Ms. Antoinette's Students - Bi Lo
My scholar has my permission to participate in the CMCS Field Trip going to Bi-Lo grocery store in Litchfield. I understand that Ms. Antoinette will send 3 students to the grocery store each Monday and will notify me prior to my scholar's turn to go.

Event Date: Each Monday
Departure Time: 11:00 AM
Return Time: 11:30 AM
Event Address: Bi-Lo grocery store, Litchfield, SC
Travel Arrangements: Ms. Antoinette or Mrs. Gammel (class parent) will drive

Scholar's First Name *
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Scholar's Last Name *
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Teacher Name *
Parent Name *
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Parent Email *
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Parent Emergency Contact Number *
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Second Emergency Contact *
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Second Emergency Contact Number *
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Authorization for Medical Care
Should it be necessary for my scholar to have medical care while participating in this trip, I hearby give the School District personnel permission to use their judgement in obtaining medical care for the scholar and I give permission for the physician selected by the School District to render medical care deemed necessary and appropriate by the physician. I understand that the School District has no insurance covering such medical or hospital costs incurred by my scholar and, therefore any cost incurred for such treatment shall be my sole responsibility.
Authorization for Medical Care *
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Scholar Allergies - Please list all allergies. *
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I agree to direct my child to cooperate with directions and instructions of the school. *
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