Emergency Form

Emergency, Transportation and Field Trip Release

Child’s Name(Required)
MM slash DD slash YYYY
Parents Home Address(Required)
Mother’s Name(Required)
Father’s Name(Required)
Emergency Contacts:
Name
Phone
 
(Parents will be called first. If parents cannot be reached please list 2 other contacts below)

Permission To Transport To Medical Facility

,to the nearest or most appropriate medical facility or hospital in the event of an emergency.
In my absence, I authorize the staff at Children’s Classic, to allow my child to be treated by emergency personal, Including but not limited to, doctors, nurses, paramedics, and other emergency medical team members.

Permission to Transport To public Schools & Field Trips permission Slip

, to participate in the transportation and field trip program at Children’s Classic.
I agree to hold the center harmless and its employees and/or volunteers in the event of an accident to my child.

I understand that transportation will be provided by either a Children’s Classic employee in a Children’s Classic Vehicle, bussing by Ogden Weber Community Action, UTA or by First Student bussing services. I also understand that occasionally the children may walk to the park near our school.

I understand that if my child’s behavior on any field trip endangers his/her safety or the safety of others that he/she will be excluded from one or more field trips and refunds will not be given.
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

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