2012 – 2013 Field Trip Release Form
J. Allen Axson Montessori School
Ms. Land’s Lower Elementary class will be attending
a field trip to: JFRD Fire Station #59
Location Address: 14097 William Skinner Parkway
Day / Date: Monday, October 28, 2013 Departing at: 9:30am Returning at: 11:30 am
Lunch Instructions: N/A
Transportation: School Bus Number of Chaperones needed: 4
Student Cost: $2.50 (if cash-exact amount) Chaperone Cost (if applicable): $ Total Amt Enclosed: $
(Payment may be made with exact cash or check made payable to J. Allen Axson.)
Return this permission with payment no later than: October 24, 2013
I give permission for my child, ______(student name), to attend the field trip as stated above for supervised activities, and agree to release and discharge Duval County School Board, its officers, agents, and employees, exercising reasonable care within their scope of employment, from liability growing out of personal injuries and property damage resulting or occurring during the afore mentioned activities, or in transit to and from said activity. In case of an emergency, I give permission for my child to receive medical treatment. In case of such an emergency, please contact:
Emergency Contact:______Phone #:______
(Please Print)
Alternate Contact:______Phone #:______
(Please Print)
Parent/Guardian:______Date:______
(Signature)
(Cut here and keep bottom portion.)
J. Allen Axson Field Trip Reminder
Confer, Davis, Land, and Hahn’s Lower Elementary classes will be attending
a field trip to: JFRD Fire Station #59
Location Address: 14097 William Skinner Parkway
Day / Date: Monday, October 28, 2013 Departing at: 9:30am Returning at: 11:30 am
Lunch Instructions: N/A
Transportation: School Bus Number of Chaperones needed:
Student Cost: $2.50 Chaperone Cost (if applicable): $ 0.00 Total Amt Enclosed: $
(Payment may be made with exact cash or check made payable to J. Allen Axson.)
Return this permission form with payment no later than: October 25, 2013
Important: If your child needs medication during the field trip, a Permission for Administration of Medication form must be completed by the parent/guardian a minimum of two school days prior to the field trip date. You may request this form from the classroom teacher.