Field Trip Participation Permission Slip

Dear Parent or Legal Guardian: Your son/daughter is eligible to participate in a parish sponsored activity requiring transportation to a location away from the parish campus. The activity will take place under the guidance and supervision of employees from CHURCH OF THE HOLY FAMILY (CHF). A brief description of the activity follows:

NAME OF EVENT: Paintball with OLS

DESTINATION: R&M Paintball 445 Miller Beach Rd., Owego, NY 13827

DESIGNATED SUPERVISOR OF ACTIVITY: Mary Strojny (607)785-4581 and Deacon Dale Crotsley

DATE & TIME OF Activity: Sat., May 30, 2015, 8:30am-12 noon

METHOD OF TRANSPORTATION: Parents/Self

COST PER PERSON: $25.00 (includes unlimited paint and hotdog/picnic lunch)

If you would like your child to participate in this event, please complete sign and return the following statement of consent and release of liability. As parent or legal guardian, you remain fully responsible for any legal responsibility, which may result from any personal action taken by the named student.

I hereby consent to participation by my child, ______, in the event described above. I understand that this event will take place away from the parish grounds and that my child will be under the supervision of the designated parish employee on the stated dates. I further consent to the conditions stated above on participation in the event, including method of transportation.

In the event of an emergency, I may be reached at ______cell/home phone

If I am unavailable, ______name of designated guardian and relationship to participant has my permission to act on my behalf and may be reached at: ______cell/home phone

Please list any information that may be helpful to us on the field trip: ie allergies, medications, fears, concerns, etc.

Child's Physician: ______Phone: ______

Insurance Co.: ______ID#: ______

______Parent's name printed Cell/home phone

______Parent's signature Today's date

Completed permission slip, release waiver and $25 must be received by: Mon., May 25, 2015 20 spots filled on first come-first served basis…you are not signed up until I have money, permissions slip and waiver!