Field Trip Permission Form for Rosanky Christian Academy
Field Day
Field Day Details
Location
Playground
Time Events Start at 9am
Transportation None Needed
Cost
Please Send student with lunch
.
What to bring
Appropriate Gym Shorts & Color Shirt to match
Team Color
Change of Clothes is encouraged! (water events)
Notes
Students will be
released following the
Field Day @ 2PM
Field Day Itinerary:
Main Events:
9AM – Egg Toss
9:30AM - 3-Legged-Race
10AM – Sponge Toss
10:30AM – Obstacle Course
Lunch – Bring a sack Lunch
Picnic under the Pavilion
Afternoon Events:
12:30 – 1:45PM – Slip-N-Slide
Kickball
1:50PM – Tug-of-War
2PM - Dismissal
I wish for my Child/ Student to
OPT out of the following Field Day
Activities:
Enclosed is my $3.00 for the
Teacher to purchase a T-Shirt from Hobby
Lobby for the Field Day events. My
child/student needs a Size ______.
I will make sure my student has an
appropriate team color shirt. I do not
want the teacher to purchase one.
Field Trip Permission Form for Rosanky Christian Academy
I hereby give my permission, on May 13th , for my child, ______________________, to participate in the first ever
Field Day sponsored by Rosanky Baptist Church & Christian Academy .
I understand that at any class, events or activities hosted by RCA, that my Child may be photographed, filmed or
otherwise have our activities recorded by Attendees, and/or its instructors. In further consideration for my Child
being permitted to attend and participate this RCA activity, I agree to allow the voice, image and likeness of my
Child to be recorded and reproduced by photo, video, film, tape or any other media, including any electronic or
digital media, and that such content may be used and reproduced for any legitimate purpose by Attendees. I agree
that RCA’s shall own all copyrights in such content.
I hereby waive any and all rights to royalties, commissions or other compensation, and any and all rights of
publicity or privacy, that my Child may have, now or in the future, related to the use or exploitation of such content
described above by RCA.
Further, I understand that the aforementioned will be supervised by authorized staff or agreed sponsors and are
hereby held harmless and released from any liability for personal injury or property damage that might be incurred
as a result of my child participating in the scheduled activity.
Additionally, in the event that emergency medical treatment is required, I authorized treatment under the direction
of any licensed physician which, in the opinion of the attending physician, may endanger his/her life, cause
disfigurement, physical impairment, or undo discomfort if delayed.
This authority is granted only after a
reasonable effort has been made to reach me by telephone at the numbers listed below.
Further, I understand that the aforementioned will be supervised by authorized staff or agreed sponsors and are
hereby held harmless and released from any liability for personal injury or property damage that might be incurred
as a result of my child participating in the scheduled activity.
Additionally, in the event that emergency medical treatment is required, I authorized treatment under the direction
of any licensed physician which, in the opinion of the attending physician, may endanger his/her life, cause
disfigurement, physical impairment, or undo discomfort if delayed.
This authority is granted only after a
reasonable effort has been made to reach me by telephone at the numbers listed below.
The undersigned assumes responsibility for any cause connected with such treatment and hereby releases the
church/school this child attends from any liability therefore.
FAMILY PHYSICIAN ____________________________PHONE ______________
X _______________________________________________________
Parent or guardian signature
Parent Cell Number:
1) ___________________________
Are you available to Text?
________________________
Date