FIELD TRIP INFORMATION/PERMISSION SLIP
Dear Parent or Guardian,
A field trip has been planned that will serve as an enrichment experience for those students participating.
The trip will serve as an enrichment activity to enhance a regularly scheduled part of the instructional
program. Students will not be allowed to take the trip unless parental permission is granted.
The CIS program is interested in providing educational opportunities through the field trip. All school
rules apply. Each student is expected to follow instruction of the CIS Site Director at all times. Each
student is to attend all prescribed functions designated as the purpose of the field trip. Misbehaviors can
result in parents being notified and ask to come and remove you for the field trip.
The Following Details Are Provided For Your Information:
DESTINATION:
SUPERVISING TEACHER:___________________________________SCHOOL:__________________
DEPARTURE DATE AND TIME:
______
RETURN TO SCHOOL DATE AND TIME:
MODE OF TRANSPORTATION:
COST OF FIELD TRIP:
DUE TO TEACHER BY:
ARRANGEMENT/COST FOR MEALS:
______
DETACH AND RETURN BOTTOM PORTION
-----------------------------------------------------------------------------------------------------------------------------PARENTAL FIELD TRIP CONSENT FORM
Destination:
Teacher:
Complete the Following:
Student Name: ____________________________ Parent Name:
Phone:  Evening
 Daytime
 Cellular
 Pager
Address:
Date of Student’s Birth:
If parent cannot be located in the event of an emergency, contact:
Name:
Address:
Phone:  Evening
 Daytime
 Cellular
 Pager
I hereby certify that (student’s name) __________________________________________ has permission
to participate in the field trip according to the policies and provisions as stated above.
Parent Approval Signature
Important information about your child (medications, allergies, etc.):
*Revised FTP050713
Date _____/_____/_____
Field Trip Information
Check List
___ Have you send in purposed field trip to CIS office? YES NO
___What is the date of the field trip? _______________________
___Where is the field trip? _______________________________
___ Do you have a confirmation from the CIS Executive Director approving field trip?
___Date Approved: ________________________
___What is your mode of transportation? ___Yellow bus ___Activity Bus
___Have you secured the bus with your assistant principal? YES NO
___ Do you have a bus driver? YES NO
___ Name of Bus Driver: ___________________________
YES NO___
Board Policy requires one chaperone per 15 students. A background check must be made on all
Chaperone prior to the field trip. Please List the name(s) of all chaperones:
_____________________________________ ____________________________________
_____________________________________ ____________________________________
_____________________________________ ____________________________________
List names of all students going on the field trip for securing insurance. Information is needed one
week prior to the event.
1________________________________________
3________________________________________
5________________________________________
7________________________________________
9________________________________________
11_______________________________________
13_______________________________________
15_______________________________________
17_______________________________________
19_______________________________________
21_______________________________________
23_______________________________________
25_______________________________________
27_______________________________________
29_______________________________________
31_______________________________________
2______________________________________
4______________________________________
6______________________________________
8______________________________________
10_____________________________________
12_____________________________________
14_____________________________________
16_____________________________________
18_____________________________________
20_____________________________________
22_____________________________________
24_____________________________________
26_____________________________________
28_____________________________________
30_____________________________________
32_____________________________________
____________________________________________________________________________________
Site director
school
date
*Revised FTP050713
Purpose of the CIS Field Trip and how it relates to the CIS
Curriculum and the Common Core Standards
CAREERS IN FOCUS:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
CHAMBER BUSINESS EXPO:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
CHAMBER STUDENT BUSINESS EXPO:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
REALITY STORE:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
SITE FIELD TRIP (SERVICE LEARNING):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
OTHER:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________________________
Site Director
*Revised FTP050713
School
date