--- title: Permission slip description: A parent or guardian gives permission for a child to take part in a trip or activity, with health notes and emergency contacts. --- # Permission slip A parent or guardian gives permission for a child to take part in a trip or activity, with health notes and emergency contacts. ## Who signs - Parent or guardian ## Fields - Parent or guardian: School or group (text) - Parent or guardian: Trip or activity (text) - Parent or guardian: Date (text) - Parent or guardian: Child’s full name (text) - Parent or guardian: Child’s date of birth (text) - Parent or guardian: Class or year (text, optional) - Parent or guardian: Health notes (text) - Parent or guardian: My child will bring medicine (checkbox) - Parent or guardian: Dietary needs (text, optional) - Parent or guardian: Emergency contact’s name (text) - Parent or guardian: Their phone (text) - Parent or guardian: My phone (text) - Parent or guardian: If I cannot be reached, I agree that the adults in charge may get urgent medical help for my child (checkbox) - Parent or guardian: How the group travels (choice) - Parent or guardian: Cost per child (text, optional) - Parent or guardian: What to bring (text, optional) - Parent or guardian: I agree that photographs that include my child may be taken and used inside the Group’s own newsletters and noticeboards (checkbox) - Parent or guardian: Printed name (text) - Parent or guardian: Parent or guardian signature (signature) - Parent or guardian: Parent or guardian date signed (date signed) ## The document Permission Slip For a trip or activity ____ (School or group) (the “Group”) is planning ____ (Trip or activity) on ____ (Date). Please read the details below, fill in what is asked, and sign if you agree that your child may take part. Section 1: About my child 1.1 My child’s full name: ____ (Child’s full name) 1.2 My child’s date of birth: ____ (Child’s date of birth) 1.3 My child’s class or year: ____ (Class or year) Section 2: Health and care 2.1 Allergies, medical conditions, medicines or anything else the adults in charge should know to look after my child safely (write “none” if there is nothing): ____ (Health notes) 2.2 If my child needs to take medicine during the trip, I will give it to the adults in charge in its original container with written instructions: ____ (My child will bring medicine) My child will bring medicine 2.3 Dietary needs: ____ (Dietary needs) Section 3: In an emergency 3.1 Emergency contact, if I cannot be reached: ____ (Emergency contact’s name), phone ____ (Their phone). 3.2 My own phone number during the trip: ____ (My phone) 3.3 ____ (If I cannot be reached, I agree that the adults in charge may get urgent medical help for my child) If I cannot be reached, I agree that the adults in charge may get urgent medical help for my child Section 4: Getting there and back 4.1 The group will travel by ____ (How the group travels). Drivers will have a valid licence and insurance, and children will use the seat belts or restraints that the law requires. 4.2 The adults in charge will count the children at the start, at each stop and before leaving each place, and will keep a list of who is with them. Children will always be in a group with an adult and will not be left alone. 4.3 If my child will be collected by someone other than me at the end, I will tell the Group in writing before the trip. Section 5: Cost and what to bring 5.1 The cost of the trip, if any, is ____ (Cost per child). If my child needs money for food or the shop, I will send it in a labelled envelope, and the Group is not responsible for money or valuables that are lost. 5.2 My child should bring: ____ (What to bring). My child should wear clothes and shoes suitable for the activity and the weather. Section 6: Photographs 6.1 The Group may take photographs during the trip for its own records and newsletters. ____ (I agree that photographs that include my child may be taken and used inside the Group’s own newsletters and noticeboards) I agree that photographs that include my child may be taken and used inside the Group’s own newsletters and noticeboards Pictures will not be put on public websites or social media without separate consent. Section 7: What I understand 7.1 The Group will supervise the children and take reasonable care, and will tell me promptly about any accident or serious problem. An activity can carry some risk of injury even when everyone is careful, and I accept the risks that are a normal part of this one. 7.2 My child will follow the rules the adults in charge give. The Group may send my child home, at my cost, if my child’s behaviour is a danger to themselves or others. 7.3 I may withdraw my child at any time before the trip by telling the Group in writing. Signatures I am the parent or legal guardian of the child named above. I give permission for my child to take part. Parent or guardian ____ (Printed name) Printed name ____ (Parent or guardian signature) Signature ____ (Parent or guardian date signed) Date ## Use it Sign up free and this template opens in your workspace with the fields already placed: /signup?starter=permission-slip A starting point in plain words, not legal advice. Change anything that does not fit before you send it.