DETROIT ACADEMY OF ARTS AND SCIENCES SCHOOL DISTRICT

2985 E. JEFFERSON 3100 E. JEFFERSON

DETROIT, MI 48207 DETROIT, MI 48207
313-259-1744 313-259-1744

PERMISSION SLIP
Please complete both top and bottom of form

(Name of Student) ______________________________________________ has permission to attend

Place: Bonaventure Skating Station

24505 Halstead
Farmington Hills, MI

DATE: February 16, 2017, TIME: 9:00AM 2:00PM COST: $18.00

Cost includes: transportation, entrance into the skating rink, skate rental,
pizza, and a beverage.
*No outside food or drinks will be admitted.

I understand the nature of the activity in which my son/daughter will be participating and
that he/she is expected to abide by all school regulations during the course of the activity. I
hereby give my permission for him/her to participate in the above-described activity. I
further agree that, in the event of an accident, illness or any other circumstance requiring
medical treatment, such treatment may be procured for my son/daughter without financial
obligation to the district. I accept full responsibility for my childs safety while engaged in
this activity. I understand that the staff of Detroit Academy of Arts & Sciences is not liable
for any injuries or accident(s) to my child as a result of this trip.

_______________________________________________________________________ _______________________________
Signature of Parent/Guardian Date

Emergency Contact Person

Name _____________________________________________________________ Relationship _____________________

Telephone # ___________________________________ Cell Phone # _________________________________

Chaperones are not required for this activity. However, parents/guardians are
invited to meet us at the BonaVenture Skating Station.

PERMISSION SLIP & MONIES ARE DUE BACK BY FEBRUARY 14, 2017