23 PENNSYLVANIA AVENUE

NEWARK, NJ 07114

FIELD TRIP CONSENT & RELEASE

My child, ______, has my permission to participate in all basketball games, and transportation thereto, for the 2015 Basketball season.

I understand thatvetted, fingerprinted coaches and/or LCCS staff members will chaperon the games and bus trips to the games

Method of Transportation: School Bus

*Times/dates of departure will vary by game and date. Please see game schedule for dates and times of games.

At the conclusion of each game, my child will:

____walk home

____take a public bus home

____ I will pick him/her up.

____He/she will be picked up by ______

______

(Please provide the names of any potential carpools student may have)

Signature______Date: ______.

Parent or Legal Guardian

Students on field trips remain under the supervision of the Link Community Charter School and are subject to its rules and regulations. Students violating rules or disregarding those in authority on a field trip, may be summarily and immediately dismissed from the trip. Parents/Guardians are responsible for ensuring that their child/children will be picked up from the school on the date and time of the return set forth above.

RELEASE & HOLD HARMLESS

I hereby consent to my child’s participation in the event described above. I understand that this event will take place away from the Link Community Charter School grounds and that my child will be under the supervision of the designated Trip Leader and / or designee on the stated dates. I further consent to the method of transportation stated above. I agree to waive and relinquish; fully release and discharge; and indemnify and hold harmless the Link Community Charter School, and their committees, boards, officers, agents and employees, including but not limited to teachers, supervisors, counselors, chaperones, volunteers, administrators and directors, from any and all claims for injuries, damage or loss which may occur to my child as a result of my child’s participation in this trip, including method of transportation.

Parent’s or Legal Guardian’s Signature______Date______

Address______

Telephone No. where parent can be reached______

**THIS FORM DOES NOT GUARANTEE THAT YOUR STUDENT WIL HAVE TRANSPORTATION TO ALL OF THE GAMES LISTED ON THE SCHEDULE. FURTHER COMMUNICATION HOME WILL INIDCATE WHICH GAMES LINK WILL PROVIDE TRANSPORTATION TO**