Student Career Trek/Field Trip Absence Request Form
X out of school ___in school
Part I (to be filled out by student- please print)
ID Number________ Student’s Full Name______________________________
email __________
Date of Field Trip: Periods missed: 1,2,3,4,5,6,7,8
Activity Name: Career Trek
Sponsor: Mrs. Oakes, Career Advisor 847-755-2657
Destination:
Transportation: Bus driven by District 211
Students: Teachers must
sign below indicating they are aware of this trip.
Period: Period:
1._________
5.______
2.__________ 6.______
3.__________ 7.
______
4,__________ 8.
______
Part II (to be read and signed by parent for outside school trip)
My son/daughter (named above)
has my permission to participate in this field trip. I understand that Student Accident Insurance,
if I have paid for the coverage is in force on these trips only when the
student is under the general supervision of the teacher or supervising adult
appointed by the school. The student is
not to remove himself/herself from that supervision by unauthorized conduct,
such as leaving the group. I further
understand that all rules and regulations governing student conduct remain in
effect while the student is participating in a supervised field trip. My permission is granted to the supervising
adult to allow him/her to take all necessary actions should an emergency
arise. In case of an accident or
incident requiring medical attention, the faculty supervisor will attempt to
contact parents immediately. Emergency
numbers and physician are listed below.
I give the faculty supervisor permission to arrange for medical
attention and I accept financial responsibility for that attention should the
supervisor be unable to reach me.
NOTE TO PARENTS: The career advisor does not have access to your child’s academic record. Please discuss your student’s current class work and the resulting burden missing class will place on him/her. Career treks are limited to 4 per year and no more than 2 per quarter.
_________________________ ______ ________________ _______________
(Signature of parent or
guardian) (date) (Home phone #) (Work phone #)
Physician’s
Name______________________________ phone
#________________________
Alternate
Contact:______________________________
phone #_______________________
Parent/Guardian please note
any medical/allergies/behavioral concerns regarding above mentioned
student_______________________________________________________________________.