FIELD TRIP PERMISSION SLIP KINNIKINNICK KIDS CARE KINNIKINNICK CCSD #131

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1 1. By signing this form, I am providing consent for my child to participate in the field trip listed below. 2. In a medical emergency, I understand my child will be taken by ambulance to the closest hospital or trauma center. I understand all medical fees are mine, the parent/guardian s responsibility. 3. The Program Director or District Administrator has my permission to sign any medical forms which are needed. This will assure that treatment of any injury/illness can begin as soon as possible. By signing this form, I understand I grant my permission for school personnel to act on my behalf in the case of a medical emergency. I acknowledge every effort will be made to contact me prior to exercising the DATE Friday, June 1, 2018 Friday, June 8, 2018 Friday, June 15, 2018 Friday, June 22, 2018 Friday, June 29, 2018 Friday, July 6, 2018 Friday, July 13, 2018 Friday, July 20, 2018 Friday, July 27, 2018 Friday, August 3, 2018 Friday, August 10, 2018 DESTINATION Coral Cove (S.Beloit, IL) Henry Villas Zoo (Madison, WI) Volcano Falls (Loves Park, IL) Bike Ride (The Mix, Rockton, IL) Laser Quest (Rockford, IL) Rock Cut State Park (Loves Park, IL) Bike Ride (Hononegah Forest Preserve, Dairy Hause, Rockton, IL) Forest Hills Bowling Lanes (Loves Park, IL) Bike Ride (Roland Olson Forest Perserve, Poplar Grove, IL) Magic Waters (Rockford, IL) Santa s Village (E. Dundee, IL) PARENT / GAURDIAN SIGNATURE DATE

2 Coral Cove Family Fun Center, South Beloit, IL DATE(S) June 1, :30 PM 4:30 PM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN NEED: To wear a red shirt, socks and shoes. Optional spending money PARENT/GUARDIAN

3 Henry Villa Zoo, Madison, WI DATE(S) June 8, :15 AM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN NEED: To wear a red shirt. Brown bag lunch (unless being purchased from camp). Spending money is optional.

4 Volcano Falls, Loves Park, IL DATE(S) July 15, :30 PM 4:30 PM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN NEED: To wear a red shirt. Spending money is optional.

5 Bike ride to The Mix in Rockton, IL DATE(S) June 22, :00 PM MODE OF TRANSPORTATION Bike brought from home CHILDREN NEED: Bike from home (please be sure the bike is in good working condition). Helmet Water bottle (that can go on the bike) Red Shirt, tennis shoes, socks Spending money for a treat *NO TRAINING WHEELS

6 Laser Quest, Rockford, IL DATE(S) June 29, :30 PM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN DO NOT NEED TO WEAR OR BRING ANYTHING SPECIAL (they like to wear dark clothes)

7 Rock Cut State Park, Loves Park, IL DATE(S) July 6, :30 AM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN NEED: To wear a red shirt. Brown bag lunch (unless being purchased from camp) CHILDREN MAY: Bring a fishing pole with fishing line and hook. (Please do not attach the hook to the fishing line; this will be done by camp staff at the park.) Camp will provide the bait. By signing this form, you are providing consent for our child to participate in the field 1. In a medical emergency, your child will be taken by ambulance to the closest hospital or 2. Your permission is requested for the Program Director or District Administrator to sign

8 Bike ride to Hononegah Forest Preserve, Dairyhaus in Rockton, IL DATE(S) July 13, :00 AM MODE OF TRANSPORTATION Bike brought from home CHILDREN NEED: Bike from home (please be sure the bike is in good working condition). Helmet Water bottle Wear a red shirt, tennis shoes and socks Spending money for Dairyhaus *NO TRAINING WHEELS

9 Forest Hills Bowling Lanes, Loves Park, IL DATE(S) July 20, :30 PM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN MUST: Wear a red shirt. Wear/bring socks (bowling shoes will be worn). Know their shoe size.

10 Bike ride to Roland Olson Forest Preserve then to the Trail Stop Ice Cream Shop in Poplar Grove, IL. DATE(S) July 27, :30 AM MODE OF TRANSPORTATION Bike brought from home. CHILDREN NEED: Bike from home (please be sure the bike is in good working condition). Helmet Water bottle Brown bag lunch (lunch from camp will be available) Money for ice cream treat

11 Magic Waters, Rockford, IL DATE(S) August 3, :15 AM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN NEED: To wear a red shirt. Wear/bring a bathing suit Bring a swim towel Brown bag lunch (unless being purchased from camp) Spending money is optional.

12 Santa s Village Azoosment Park, East Dundee, IL DATE(S) August 10, :00 AM 4:30 PM MODE OF TRANSPORTATION FIRST STUDENT BUS COMPANY CHILDREN NEED: To wear a red shirt, tennis shoes and socks. Bring a brown bag lunch, unless being purchased from camp. Spending money is optional.

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