Oshkosh
Area School District
Parental/Legal Guardian
Consent Form
We, as parents or guardians of ______________________________ do hereby
grant our (name
of child)
permission
and consent for such child to participate in the field trip or extracurricular trip described
as
______________________________________________ to be held on
___________________ .
(description
of activity) (date)
In granting such permission and
consent, we specifically recognize that such consent and participation in the
field trip is voluntary and that failure to grant consent will in no way result
in any impact on the grade of such child for failure to participate in the
field trip or extracurricular trip.
In grant such permission and
consent, we
1.
Acknowledge
and assume full responsibility for any and all damage to person or property
caused by our child or ward during such activity.
2.
Expressly
authorize emergency medical or dental treatment deemed necessary by the school
district, its agents, and employees during such activity.
3.
Expressly
agree that in the event that any disciplinary action or the health of my child
requires that my child be returned home during such activity that such return
shall be accomplished at our expense.
Finally, we expressly
acknowledge that we have carefully read this statement and understand its
impact and effect. We acknowledge and
understand that if we have any questions in regard to this statement that we
have exercised our right to have it reviewed and further explained to us prior
to our signing.
Dated this ______ day of __________, 200___ . ___________________________________________
(Signature of Parent or
Guardian)
________________
_________________________________________________________________
(Phone) (Address) (City) (State) (Zip)
If you decline to grant your permission,
please state your reason(s) and sign below:
Dated this ______ day of __________, 200___ . ____________________________________________
(Signature of Parent or
Guardian)
________________
__________________________________________________________________
(Phone) (Address) (City) (State) (Zip)