TRIP PERMISSION SLIP

______________, referred to as PARENT, is the parent and lawful

guardian of ____________, a minor, and agrees:

____________________________ is organizing a trip for the purpose

of:

________________________________________________________________

on _____________ through _____________.

____________ has the permission of PARENT to participate in this

trip and all activities thereof. ______________, ____________ and

the other employees and adult agents of _______________________

are herewith given the following authority on the dates stated

above:

To consent to any medical treatment that may be required by

___________________ in the place and with the same authority as

___________________.

Further, in consideration of the services performed by _________

_____________________ and the employees, servants and agents of

____________________________, ____________, ______________ and the

other employees and agents of Orange District School Board are

herewith released from liability for all actions taken in good

faith during the trip.

Dated: ______________________________________

_______________________________________________________________