SVMS Cougar Team
Pittsburgh Fieldtrip May 16, 2018
Permission Slip due back to homeroom on April 25th
Student’s Full Name ______HR # ______
Parent Signature ______
Emergency Phone # ______
8:00 a.m.Leave SVMS by Coach Bus 8:45 a.m. Pick up Tour Guides from the Heinz History Center, PGH, PA 9:00-11:30 a.m. PGH Tour (subway ride, Duquesne Incline, Point State Park) 11:45-12:15 p.m. Lunch
12:30-4:00 p.m.Pirate Game at PNC Park
4:30 p.m.Return to SVMS by Coach Bus
*IMPORTANT! All students will need a ride homefrom the SV campus at 4:30 p.m. Please arrange now to have a ride or share rides in a carpool. You can meet your child in front of the middle school building.
Lunch: All students will need a bag lunch on the day of the field trip. Please packdisposable items. No glass. Be sure that drinks have lids. No soda cans.
______My child would like to purchase a school bag lunch for the trip.
______My child will bring a bag lunch from home.
Students may bring money with them to purchase food at PNC park. Please dress in layers and wear good shoes. We will be walking during many of our stops. Black and gold clothing is encouraged to support the Pirates!
Field Trip Medication Form
School health personnel are generally not in attendance on field trips. Medication andtreatments should be administered prior to departure or upon return to school whenever possible. If a student requires life-saving medication (Inhaler/Epipen) or a treatment (Diabetes) in order to participate in the program, and they have permission on file to carry their inhaler or Epipen, they may take it on the field trip with them. If a student requires oral medication to participate in the trip, a parent or nurse will be required to attend the trip.
Please complete the following if your child receives a medication or treatment at school on a daily or “as needed” basis that will be required during this field trip.
______will/may require ______
Name of student Medication/treatment OR NONE
______**** Please sign even if student requires NO treatment.
Signature of parent
Please choose an option below for when a nurse/parent/guardian is unable to attend field trip:
The prescribed dose can be withheld on the day of the field trip (requires a doctor’s order).
The time can be adjusted to be administered upon return to school (requires a doctor’s order).
***For Epipens, Diabetic supplies and inhalers please initial one of the following statements:
______I will send my child with their Epipen, Inhaler or Diabetic Supplies.
______I wish for the school nurse to send the Epipen, Inhaler or Diabetic Supplies that are stored in the health office.