Excursion+Permission+Slip

DENVER PUBLIC SCHOOLS EXCURSION PERMISSION To the parent or guardian of _______________________________________________________ (Pupil Name) Today's classrooms extend beyond the physical limits of a room or even a building. Teachers recognize the values of taking school children on field trips or excursions. Among other educational benefits, children get to see and hear things which cannot be brought into the classroom. On some excursions, children take school buses. On others, they walk or use some other means of transportation. If you sign in the space below, your child will be allowed to join in these field trips during the current school year. However, he/she will still be given information to take home before each excursion – by note, by PTA newsletter, by a school's monthly calendar, or by some other means - to let you know the place to be visited and the date of the excursion. At that time, you may refuse to give your permission for your child to go on this specific excursion. You should know that the School District is not responsible for any injury substained by a pupil. **PARENT'S CONSENT** _________________________ ___________________________________ (Date) (Signature of Parent/Guardian) **DENVER PUBLIC SCHOOLS** **__PUPIL PARTICIPATION RELEASE__** I, _______________________________, a participant in ____________________________ from _______________________________school, if accepted, promise to support and uphold the standards set forth by the Denver Public Schools, I will, further, strive to be friendly to all members of the group, accept the will of the majority whenever a matter of choice presents itself, and accept the suggestions and recommendations of the leaders in all matters relating to the program or to my personal conduct. It is agreed that this is a supervised program and that the group standards must be observed. The trip administration reserves the right to terminate the participant's membership for failure to maintain these standards or if his or her acts of conduct are deemed detrimental to or incompatible with the interest, harmony, comfort or welfare of the activity as a whole. It is agreed that the following specific guidelines for overnight travel will be observed: If a participants membership is terminated, the former participant will be sent home at his or her expense. I have thoroughly read and accept the guidelines above. I understand that if these guidelines are not followed, the administrator and advisors will meet and decide on the disciplinary action. Depending on the seriousness of the infraction, this disciplinary action may mean being campused or released from the program and sent home at my own expense. _____________________________________ _____________________________________ **DENVER PUBLIC SCHOOLS** **__PARENT PERMIT FOR PUPIL TO PARTICIPATE IN AN EXTENDED EXCURSION__** a pupil at ____________________________________High School, be permitted to participate in an excursion to ______________________________________ on ____________________________. Transportation will be by ___________________. To my knowledge, this student is in satisfactory health to participate fully in this activity. In case of emergency, I direct that I or ___________________________ be called or contacted at _________________. Home Phone: __________________ Work Phone _________________ Doctor's Name _________________________ Doctor's Phone Number _________________ Name of Insurance Carrier: _________________________________________________ Name of Insured: _________________________________________________________ In addition, the Denver Public Schools requires that all students be insured for medical coverage under the official insurance carrier for the District. The premium is paid for each student by the participating school. Maximum coverage limit - $5,000 (No deductible). Diabetes Epilepsy  Allergies  Heart Disease  Other Describe in detail _____________________________________________________________________ ______________________________________________________________________ Directions for care: Medications taken ______________________________________________________________ When ________________________________________________________________________ Other Recommendations _________________________________________________________ _________________________________________________________________________ ___________________________________________________________________ Signature of Parent or Guardian ___________________________________ Date **SPECIAL POWER OF ATTORNEY FOR MEDICAL CARE** Know all men by these present, that I ________________________________________ a legal resident of _____________________________________________________________________________________ (Address) (Zip code) (City or County) (State) and (if Military) presently stationed at _____________________________________________ desire to execute a SPECIAL POWER OF ATTORNEY, and by these present, do make, constitute, and appoint as my Attorney-in-Face __________________________________________________________________, whose address is ___________________________________________________________________________________ (Address) (Zip code) (City or County) (State) GIVING and GRANTING unto my said Attorney-in-Fact to: Authorize and execute consent for any and all medical and hospital care and treatment, including major surgery, if deemed necessary by a duly licensed physican selected by my Attorney-in-Fact, for the health and well-being of my following named child: Child's full name: __________________________________________________________ FURTHER, I do authorize my aforesaid Attorney-in-Fact to perform all necessary acts in the execution of the aforesaid authorization with the same validity as I could effect if personally present. Any act or thing lawfully done hereunder by said Attorney-in-Fact shall be binding upon myself and my heirs, legal and personal representatives, and assigns. PROVIDED, however, that all business transacted hereunder for me or for my account shall be transacted in my name, and that all endorsements and instruments executed by my said Attorney-in-Fact for the purpose of carrying out the foregoing powers, shall contain my name, followed by that of my said Attorney-in-Fact with the designation “Attorney-in-Fact”. FURTHER, this Special Power of Attorney shall be effective as of: (Date) __________________, 20_____, and shall become NULL and VOID after (Date) __________________, 20_____, unless sooner revoked or terminated by me. ________________________________________________ (Signature of Legal Parent and/or Guardian) Subscribed and sworn to me this ________ day of _______________________, 20_____. By (name of legal parent and/or guardian) ____________________________________________________
 * 1) There will be NO formal dating either with the "locals" or within the group.
 * 2) The gathering of opposite sexes must not be in dormitories, except in designated areas.
 * 3) The curfew will be midnight unless otherwise specified by the administrator for certain occasions.
 * 4) My advisor must be informed of my whereabouts at all times. I am also aware that whenever I am away from the hotel, I will be a group of at least three group members.
 * 5) There is to be NO purchase, possession, usage, or sale of illegal drugs or alcoholic beverages. If this happens, it is understood that this means immediate release from the program.
 * Participant's Signature**
 * Parent's or Guardian's Signature**
 * 1) I hereby give permission and request that _________________________________________
 * 2) (Name of Student)
 * 1) If some emergency necessitates attention beyond first-aid care, which may be available, I understand that I will be contacted, if possible, and that additional medical attention, as needed, will be obtained at my expense.
 * 1) Do you carry medical insurance on this student? Yes ___ No ___
 * PLEASE REPORT HERE THE HEALTH PROBLEM OF THIS CHILD** and give us directions for his or her care:
 * STATE OF: _________________________________________ NOTARY: ___________________________**
 * COUNTY OF: _______________________________________ My commission expires ___________________**
 * (SEAL)**