[] 1 Step 1 Emergency Card and Field Trip Release Child's Last Nameyour full name Child's First Nameyour full name Languagepick one!GenderMaleFemale Birthdateof appointment Home Phone Numberyour full name Address (Street, City, State, Zip)your full name Father's Nameyour full name Mother's Nameyour full name Father's Cell Phone Numberyour full name Mother's Cell Phone Numberyour full name Father's Workplaceyour full name Father's Workplace Phone Numberyour full name Mother's Workplaceyour full name Mother's Workplace Phone Numberyour full name Emergency Contacts Name of First Emergency Contactyour full name Relationshipyour full name Phoneyour full name Name of Second Emergency Contactyour full name Relationshipyour full name Phoneyour full name Primary Physician Nameyour full name Phoneyour full name Dentistyour full name Phoneyour full name Languagepick one!Do we have your permission to take your child to the hospital? YesNo Preferred Hospitalyour full name Allergies or illnesses we should be aware ofyour full name Other people besides parent and emergency contacts who have permission to pick up your child from schoolyour full name Parent Email (for school notifications)a valid email Parent Name (this serves as your signature)your full name Date FIELD TRIP RELEASE FORM (NOTE: The Field Trip Release Form is primarily only used by the Pre-K classroom. It is VERY rare that our other classes take field trips.) Children learn best by having opportunities to see for themselves, to touch, taste, smell, and hear new experiences. As they discuss their new experiences, opportunities are presented for expanding the child’s knowledge. Field trips provide children firsthand information, observation, study and broadening of concepts.First English Lutheran Preschool has my permission to arrange carpools to transport my child, Child's Nameyour full name on planned trips away from the preschool. Every possible precaution will be taken to ensure the health and safety of my child. I will provide a car seat for my child to be transported to and from field trips. I will be given information prior to each trip that my child will be offered to attend. I myself can provide transportation for my child for the Field Trips. Each child attending any field trips, and the parents or primary caregivers of such child, shall assume all risks of loss or damage and expressly release the First English Lutheran Preschool, its trustees, teachers, and all other agents and employees for liability therefore. Parent/Primary Caregiver Signatureyour full name Dateof appointment Submit Form Previous Next