000 한국학교

000Korean School

www.00koreanschool.org

Logo                                                          00koreanschool@gmail.com

PARENT/GUARDIAN PERMISSION SLIP

Dear Parents:

000 Korean School is planning a day trip to:

The trip will be on                                        from                            and we will return around                at School.

PARENT/GUARDIAN PERMISSION SLIP

Student name:                                         has permission to go on a day trip to:

In consideration of the benefits derived, we wxpressly waive all claims against, agree to hold harmless or indemnify the 000 Korean School or their representatives on account of any accident, injury, illness or other damage that may occur in connection with, or incident of this trip. The student is in good physical condition, unless I have otherwise stated on this slip. (Please list any allergies, unusual health conditions, or handicaps, and/or authorized medications that the Student is currently using.)

In Care of Name:

Emergency Address:                                 City/State

Notify:

(Relatives Phone Only)

Relationship

Please list any medications that the student is currently using.

In case of Emergency: I understand that every effort will be made to contact me. In the event that I connot be reached, I hereby give my permission for the physician, selected by the adult leader in charge, to secure proper treatment which may include hospitalization, anesthesia, surgery or injections of medication for may son/daughter/dependant.

Parent/Guardian Signature:                               Date

I will live by the 000 Korean School’s Law, and Motto & Slogan and abide by the Outdoor Code. Failure to obey these requirements can result in my parents being called to com and take me home from the trip.