Junior Mercy Day & Retreat Permission Form
Please complete and submit electronically no later than Welcome Back Day
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Description, Date, Time, and Location of Field Trips:  
1. Mercy Day Service Project: September 24, 2025 at various service site locations in greater Little Rock  
2. Junior Service Learning: through Theology class at assigned service sites in the Little Rock area for the school year
3. Junior Class Retreat April 22, 2026 from 8:00 a.m. until 3:00 p.m. at Diocese of Little Rock’s St. John Center in Little Rock  
Method of Transportation:   Students will drive or ride with other juniors in personal vehicles.
Special Instructions:  Will be communicated to students before the events
Junior Student Name (Last, First) *
I/We, give permission for my/our daughter to participate in above field trips under the conditions stated above.  I/We hereby release and hold harmless of neglect the school, any and all faculty, staff, and/or members of the administration of Mount St. Mary Academy for any harm to my/our daughter as a result of transportation to and from the event or as a result of the participation in the event itself.
I have read and agree to the junior field trip permission form. *
Required
Parent Name filling out form *
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