Aspen View Regional Division No.19

EEAE-E- 2

Parent/Guardian Consent Form

Student’s Name: _________________________________________________

Last Name First Name

Address: _________________________________ Phone: ______________

School: __________________________________ Grade: ______________

Date(s) of Trip: ________________________________________________________

Destination: __________________________________________________________

Expected Departure Time: ___________ Estimated Arrival Time: ___________

The above-named son/daughter has my permission to be transported in a private

vehicle by _________________________ in accordance with Division policy.

_________________________________________

Signature of parent/guardian

____________________________

Date

================================================================

SCHOOL DIVISION USE ONLY

Received by: _______________________________________

Date: ______________________________

Comments: ________________________________________________________

__________________________________________________________________

__________________________________________________________________