Activities Permission Request Athletics Version 112.0

First NameMiddle InitialLast NameEmail Address

PositionPhone NumberSelectionSelection

Shelby Email Address

Last Name

First Name

Today's Date

Position

Supervisor

School

Must be accurate for approval notification

Phone Number

SelectionField Trip Type Other

SelectionSelectionSelectionSelection

Teacher / Sponsor Name(s)

Number of Chaperones

Field Trip Type

Teacher

Adult

Nurse

See 'Chaperone Ratios' in Fieldtrip Guidelines

Month

CitySelection

State

City

Out-of-State Location

Overnight

Out of State

If you answer “Yes” to either of these, send the itinerary to your Principal.

Year

Date for Trip

Activities Permissions Request

Athletic Events Only – NO Cheerleading OR Band

instance number

Purpose of the Amount Being Charged

Trip Charged

If nothing, leave blank.

Amount (per student) Being Charged for the Trip

EVENTS FOR THIS MONTH ONLY MAY BE LISTED ON PAGE 2.

Trip Details

Itinerary Link

Please copy and paste a Google link to your travel proposal in the space below and ensure share settings are set for anyone with the link to view the document.