus to Fall Leadership Rally in Perry, GA. I also understand that my child will be representing the ECBOE, Effingham College & Career Academy and the Effingham Healthcare Science Program at this event.
I consent to my child’s participation in any or all activities and I know of no restrictions on my child’s ability to participate in these activities except as follows:
By signing this consent form, I understand that my child will be subjected to the policies, rules and regulations of Effingham College & Career Academy, and the Effingham County Board of Education. My student will exhibit exemplary behavior and character while on this trip as they are representing the aforementioned entities. I further understand that administrators and teachers may refuse my student permission to go on the field trip due to behavior, attendance, and grade issues at school. Finally, I understand that my child will wear school appropriate Jeans and our HOSA t-shirt.
In the event of an emergency, I understand that I am to contact Effingham College and Career Academy for instructions regarding contacting my child. For information regarding this trip, I understand that I am to contact Mrs. April Platt, ECCA Healthcare Science Director, (912)754-5610 or at .
Please fill out the reverse of this form.
Student Name:
Parent/Legal Guardian Name:
Address: City, State Zip:
Home Phone: Cell Phone:
Business Phone: Email:
Emergency contact in case parent/legal guardian cannot be reached:
Name: Relationship:
Home Phone: Cell Phone:
Business Phone: Email:
Please list known allergies:
Please list medications your child takes at school:
I have read and fully understand the content of both sides of this form.
Signature of Parent/Legal Guardian Date
Notes:
Food: Please send money with students. We will stop in Dublin for McDonalds on the way. Student will eat at the fair for lunch (can be expensive) and we will stop on the way home for a quick break but not to eat dinner.
1. Schedule 6:00 am Depart ECCA for Perry, GA
9:30 am Take Statesman Award Test
12:00pm-5:00pm Fair
5:00 pm – 8: 00 pm Leave Fair, Return to ECCA