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Junior Class Corning Permission Slip

The junior class will be taking a field trip to the Corning Museum of Glass

Location: Corning, NY

Date: May 1, 2025

Departure & Return times: Leaving school at 8:00 a.m. and arriving back at school at 5:00 p.m.

Cost: $0

Lunch: Students are to bring a bagged lunch OR money to buy lunch

Dress Code: . Casual dress. No shorts.

Transportation: Van and personal vehicle

Chaperones: The trip will be chaperoned by Mrs. Musser and Mr. Brown

Emergency Phone numbers: Mrs. Musser 570-856-0773

Student First & Last Name*

Answer Required

Parent/Guardian First & Last Name*

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Parent/Guardian Phone Number*

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Emergency Contact Name*

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Emergency Contact Phone Number*

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Family physician*

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Family physician phone number*

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Special medical conditions:

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I give my consent as the parent or guardian of the above named student to participate in this event. In doing so, I agree to the following:

In case of a medical emergency, I grant the chaperones the right to authorize medical care, if none of the persons named above can be reached.
I agree to pay the expenses of returning my child home before the end of the event if he or she does not adhere to the established standards of conduct.
The school is not responsible for damage or loss of property personally owned by my child.

Parent/Guardian Signature*

Signature Required

Confirmation Email

Confirmation Email *

Email Required