Model UN Club
  • Moderator: Mr. Jardines
Permission Form



General Permission Form for School Sponsored Field Trips

Students Name:______________________________________COR:____________

Cell Phone#: (          )____________ E-Mail Address: ________________

Parent/Guardian’s Name: _______________________________________

Emergency Contact or Cell#_____________________________________________________

Event:   Connetquot H.S. Model U N Conf., Long Island, NY

Date(s) of the Event:     Saturday, April 6th, 2013

Departure time from Prep:  8am    Estimated Time of Arrival to Prep:   9pm
*Students will be instructed to call a parent before returning to Prep to arrange a pick-up.

Departure/Arrival Meeting Location:    St. Francis Prep parking lot

Transportation provided by:     SFP   (yellow bus)

Class/Teacher (Chaperone):  Mr. Charles Jardines  

            I hereby give my child permission to attend the aforementioned event. I am also aware that my child is
responsible for abiding by all school rules of St. Francis Preparatory will enforce discipline to students who are in violation of any school rule or regulation. In the unlikely event of an emergency, please contact me at the number listed above.

Parent/ Guardian Signature: _________________

Please use the reverse side for any pertinent information regarding health or dietary concerns related to your child’s well-being and that you like to make the chaperone away of. Copy this document for safekeeping and return the signed original to the teacher/moderator for record keeping.