Student’s Name/Period:

Grade:  8

Destination of Trip: Town of Summerville (area around school)

Date of Trip Any date between May 5 and May 12, 2011

Purpose of Trip:  To photograph relevant images for exam

Method of Travel:  Walking

Note:  If you know in advance that you will need to pick up your child early from school one day during the time range above, please let me know below.  Your child will stay on campus under the supervision of another teacher until your arrival.  We may go walking to take photographs any period(s) in the date range listed above.

Any student who has a discipline referral to an administrator one week prior to the trip will not attend the walking trip.    He or she will remain at school under the supervision of another teacher.   Any misbehavior in any form during the walk will be dealt with in accordance with existing school rules and procedures established for handling in-school misconduct. 

The undersigned has read the above and discussed the behavioral expectations with the student.  It is understood that the undersigned will not hold the school responsible for any possible accident or injury.  In case of an emergency permission is given for a school representative to act in the best interest of my child. 

IMPORTANT:  My child has the following medical limitations/allergic reactions:

I can be reached at (phone):

Alternative Emergency Number:

Doctor's name and phone number:

(PLEASE include this just in case something happens while we are walking!!!)

Parent Signature

Date

Student Signature

Date