St.

Rocco Youth Group

PARENTAL PERMISSION FORM FOR FIELD TRIPS

Members Name ________________________________ Age_______ Date ____________________

Leaders Name _____________________________________ Group _________________________________

Destination of Trip ______________________________ Date of Trip ____________________________

Type of Transportation __________________________________________________________________

Time Leaving ____________________________ Time Returning _________________________

Type of Clothing: Casual Attire ___________________ Dress Up ______________________________

Lunch: Bring __________ Will Buy ___________ Cost, if any, of Lunch ____________________

PLEASE RETURN THE SECTION BELOW TO SECRETARY OR GROUP LEADER:

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THIS FORM TO BE RETURNED NO LATER THAN _________________________________________(Date)

I, (we) the undersigned, parent(s), and/or legal guardian(s), of ___________________________________

(Youth Group Member’s Full Name)
________________________________________, (does not have) (has) my/our permission for the minor

Youth Group Member named above to

attend_____________________________________________________________
(location)

on __________________, ______________________________.
(day) (date)
under the supervision of Group Leader, Pastor, advisors, or volunteer parents.

NOTE: In consideration for the volunteer or assigned supervisory services rendered by Group Leader, Pastor,
advisors, and/or volunteer-parents, including volunteer transportation provided , the above, St. Rocco Church, St.
Rocco School or the Dioceses of Cleveland shall not be liable on account of any personal injury or damage
sustained by Youth Group Member.
Parent’s Signature __________________________________________________ DATE _____________

INDICATE RELATIONSHIP TO STUDENT ________________________________________________