Off Site Activities Permission Form (Admin Form)

Off Site Activities Permission Form
Section 1 - Program completes prior to parental consent
Student's Name*
First Last
Program
Name of Educator(s) responsible for child
Name of the off-site location and address
Dat of off site activity
- Monday-Friday
Time leaving and returning to program
- 8:30 AM -9:30 AM
- 10:00 AM - 11:00 AM
- 11:00 AM - 12:00 PM
- 2:00 PM - 3:00 PM
- 3:00 PM - 4:00 PM
- 4:00 PM - 5:30 PM
Method of transportation:
- Walking
Fee associated with activity (if any)
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