Simply Natural Creamery

(St. Thomas Elementary School)

As parent/legal guardian of ___________________________________, I grant
(Print Students Name)

permission for him/her to participate in the fieldtrip described below.

Destination: Simply Natural Creamery (School completes form down to signature line.)
Nature or purpose of the trip: To learn about cows and how Ice Cream is made naturally.
Date/time leaving: May 14, 2016/8:30 am

Date/time returning: May 14, 2016/2:00pm

Sponsors/Chaperones: _____________________________________________________
________________________________________________________________________
Cost of Trip Per Child: $8.00
___________________________________
Signature of Parent/Guardian

__________________
Date

I am aware that when I am on a school-sponsored trip, I am under the jurisdiction and supervision
of the school-employed sponsors/chaperones and that my behavior must conform to the Code of
Student Conduct, the school's Student Handbook, and reasonable instructions from chaperones. I
understand I will be subject to appropriate disciplinary action for violations of these rules and
regulations.
___________________________________
Signature of Student

[Type text]

[Type text]

__________________
Date

12-1/12 RWS