Dear ______________________________  ,
(Teacher's name)

I,                                                           , am the                                                       
(Name of Parent/Guardian)                         (Father, Mother, Custodial Parent,Legal Guardian)

of                                                            , a student at St. Joan of Arc School in the                Grade.
    ( Student's Name)

I hereby request permission for the above-named child to attend 

                                                                at  
            (Type of Field trip)                                        (Place)

______________________________________ on____________________________________
(Teacher's Name & Class)                                            (Date of Field Trip)

from                                              to                                            , and I consent to the child's
                (Time)                                        (Time)

participation in such a field trip.

I understand that the children will go to the field trip by                                                    .
                                                                                        (Means of Transportation)

In consideration of the child being allowed to participate in the field trip, on behalf of my child, my spouse and myself, I hereby assume all risks in connection with the field trip, and I further release, discharge, and/or otherwise indemnify the Diocese of Cleveland, the Bishop of the Roman Catholic Diocese of Cleveland, St. Joan of Arc School, St. Joan of Arc Parish, employees and volunteers from all claims, judgments, liability by or on behalf of my child, myself and my spouse for any injury or damage due to the child's participation in the field trip including all risks connected therewith whether foreseen or unforeseen.  Furthermore, I acknowledge that it is my responsibility to provide health insurance for my child.

I fully understand what is involved in the field trip, and I understand that I have the opportunity to call the teacher and ask him/her about the field trip.

IN CASE OF AN EMERGENCY, I CAN BE REACHED AT:  
                                                                                                      (Person and phone number to call)
 
                                                                                                       __________________________________
                                                                                                        (Parent/Guardian Signature)
 

August, 2001