Please text Ania Roland at 248-579-3307 what day you will be attending!!

Field Trip Permission Form To: Parent/Legal Guardian From: Bloomfield Township Public Library Travel to: Priest Elementary School On: April 22, 2013 .

8am to 12:30pm. .

Travel to: Bennett Elementary School On: Via: April 23, 2013

8am to 12:30pm .

Student Drivers

For: Volunteering for The Reinstitution of the Arts into Detroit (R.A.D.) Cost: $5 Participating Students must be at Bloomfield Township Public Library at 8am
(Bloomfield Township Public Library,1099 Lone Pine Rd) Faculty of Bennett and Priest will supervise students

Parental Consent and Waiver I, (parent/ legal guardians name)______________________________, on behalf of (Student name)____________________________a minor, do hereby grant permission for this student to travel as outlined above, as well as, release and hold harmless R.A.D., its officers, directors, employees and all school affiliates from all claims for injury and damage of any kind resulting from my participation in R.A.D. I do fully and completely waive any and all claims for liability or damages that could be brought as a result of any injury that may be sustained while my child is working with R.A.D. I further give permission for my child to be photographed and for those photographs to be published. I agree that my child will not post any pictures of students online. This Release is entered into knowingly, willingly and deliberately and is signed in consideration of my child being able to participate in R.A.D. I consent to my child driving him/herself as well as other R.A.D. participants to and from R.A.D. events.
Please circle the high school the student is currently attending: Lahser or Andover Does the student wish to drive themselves and fellow volunteers? Yes or No If yes, how many students (including yourself) can you drive? ___________ Which date will you be attending? April 22nd (Even Day) or April 23rd (Odd Day)

Parent Signature:_______________________________ Date:_________________________ Phone:______________________________ Fathers Business Phone _________________ Mothers Business Phone_________________
Parents please call the attendance office to confirm that your child will be attending RAD on the respective date, otherwise, he/she may not be excused for missing school. Important information: Please make sure that your child is at the (Bloomfield Township Public
Library,1099 Lone Pine Rd) at 8am on the correct date so that attendance may be taken and that all volunteers are well versed in the procedure of R.A.D. before embarking on the field trip. Please pack a lunch or bring money to buy lunch.

Please return to Austin Burchill (Lahser) or Matt Lefkofsky (Andover)