Holy Family School • 502 East Main Street • Danville, IL. 61832 • (217) 431-5108 • fax: (217) 442-0732
        Field Trip Permission Slip
(last update: 7/10/08)


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Holy Family School
Field Trip Permission Slip

A field trip is being planned for:_____________________________________________                                                                                                      
Date of trip:                
Trip description & educational (include objectives) purpose (include place(s) to be visited, type of event)  __________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________                                                                                                         

Student’s Name:  ________________________    DOB:  ___________________

Parent/Guardian’s Name:  __________________________________________

Home address:  _______________________ Home Phone:  ________________ Work: ___________

I, _________________ as the parent/guardian, grant permission for my child, ____________,

to participate in the following activity at a location away from the school.  This activity will take place under the guidance and direction of school employees and/or volunteers from Holy Family School:
        Destination of event: _____________________________________________________

        Individuals in charge: ____________________________________________________

        Estimated time of departure and return: _____________________________________

        Mode of transportation to and from the event: ________________________________

        My child is to bring the following items: _____________________________________

    I understand the risks such a trip presents to my child, including. But not limited to, serious personal injury or death.  Any questions I have concerning this activity have been answered.
As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named minor ("participant").
In consideration for my child being allowed to make this trip, I hereby RELEASE AND AGREE TO INDEMNIFY AND HOLD HARMLESS the Diocese, the parish, the school and all their employees and agents, and the volunteers assisting the school, from any and all liability for injuries, damages, medical expenses, or any loss to my child or family or me (including attorneys’ fees) arising from or related to my child’s participation in this activity,

___________________________    ______________         ____________________________                                                                                                                  parent signature                                   date                                  parent signature

Please read this permission slip - parent signatures and date of signature required.
Return permission slip to school with your child as soon as possible.
Failure to return this permission slip will disqualify your child from attending the field trip.