MOUNT PLEASANT MIDDLE SCHOOL
LIVINGSTON, NEW JERSEY
FIELD TRIP/WALKING TRIP PERMISSION FORM
DATE __________________
To the Parent or Guardian:
As part of our school activity, we are planning an educational trip by ( ) chartered bus or
( X ) school bus to: The College of Saint Elizabeth, on Thursday, May 25, 2016.
We will be departing at: 8:30 A.M. and returning by: 2:00 P.M. The charge for the round trip is $0.
If you wish your son/daughter, _________________________________ to take this trip, will you
kindly sign the form below and return it to us.
NOTE SPECIAL ARRANGEMENTS:
Students are responsible for reaching out to their teachers and making up missed class work.
 Bring a bagged lunch with drink (no glass)
 Bring an extra bottle of water
 Bring all necessary written material (both speeches), a pen/pencil, & highlighter
 Dress in professional attire
---------------------------------------------------------------------------------------------------------------------------MOUNT PLEASANT ELEMENTARY SCHOOL
LIVINGSTON, NEW JERSEY
DATE: ___________
Trip to:
Debate Tournament/College of Saint Elizabeth
Date of trip:
Teacher Sponsor:
Thursday May 26, 2016
Miss DeMatteo
To the teacher:
I hereby give consent for my son/daughter,
(use full name please), to take the above trip.
___________
Please complete below if your child is presently approved to receive medication while
attending school.



Name and phone number of parent or adult relative to attend the trip:
________________________________________________________________
Doctor’s authorization to suspend medication is on file in nurse’s office.
Neither parent nor adult relative can attend.
 Miss DeMatteo is Epi-Pen trained
_
Parent or Guardian
Date