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Beaty Museum Field Study Parental Consent Form:
This is a consent form for allowing students to conduct field study within the Lower Mainland for course work in science class
FIELD STUDY: BEATY MUSEUM, UBC
ON A DAY 1 DATE IN JANUARY, the Biology Class will be visiting the Beaty Biodiversity Museum located at UBC. Website is here: http://beatymuseum.ubc.ca/ and its address is here: 2212 Main Mall, Vancouver, BC V6T 1Z4. Students are expected to arrive at the museum for attendance and they will be dismissed from the museum.
ITINERARY : Check the choice that you belong to according to your block. Your itinerary depends upon your block
First Name of Student
Your answer
Last Name of Student
Your answer
Student number
Your answer
science block
Your answer
email of student
Your answer
Cell phone number of student
Your answer
As a student participant, I agree to email this consent form to the teacher whose blocks are affected by this field study. I understand that if my teacher is not notified, MY PERMISSION FOR THIS FIELD STUDY MAY BE AFFECTED by the teacher
THE COST of this field study is estimated to be $8 for a one time visit and I'm investigating how to get a membership for a higher cost. The membership gives you one year access
THE FOLLOWING SECTION OF THE ONLINE FORM IS TO BE COMPLETED BY THE PARENT or guardian . I certify that I am the parent or legal guardian of (Student's Full Name)
Your answer
Parent/guardian First Name is
Your answer
Parent/guardian Last Name is
Your answer
Students are going to travel to and from the destination above
As a parent or guardian, I understand that students are responsible for their own transportation to the destination and this transport may be unsupervised. I agree to this
As, parent/guardian, I give permission for (name of student)
Your answer
to participate in the field studies described above. I understand my child may be exposed to a risk of injury due to accident while participating in this activity
Should it become necessary for my child to have medical care, I hereby give the teacher permission to use his/her best judgment in obtaining the best of such service for my child. I understand that any cost will be my responsibility. I also understand that in the event of illness or accident, I will be notified as soon as possible via the emergency contact information provided by me
Medical/Emergency information
OPTIONAL :My child's BC health number is
Your answer
emergency contact information: name of person and telephone
Your answer
I certify that I am the Parent/Guardian of the student named in this form and that I have completed this consent form
My phone number is
Your answer
My email is
Your answer
The school will provide a paper form for the parent to write a signature. I will sign the form when the student presents it to me and the form will be returned to the teacher.
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