#1400 @001 Please state the name of the parent: @002 Please state the name of the child: @003 Please state the name of the entity organizing trip: @004 Please state purpose of the trip: @005 Please state the starting date of the trip: @008 Please state the ending date of the trip: @006 Please state name of chaperone: @007 Please state name of second chaperone: #end control section #1400 /* Para. 1400: Permission for trip */ TRIP PERMISSION SLIP @001, referred to as PARENT, is the parent and lawful guardian of @002, a minor, and agrees: @003 is organizing a trip for the purpose of: @004 on @005 through @008. @002 has the permission of PARENT to participate in this trip and all activities thereof. @006, @007 and the other employees and adult agents of @003 are herewith given the following authority on the dates stated above: To consent to any medical treatment that may be required by @002 in the place and with the same authority as @001. Further, in consideration of the services performed by @003 and the employees, servants and agents of @003, @006, @007 and the other employees and agents of @003 are herewith released from liability for all actions taken in good faith during the trip. Dated: ______________________________________ _______________________________________________________________ @001