NEIGHBORHOOD WALK PERMISSION SLIP

September 5th, 2006

Dear Parents/Guardians:

This is a generic permission slip allowing your child to leave the P.S. 171
premises to go to ALL museums on Museum Mile (i.e., Fifth Avenue from
East 80th Street – East 105th Street), the public library, ANY PART of
Central Park or on an educational neighborhood walk between the East
River and 5th Avenue from 96th to 116th Streets.

No student will be able to attend without a signed permission slip. Please

sign the bottom of this form so that your child may attend.

Only those students who have shown an ability to pay attention and
follow rules and directions may go on a trip. In addition, students must
have good homework and classwork habits to be allowed this privilege.

Thank you.

Very truly yours,

Ms. Shubitz
Ms. Shubitz
Class 5-310

Cut off here (you keep the top portion)

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I give my child, __________________________, permission to go with Ms.

Shubitz and/or Class 5-310 on neighborhood outings during the school
year. Neighborhood outings include: ALL museums on Museum Mile (i.e.,
Fifth Avenue from East 80th Street – East 105th Street), the public library,
ANY PART of Central Park or on an educational neighborhood walk
between the East River and 5th Avenue from 96th – 116th Streets.

X _______________________________(Parent/Guardian’s signature)

Phone Number: (HOME/WORK): _______________________________________

(CELL): ______________________________________________

1. Emergency Contact Name & Number:

____________________________________

2. Emergency Contact Name & Number:

____________________________________