Field Trip Permission to CAC
Your child is eligible to participate in a school-sponsored activity requiring transportation to a location away from the school building and grounds. This activity will take place under the guidance and supervision of employees from St. Mary’s Catholic School.

A brief description of the activity follows: The students will listen to and appreciate the cultural significance of opera music.

Name of Event: CAC UMHB Opera Performance and picnic lunch at park
Designated Supervisor of Activity: Mr. Charles Klein, Mrs. Anne Bullock
Departure Date.Time: 10/24/17 9:50 AM
Return Date/Time: 10/24/17 1:00 PM
Location: CAC Temple, TX
Method of Transportation:
Food: Bring sack lunch for park picnic after performance for Chaperones as well as students.
Dress Code: St. Mary's Catholic School Spirit Wear
Cost: $3.00
Please respond by: October 16, 2017

By submitting this form you agree to this event. You give consent and release of liability. As Parent/Guardian you remain fully responsible for any legal responsibility which may result from any personal actions taken by the named student.

In consideration for the making of the arrangements for this trip, I/We hereby release and save harmless the St. Mary’s Catholic School, all its employees and the Diocese of Austin from any and all liability arising to my child as a result of this trip. I also agree to allow my child to travel on this trip in a private vehicle.

If emergency treatment is required for my child, I/We authorize St. Mary’s Catholic School personnel to follow area EMS regulations in caring for my child.

Note: If your child(ren) are 8 years or younger they are required by law to be in a booster seat.

Email address *
I/We, the Parent(s)/Guardian(s) of (child's name) ______________________ request that St. Mary’s Catholic School allow my child to go to the above mentioned event. *
Your answer
Grade *
Parent/Guardian’s Electronic Signature *
Your answer
Emergency Contact Phone *
Your answer
Cost per student/chaperone $3.00 *
8 Chaperones are needed
We are blessed that many parents are able to help chaperone, therefore we will contact you if need you to chaperone.
Reminder: Chaperones must be EIM Compliant.
I can Chaperone -
Drivers Needed
We are blessed that many parents are able to help drive, therefore we will contact you if need you to drive. If you are driving, please give the office has a copy of your car insurance and driver's license.
My car holds _____ plus the driver.
Your answer
Name of the driver
Your answer
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