PTA Permission Slip Form

PTA PERMISSION SLIP FORM

Event Information

Event Name:

Event Location:

Event Date:

Departure Time:    Return Time (approx.):

Student Information

Student Full Name:

Parent / Guardian Information

Medical Information & Emergency Authorization

I authorize event supervisors and authorized medical personnel to provide emergency medical treatment for my child if I cannot be reached: Yes

Transportation & Cost

Transportation provided (check applicable): School/Charter Bus Parent/Guardian Drive Walking/On-site Other

Permissions & Releases

I grant permission for my child to participate in the event described above and to travel under the supervision of PTA-approved chaperones and school personnel: Permission granted

Photo / Media Release: I consent to photographs, video, or other media in which my child may appear for PTA or school educational/promotional use: I consent I do not consent

I authorize a PTA chaperone or school staff to administer the medication(s) listed above if necessary: Yes No

Liability Release: To the fullest extent permitted by law, I release and hold harmless the PTA, its officers, volunteers, employees, and agents from liability for injury, loss, or damage arising from my child's participation, except where caused by gross negligence or willful misconduct.

Behavioral Expectations

Students are expected to follow school rules and chaperone instructions. Failure to comply may result in my child being sent home at my expense and/or disciplinary action by school administration.

Acknowledgment and Authorization

By signing below I certify that the information provided on this form is true and complete to the best of my knowledge. I understand the nature of the activity, the risks involved, and I voluntarily consent to my child's participation. I authorize the PTA and school staff to take reasonable actions as described above in the event of an emergency.

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