DuPage High School District 88

Addison Trail High School

213 N. Lombard Rd.
Addison, IL. 60101

Student ID# _________________________

Students Name_______________________
PARENTAL CLEARANCE AND CONSENT FORM FOR AUTHORIZED FIELD TRIP ACTIVITIES

TEACHER/SPONSOR: This form is to be used in the organization of field trip activities which have been
authorized by the principal as a approved part of the education program of the school.
The sponsoring teacher will issue this form to the student early enough so that the completed form can be
delivered to the principals office at least two (2) school days before the date of the activity. This is
necessary so that the teachers of the student may be forewarned about his/her coming absence early
enough to make any needed changes in teaching plans. Failure to comply with this courtesy rule may
result in cancellation of the activity.

Music
ACTIVITY Perform
__________________________________________________DEPT.____________
halftime with the NU marching Band
Dycke
Stadium,
Evanston
Northwestern
University
PLACE/DESTINATION_________________________________________________________
PURPOSE to
____________________________________________________________________
perform at halftime with the Nirthwestern University Marching Wildcats in a
_____________________________________________________________________________
mass band.
6 am
4 PM
DATE OF ACTIVITY____________LV
AT________________ARR
AT__________________
9/5/15
M. Corey
TEACHER SPONSOR__________________________________________________________
MODE OF TRAVEL(Bus,Auto)_______________NAME
OF DRIVER___________________
BUS
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Teachers signature does not indicate approval of absence. Signature does indicate knowledge of the pre-arranged
absence. Comments might suggest the effect of absence on the students progress in class.
SUBJECT
TEACHERS ACKNOWLEDGEMENT
GRADE AT RISK
COMMENT

1.____________
2.____________
3.____________
4.____________
5.____________
6.____________
7.____________
8.____________

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

__________
__________
__________
__________
__________
__________
__________
__________

____________
____________
____________
____________
____________
____________
____________
____________

PARENTAL APPROVAL OF STUDENTS PARTICIPATION

TO THE PARENT: While the school endorses well-planned field activities as a valuable part of the extracurricular
program and classroom instruction, it can assume responsibility for safety and welfare of students while they are offcampus only to the point of reasonable provision for their supervision by memb ers of our staff. Your signature
hereto shall constitute and evidence your agreement to permit the participation of your son/daughter, the above
described activity. Field trips are an extension of regular school programs; consequently, all rules and regulations
governing student conduct are in effect.
________________________________ _____________
Student Signature
Date

____________________________ _____________
Parent or Guardian Signature
Date

*NOTE: For overnight trips parents must read, sign and date the back of this form.

DUPAGE HIGH SCHOOL DISTRICT 88

SPECIAL EVENT/OVERNIGHT TRIP
CONSENT AND RELEASE FORM
Your child, ____________________________________________, has been offered the

Perform halftime with the NU marching Band

opportunity to participate in the __________________________________________________
____________________________________________________________________________
9/5/15
Dycke Stadium, Evanston Taking place in ____________________________________
on ________________________
Northwestern(location)
University
(date)

Your signature below constitutes and is evidence of your agreement:

1. to accept general liability and permit the participation of your child in the event; and
2. release and hold harmless School District 88 and any of its teachers and/or its representatives
from all liability arising out of their negligent or wrongful acts or omissions regarding your
childs participation in the event and transportation to and therefrom. Swimming in a pool or
at a waterfront will only be permitted if an adult (21 years old or older) certified lifeguard is
on duty and a school chaperone is present.

________________________________________
(Parent or Guardian)

___________________________________
(Date)

________________________________________
(Address)

___________________________________
(Phone)

Chaperone(s) (if any)

M. Corey
________________________________________
(Name)

___________________________________
(Position)

________________________________________
(Name)

___________________________________
(Position)

NOTE: For authorized field trip activities parents must read, sign and date the other side
of this form.