Parish of St. Bernard of Clairvaux

FIELD TRIP/SERVICE TRIP

GENERAL PERMISSION SLIP

I, we, the parents of __________________________ request St. Bernards Youth Program to allow

my child to participate in______________________________(event) on _________________(date).

I give permission for my child_________________________ to attend ___________________ (event)

in __________________(place) on __________________(date).

In consideration of the making arrangements for the trip by the St. Bernard Youth Program, I

hereby release and save harmless the St. Bernard staff and sponsors from any and all liabilities for

any injuries, loss or other claims arising out of or resulting from this trip.

Signature_________________________________________ Date ___________________________

Address __________________________________________

Phone ____________________________________________