Cedar Hill Independent School District

PARENTAL PERMIT FOR STUDENT FIELD TRIP

Campus: CEDAR HILL NINTH GRADE CENTER / Teacher: Melodi Parker
Address: 1515 W. Beltline Rd., Cedar Hill, TX 75104 / Phone Number: (469)272-2050

Dear Parent/Legal Guardian:

A school trip to University of North Texas - Dallas (teacher: list specific information regarding field trip/exhibit) involving your student is scheduled for December 2, 2016 from 10:00 am - 1:00 pm. We plan to travel by school bus. We will leave at 9:15 am and should return to the school at approximately 1:45 pm. Your signed permission is necessary for your student to participate in this field trip. If your student does not have permission to participate, he/she will spend the school day at in their normal classes.

You will need to send a sack lunch in a brown paper bag, along with a drink

Other: By signing this form you give consent for your child to attend a college tour at the University of North Texas - Dallas, which includes lunch in the campus dinning hall.

PLEASE SIGN AND RETURN THE FOLLOWING FORM

Student Name: ______

Has my permission to go on the school trip listed above. Does the student have any medical

conditions or special needs? If yes, please list below.

______

______

______

I want Child Nutrition to provide a sack lunch for my child according to the price of his/her lunch status.

Does not have my permission to go on the school trip listed above.

In case of an emergency, I hereby authorize a representative of the Cedar Hill Independent School District to seek medical attention for my child on the date of the school trip.

I also hereby release, waive, discharge and covenant not to sue, and agree to hold harmless for any and all purposes the sponsor, Cedar Hill ISD and/or any of its employees and volunteers, from any and all liabilities, claims, demands, or injury, including death that may be sustained by participant while participating in such activity.

Family Code - Section 32.001 Consent by Non-Parent

(a)  The following persons may consent to medical, dental, psychological, and surgical treatment of a child when the person having the right to consent as otherwise provided by law cannot be contacted and that person has not given actual notice to the contrary; …

4.  an educational institution in which the child is enrolled that has received written authorization to consent from a person having the right to consent;

5.  an adult who has actual care, control, and possession of the child and has written authorization to consent from a person having the right to consent; …

Parent/Legal Guardian Signature: ______Date: ______

Relationship to Student: ______

Emergency Numbers: Home: ______

Cell: ______

Work: ______