PARENT PERMISSION AND REGISTRATION FORM

INTERNATIONAL EXCHANGE PROGRAM

I/We, the parents/guardians of the student named below, understand the nature of the trip abroad being
planned to Argentina during April 2015 vacation.

We understand that transportation will be by plane, buses once in Argentina and we are in accord with the
purposes of and procedures governing the trip.

We hereby grant permission for our son/daughter_______________________________ to participate. We

understand that adequate and appropriate supervision will be provided. We recognize, however, that
unanticipated situations and problems can arise on any trip, school-sponsored or otherwise, which situations
or problems are not reasonably within the control of the supervising teacher(s) or staff (including volunteers).
We further agree to release and hold harmless International School of Boston, their agents, officers,
employees, and volunteers, from any and all liability, claims, suits, demands, judgments, costs, interest and
expense (including attorneys’ fees and costs) arising from such activities, including any accident or injury to
the student and the costs of medical services.

In the event of an injury requiring medical attention, I hereby grant permission to the supervising teacher(s)
or staff (including volunteers) to attend to my son/daughter. If the injury warrants further medical attention, I
expect every effort will be made to contact me to receive my specific authorization before action is taken.
If efforts to contact me are unsuccessful, I grant permission for necessary medical treatment to be given. In
addition, I hereby give my permission to the supervising teacher(s) or staff (including volunteers) to take my
child to the physician, dentist, or to the hospital if an accident or serious illness occurs on the trip and I
cannot be located.

In the event that a student must return to Boston independently for reasons of health, accident, failure to
conform to rules established by the teacher in charge, etc., we agree to accept full responsibility for and to
pay for the cost of medical care, transportation and other incidental expenses.

______________________________ _______________________________________________________
Student Name (Please print) Parent or Guardian (signed) Date

Home Phone___________________ Work Phone_________________ Cell Phone_________________________

If the student requires medication, I understand that I am obligated to ensure that the medication and the
Medication Authorization Forms are on record in the Health Office. (If ordered by the student’s physician, an
epipen must be provided for all field trips)

COST OF TRIP: $2,500

I, ________________________________, agree to pay the amount mentioned above that covers international

flights and transportation from Buenos Aires to Iguaçu.

A non-refundable deposit of $400 is due October 31st. Please make checks payable to ISB.

Other payments due dates are:

 December 5 = $ 550
 January 9 = $ 550
 February 6= $ 500
 March 6= $ 500
 EMERGENCY MEDICAL AND FIELD TRIP FORM
Argentina
April 2015

Student _______________________________________ DOB ____________________________

Phone _____________________________________
Address ________________________________________________________________________
Parent/Guardian ____________________________________________
Phone:
Cell phone _________________________ Home ______________________ Work _________________

Other Contact ___________________Phone: Home _______________ Work ____________

Doctor _______________________________________
Phone _______________________________________
Insurance Company ________________________________________
Policy Number ______________________________________________

Medical Information and/or Restrictions (allergies to insect bites, hypoglycemia, etc.):

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

I consent to and authorize the chaperone(s) of the trip to take whatever

reasonable steps they deem necessary in order to provide emergency medical
care for my child. I further agree to permit my child to be transported to a medical
facility by ambulance or other commercial vehicle.

________________________________ ______________________________
Parent/Guardian Signature Date
 Exchange Program with Argentina

Visit Argentina during April break!

Washington School students (http://www.washington-school.com.ar/es/default.asp) will welcome

ISB students in Buenos Aires and introduce them to their city. After a few days in Buenos Aires, students will
visit the Iguaçu Falls and do some community service (more details to come), before going back to
Argentina’s capital.
Trip Information:
 Maximum of 20 students
 $2500
 Deposit: $ 400 non-refundable. Payable to ISB before October 31, 2014