BOARD OF EDUCATION
July 10, 2007
Dear
Parents/Guardians:
On
(see
dates below), the NMHS Band and
Color Guard will take a field trip to competitions/camp in (see
below). The teacher in charge of
the field trip is Mr. Jon Grauer.
Buses
will leave the school at to be determined. They will return to school at about to be
determined. Parents (are, are
not) requested to arrange transportation for their son or daughter from school
to home on this day.
The
total cost for your son or daughter will be $ -0- payable by check to New Milford Public Schools.
Students
are required to wear clothing appropriate for this occasion. Lunch (should, should not) be brought from home.
All
school rules apply to field trips.
Infractions of these rules will be reported to the school
administration. Appropriate action will
be taken and, if necessary, will include the dismissal of a student from the
field trip with notification to his/her parent or guardian and the appropriate
school authorities. Please be aware that
in extreme cases the parent or guardian may have to travel to the site of the
field trip to transport their child home.
In
case of emergency or anticipated threats, the Board of Education and its agents
reserve the right to cancel, modify and/or shorten the
trip. Should the tour operator or any other third party be unable or unwilling
to refund any prepaid costs, the Board will not be responsible for refunding
any monies. The Board’s agents will attempt to assist parents in the collection
of lost fees, but neither the Board nor its agents will be responsible for
refunding monies.
Please
fill out the permission slip below and the medical authorization on the back
and return the entire form to your son or daughter's teacher no later than ASAP.
Rehearsals every Tuesday
night starting on July 10, SIM
Camp August 13-17, September 8 –
Sincerely,
Mr.
Greg P. Shugrue
Principal
I give permission for my son/daughter
________________________________ ID #__________ to take the school trip on (see
dates above) I assume full responsibility for my son/daughter's
participation in this trip.
I (can, cannot) volunteer my services as a
chaperone. (Teachers will notify volunteers
selected.)
______________________________
Parent's/Guardian’s Signature
EMERGENCY
MEDICAL AUTHORIZATION
Student
Name: ________________________________________
Address:
_____________________________________________
Telephone #:
_________________________________________
PURPOSE: To enable parents and guardians to authorize the
provision of emergency treatment for students who become ill or injured while
under school authority, when parents or guardians cannot be reached.
PART I (TO GRANT CONSENT)
In the event reasonable attempts to contact me at one of these telephone numbers: ________________________ or _______________________ and another parent or guardian at ____________________ (phone number) have been unsuccessful, I hereby give my consent for (1) the administration of treatment deemed necessary by Dr. ___________________ (preferred physician) or Dr._______________________ (preferred dentist), or, in the event the designated preferred practitioner is not available, another licensed physician or dentist; and (2) the transfer of the child to New Milford Hospital or any hospital reasonably accessible.
*This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists, concurring in the necessity for such surgery, are obtained prior to the performance of such surgery.
Facts concerning the child’s medical history, including allergies, medications being taken, and any physical impairments to which a physician or dentist should be alerted are:
Date: _______________________
Signature of Parent/Guardian: __________________________________________
Address: ____________________________________________________
DO
NOT COMPLETE PART II IF YOU COMPLETED PART I
PART II (REFUSAL TO CONSENT)
I do not give my consent for emergency medical treatment of my child. In the event of illness or injury requiring emergency treatment, I wish the school authorities to take no action or to:
Date: __________________________
Signature of Parent/Guardian: __________________________________________
Address: _______________________________________________