Ecology Day Camp Transportation by Field Station Truck Consent Form

Overview

At Ecology Day Camp, students will engage in activities that take place at various locations around the UM Field Station. To participate in these activities, such as wildlife-spotting, students will occasionally be transported around the UM Field Station in the back of a pick-up truck without safety restraints. Students will be monitored at all times by teachers and counselors riding in the back of the vehicle with them. At no time will students be permitted to stand up in the moving vehicle. Students will be required to ride while sitting on the bed of the truck.

If you give your consent for your child to participate in activities that include riding in the back of a pick-up truck, please check the box giving consent and sign below.

If you do not give consent for your child to participate in activities that include riding in the back of a pick-up truck, please check the box that does not give consent and sign below. Note that an alternative activity will be provided for your child.

Transportation by Field Station Truck Consent

Student Information

Student Name * Required
First Middle Last

Parent or Guardian Information and Consent

Parent/Guardian Name * Required
First Last

Home Phone *

Cell Phone *

Email *

Parent/Guardian Consent *

I, the custodial parent/guardian of the listed child, give CONSENT for my child to ride in the back of the truck without safety restraints for the purpose described above.
I, the custodial parent/guardian of the listed child, DO NOT GIVE CONSENT for my child to ride in the back of the truck without safety restraints for the purpose described above.

Parent/Guardian Signature *

Please type your name to sign this form.