All Saints Catholic School | Kenosha, WI

262-925-4000

Field Trip Informer – 4th Grade (Miceli), Kenosha Rotary Safety Center

Grade: Grade 4B, Room 103, Mrs. Miceli

Destination: Kenosha Rotary Safety Center, 5716, 14th Ave., Kenosha, WI 53140

Date & Time:

  • Wednesday, February 9, 2022; 12:00 – 3:00 PM

Trip Cost: No Cost

Transportation: Provided by Kenosha Rotary Safety Center

Lunch: At school

Uniform: Required

Chaperones: N/A

Specific Information/Instructions: Due date for online permission slip is Wednesday, February 2, 2022

Field Trip Permission

  • Medical Information and Release

    In the event of an emergency, I give permission to transport my child to a hospital for emergency medical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. On field trips that occur during the length of the school day, any prescription medication already provided to the school will be carried and administered by staff. If you are unable to reach a parent/guardian, contact:
  • Please furnish medical information about your child/ward, which may be pertinent to his or her participation in the above-identified activity.

  • Digital Signature: Parent/Guardian Consent

  • In consideration for my child/ward's participation. I agree to reimburse and indemnify the parish/school for all reasonable legal and court fees incurred by parish/school in defending a lawsuit that I or my child/ward may bring against the parish/school which relates to the above named activity if the parish/school is found not legally liable by the courts and prevails in the lawsuit. If the parish/school is found legally liable for injuries sustained by child/ward, this paragraph will not apply.

    I certify that I have an understanding of this agreement and any risks and hazards associated with the activity described above that my child/ward will be participating in. I further understand that I had the opportunity to fully discuss this agreement with a representative of the parish/school to clarify any concerns or questions about the activity or this agreement that I may have had.
  • By entering my full name, I attest that this constitutes my legal electronic signature on this form.
  • MM slash DD slash YYYY

4400 22nd Avenue
Kenosha, WI 53140
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262-925-4000 | [email protected]

FAITH. VALUES. RIGOR.