School
Permission Slip
Date: 12/12/2023 Time: 09:00 AM
Location: Museum
Cost: 20 $
Transportation: Bus
Student Name Kerry Martinez Grade/Class 3
Parent/Guardian Shannon Martinez Phone (222) 222-2222
Emergency Contact Dominic Martinez Phone (333) 333-3333
I, Shannon Martinez, give my permission for my child, Kerry Martinez, to participate in the above-
mentioned activity. I understand that my child will be under the supervision of school staff during
the activity and that all reasonable precautions will be taken to ensure their safety. I also
acknowledge that there may be some risks associated with this activity, and I accept these risks
on behalf of my child.
In the event of an emergency, I authorize school staff to seek medical attention for my child and
release them from any liability for any injury or illness that may result from the activity.
I understand that my child is expected to follow all school rules and regulations during the activity,
and failure to do so may result in disciplinary action.
Date 12/07/2023
Signature
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