PK Field Trip – Headwaters Academy

Enrichment Activity – Offsite Permission Form for PKs

Child's Name*
First Last
Parent/Legal Guardian's Name*
I give permission for my child to take part in this activity and I or someone that I appoint will be attending the activity with them.
First Last
Name of person bringing Pre-K to activity if other than parent or legal guardian.
First Last
Parent/Legal Guardian Signature*
I have previously completed a Medical/Liability Release Form for my child. By signing this permission slip, I am confirming that the information on his/her Medical/Liability Release Form is current and up to date. I understand in the unlikely event of an accident or emergency that my child will receive adequate care based upon the information given. I assume all risks, hazards and incidentals involved in the conduct of the activity. I do hereby release, indemnify and hold harmless Headwaters Christian Academy and South River Baptist Church from any and all loss, injury or other damage arising out of this activity.
Email*
Enter Email Confirm Email
Date*
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.