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Advanced MUN Off Campus Form

Please complete the form below. Required fields marked with an asterisk *
MUN Travel Conference*
Answer Required

Parent/Guardian Permission: 

  1. I understand that all students going on this trip will be responsible in conduct to the bus driver, to teachers or to sponsors. It is further understood that students will go and return from the event on the transportation provided and that every reasonable precaution will be maintained on the trip.
  2. I hereby acknowledge that I have been advised that the activities involved in the field trip or event are not considered by MBUSD to be of “high risk” to the participants.
  3. I understand my Student is responsible to make up all assignments missed due to this school–sponsored field trip.

Answer questions below related to parent/guardian permission. Required fields marked with an asterisk *

PGP1. Responsibility in conduct is understood?*
Answer Required
PGP2. Non 'high risk" activity is understood?*
Answer Required
PGP3. Student assignment makeup is understood?*
Answer Required

Medical Information:

  1. I, the undersigned, parent or legal guardian of the above named student, consent in advance to whatever medical treatment or procedures might be necessary for my son/daughter in case of injury or illness during the trip. Such treatment may include, but is not limited to, anesthesia, X-ray examination and medical or surgical diagnostic procedure, and shall be in the best judgment of the attending physician. I understand that every reasonable effort will be made to reach me in case of serious illness or injury.
  2. I understand the nature of the trip and recognize the problems and dangers inherent in said trip. I believe that the above named student is able to participate safely in the trip. 
  3. Any restriction on activities, foods, special medical problems or instructions should be clearly explained in the comment section of this form. All medication, except those which must be kept in the student’s possession for emergency use, MUST be kept and distributed by the staff. All medication must be registered on this form.

Answer questions below related to medical information. Required fields marked with an asterisk *

MI1. Advanced medical consent is given?*
Answer Required
MI2. Permission to participate is given?*
Answer Required