Off-Site Permission Form

Off-Site Permission July 30

Please note this application is not confirmation of your child's registration. After submitting the form, a Mentoring Coordinator will be in touch shortly to review your application.

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Permission Off-Site Visit Toronto Zoo - July 30th - 9:00-1:30

Child's Name*

First Last

Date of Birth*

Parent/Guardian Name*

First Last

Phone*

Health Card#*

Emergency Contact Name

*If different from above Parent/Guardian name.

Emergency Contact Phone

*If different from above Parent/Guardian phone number.

I grant permission for my child, to participate in this field trip event that requires leaving the camp site. This activity will take place under the guidance and direction of employees and/or mentors from Big Brothers Big Sisters South Durham and Northumberland.*

Please check here if you DO consent to the above.

Please check here if you DO NOT consent to the above.

Name if Event: Nature Walk at Toronto Zoo

Location:2000 Meadowvale Rd, Scarborough

Departure time: 9:00 am

Return time: 1:30 pm

Signature

SMS Verification

Date*

Signature Verification*