Parent Permission – Nutritional Field Trip- Monday, Dec 7
I/We the parent(s)/guardians of _______________________________________________
(Name of student)
Request that the school allow my/our son/daughter to participate in
Health Class Nutritional Field Trip, Monday, Dec 7. I/We hereby release and save harmless St. Pius X High School and any and all of its employees from any
and all liability, and from any harm arising to my son/daughter as a result of this trip.
I understand that _______________________ should be in school uniform and bring $5.00 for purchasing the healthy buffet lunch at the Hy-Vee store. I also realize that my child will need to responsibly conduct themselves as an ambassador of St. Pius X High School, and follow the rules and regulations of the field trip. He/she will need to check-in with the two afternoon classes missed (due to field trip) and complete any makeup work due to absence that day. Teacher approval below must be included on this form.
The bus will leave St. Pius at approximately and return by
Period Teacher Approval