CHAPEL HILL ACADEMY

        31 Chapel Hill Road

             Lincoln Park, New Jersey 07035

                FIELD TRIP PERMISSION FORM

                 DATE:  _________________

                 Our school will be going on a field trip to:

                 ______________________________________, on  __________________________

                                     (destination)                                                          (date)

                            from:  __________________         to           __________________

                                        (departure time)                                   (return time)

                                                      at a cost of $__________ per student.

                   ________________________________________________________ will be the chaperone(s).

                           Please sign below indicating whether or not your son/daughter will be going on the trip.

                 I give permission for ____________________________ to participate in the above field trip.   

                                                             (student’s name)                                                                                         

                  ______________________________________            ______________________

                            (signature of parent/guardian)                                                       (date)

                       __________________________________                 ________________________________

                                  (home telephone number)                                                    (work or cell number)

                   Please note:  It is essential that we are provided with the name and telephone number

                   of an emergency contact person who can act on your behalf in the event your

                   child becomes ill or has an accident while participating in the field trip.

                   _______________________________            _____________________________

                      (name of emergency contact person)                 (telephone number of contact person)

                   Instructions:  __________________________________________________________

                   ____________________________________________________________________

                   ____________________________________________________________________

                   **Field trips are an integral part of your child’s curriculum.  If your child is not participating

                       in the field trip, he or she is expected to COME TO SCHOOL on that day.  This is not

                       considered an optional holiday.