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2. 
3. Field Trip Permission Form
4. Cost
   $4.00 per student for Outreach and Tour Program (Teacher and helpers/parents are FREE)
6. To be completed by teacher/school
8. Date and Time
   Date and Time

   Date and Time
10. Teacher
11. School
13. To be completed by parent or guardian
15. Child's Name
    I give permission for my child (First and Last Name above) to attend the field trip to the Blue Sky Ecological Reserve.
17. In case of emergency
    I give permission for my child to receive medical treatment. In case of such an emergency, please contact:
19. Name (First and Last Name)
20. Phone
22. Payment
    Enclose $4.00 check (or cash) made payable to the City of Poway, if not school purchase order.
24. PARTICIPANT WAIVER AND PHOTO RELEASE
    Participant waivers must be signed by each child's parent/guardian. In order for each child/adult chaperone to be admitted to the site, the facilitator must have a waiver for each participant, signed and accounted for. Furthermore, the undersigned fully understands that participation in the above event/activities exposes the participant to risk of personal injury or property damage. The undersigned hereby acknowledges and agrees that participation in the event/activities for themselves, heirs, administrators, executors and assigns, shall indemnify and hold harmless the City of Poway from any and all claims, demands, actions or suits arising out of the connection with their participation in the event/activities.
    
    I assign to the City of Poway and its officers, employees and agents, all rights to any photographs and/or video taken of me/my child and/or any organization(s) represented by me, and any printed matter in conjunction with such photographs and/or video hereinafter referred to as MATERIAL, for advertising and marketing purposes. I hereby authorize the City of Poway to reproduce, copy, exhibit, publish or distribute any and all such MATERIAL. I and/or any organization(s) represented by me understand and agree that the City of Poway will be held free and clear of any responsibility or claim for any liability directly or indirectly associated with the use of said MATERIAL.
26. Parent/Guardian Signature
27. Date
    Date
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