• Section 9.27.F.2 Field Trip Medical Release Form

  • In case of accident or serious illness, I request that the school trip sponsor contact me at the number listed below.  If I cannot be reached, I hereby authorize the school trip sponsor to call the doctor indicated below and follow his/her instructions.  If it is impossible to contact this doctor, the school trip sponsor may make whatever arrangements seem necessary. I have legal custody of my child, and grant permission for any emergency treatment or hospital services be rendered to said minor under the general or specific direction of:

  • or any hospital emergency room physician.

Insurance Information:

Parent/Legal Guardian Contact Information:

Other Emergency Contact Information:

Signature and Date:

  • Reference: Section 9.27, Form 9.27.F.2