Field Trip Permission Δ CommentsThis field is for validation purposes and should be left unchanged.Student Name* First Last Student Date of Birth* MM slash DD slash YYYY Does the student have a photo ID?*Please choose the answer that best applies to your student. If the student has a driver’s license, please choose the first option. Yes, the student has a driver’s license Yes, the student has another form of photo ID No, the student does not have a photo ID Parent/Guardian Name* First Last Parent/Guardian Email* Parent/Guardian Phone*Emergency contact name/relationship to student*In the event of an emergency, the above parent/guardian will be contacted first First Last Emergency contact phone number*In the event of an emergency, the parent/guardian will be contacted first.Parent/Guardian Email* My child has permission to attend a field trip to a research facility on the Thursday of the cSw Virtual Boot Camp week.* Yes No Please check the location your child will visit.*Parents are responsible for ensuring their student is able to travel to the field trip location. All costs for travel (and accomodations IF applicable) are the responsiblity of the parent/student. A virtual option is available for those not able to travel to a physical location. SPECIAL TRIP OPPORTUNITY – Met Museum on the Upper East Side, NYC. Icahn School of Medicine at Mount Sinai – New York, NY National Institutes of Health – Bethesda, MD University of Pennsylvania – Philadelphia, PA University of San Francisco – San Francisco, CA University of Texas – El Paso – El Paso, TX Virtual Research Facility Visit (Live visits via Zoom) My child is not able to attend this opportunity. I agree with the following statements (check all that apply): I understand that me/my student is responsible for transportation to the field trip (if applicable) I understand that it is my/my student’s responsiblity to arrive on-time and depart when the event is over I understand that I must comply with all rules and procedures set by the hosting facility I understand that I must be respectful of others and the property (if applicable) that I will be visiting I understand that I may need to complete additional paperwork to comply with requirements of the hosting facility I understand that my permission includes handling life threatening emergencies according to the policies of the hosting institution (if applicable) I also understand that I will be contacted if an emergency involving my child occurs (if applicable) I understand that my child can attend a virtual visit if they are not able to attend an in-person opportunity SignatureYour typed name will be used as your signature indicating your permission for your student to attend a field trip as part of the Curious Science Writers summer boot camp experience.Is there anything else you would like to share?
