FIELD TRIP PARENT RELEASE FORM

If you are viewing this from our webpage, please print out form, complete and fax to Beauclerc at 904-739-5317 with your signature.

I/We consent to ___________________________________________________going to

________________________________________________on _____________________

For supervised activities, and agree to release and discharge the Duval County School Board, its officers, agents, and employees exercising reasonable care within their scope of employment from liability growing out of personal injuries and property damage resulting or occurring during the afore mentioned activities, or in transit to and from said activity.

DATED:_____________________________________________, 20__________

__________________________________________

Parent/Guardian Legal Signature

Homeroom Teacher:__________________________ Grade Level:__________________

------------------------------------------------------------------------------------------------------------

Please sign and return only the top section. Detach and retain the bottom section.

WHERE: _______________________________________________________________

WHEN: ________________________________________________________________

LEAVING SCHOOL AT: _________________ RETURNING AT: _________________

TRANSPORTATION WILL BE BY: _________________________________________

COST PER CHILD: _______________________________________________________

LUNCH: BAG LUNCH ( ) CANNED DRINK ( ) OTHER: ____________

NOTE: Most trips require payment two weeks in advance. Once payment has been made, no refunds will be issued.