The School District of Greenville County

Field Trip Permission Slip

My son/daughter, ___________________________________, has my permission to go with his/her class to

ALL BAND ACTIVITIES DURING THE 2005-2006 SCHOOL YEAR

on __________________________________________________. On the dates of this field trip, I can be reached at home at telephone number _____________________

or at work at telephone number _____________________

____________________________________ _________________________

Signature of Parent/Legal Guardian Date

LIMITED POWER OF ATTORNEY

If a serious emergency arises, it may be necessary for a physician to attend your son/daughter before the staff could get in touch with you or your designated physician. Such care can be provided only if you sign the following AUTHORIZATION FOR MEDICAL TREATMENT.

I give the teacher or administrator in charge of my son/daughter limited power of attorney to act in my absence and see that my son/daughter, ___________________

gets whatever medical treatment is necessary in case of sickness or accident.

List any medical exemptions (allergies, blood transfusion, etc) for your child.

________________________________________________________________________

________________________________________________________________________

List any significant health problems.

________________________________________________________________________________________________________________________________________________

My child is presently taking the following medicine prescribed by the doctor:

Name of medicine: _______________________________________________________

Amount taken: __________________________________________________________

___________________________________ ___________________________

Signature of Parent/Legal Guardian Date

Family Health and Accident Insurance Carrier ______________________________

Policy Number _________________________

Please notify Mr. Scheuch of any changes to this information prior to any field trips.