field trip release

The instructor must have the release from the student (parent/guardian) before the event.

(Sorry, you can't turn in forms on-line.)

Go to: http://business.fhda.edu/risk/forms

if under 18 click on Student Fieldtrip/Excursion - Minor Authorization form and print the form

for 18 or over click on Voluntary Assumption of Risk and print the form

How to fill out the form

MINOR:

Name of Student ... is easy enough, please print clearly.

Age: (age of the student) You must put your age or it will not be accepted by Risk Management!!

Instructor/District Representative: write in Mary Donahue

Campus: write in De Anza

at the bottom of the page where it says:

I, the undersigned certify that I am the parent or legal guardian of _____print the student's name________________, as the parent or legal guardian, I authorize my child to attend and participate in the following “excursions/fieldtrip” (dates/location):

Waterfront Lifeguard skills session, Cowell's Beach (or other nearby beach as necessary) Santa Cruz, May 16, 2010.

Don't forget the print name and sign name at the bottom

do not fill in the blanks for

Signature of Instructor/Staff Member ________ Date ____

DO have a parent print the info: In the event of an emergency, I can be reached at: (phone numbers)

18 or over:

Name of Student easy enough, print clearly

Age: you must put your age or it will not be accepted by Risk Management!!

Instructor/District Representative: print Mary Donahue

Campus: print De Anza

Dates of activity(ies), multiple dates are allowed, please be specific as to dates and purpose:

Waterfront Lifeguard skills session, Cowell's Beach (or other nearby beach as necessary) Santa Cruz, May 16, 2010.

at the bottom don't forget the

Signature of Adult Student and Date

don't fill in the blanks at

Signature of Instructor/Staff Member ____ Date ______

but do fill out the

In the event of an emergency, please contact: example: name, phone number, relationship to you (mom, friend, roommate?)