ROBESON EVANGELICAL LUTHERAN CHURCH
Field Trip Permission

I give my child_______________permission to participate in the field trip________________on_______________ under the supervision of the Robeson Lutheran staff, advisors and participating parents.
I hereby release, discharge, and otherwise indemnify Robeson Evangelical Lutheran Church staff and board members, advisors, and any volunteer drivers and chaperones from any claim, demand or suit by or on behalf of the above child arising out of the child’s participation in the aforementioned field trip, and/or the child’s transportation to or from the aforementioned field trip, which transportation I hereby authorize.

_____ My child has permission to drive to this event.

_____ My child must use transportation provided by the church to this event.

Signed:  ________________________________  
                   (Parent or Guardian)
Date:___________________________________ 

Youth Email address: ______________________

Home phone number: ______________________

Emergency number: ________________________ 

Preference of Hospital: ______________________ 

Insurance Information: ______________________