The Library requires written permission from a parent or guardian of each child before he/she may participate in a field trip. Accordingly, we ask that you complete this form fully and indicate your consent by selecting the appropriate choices. Name of Child: Event: Trip to: Date and Time of Trip: Date and Time of Trip:: Date Date and Time of Trip:: Time Means of Transportation:? Medical Conditions:? My child does have a medical condition necessitating special accommodations My child does not have a medical condition necessitating special accommodations I hereby grant consent for the child named above to participate in this field trip. Yes No Name of Parent or Guardian: Emergency Contact Number: Number Available During Trip: CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
