Field Trip

DEPARTMENT OF CHILDREN AND FAMILIES Division of Early Care and Education

dcf.wisconsin.gov

Use of form: Use of this form is voluntary; however, completion of this form meets the requirements of DCF 250.04(6)(a)2., DCF 251.04(4)(a)4. and 251.04(6)(a)4., and DCF 252.41(4)(a)4. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04(1)(m), Wisconsin Statutes]. This form may be used both to notify parents of the specific date, time, and destination of field trips which require the use of a vehicle and to obtain parental authorization for a child to participate in and be transported to and from a field trip. Note: The Child Care Enrollment form also contains a section for obtaining authorization from a parent to participate in field trips if the center chooses to use that form.

Instructions: Complete the form and submit to the parent / guardian for their signature prior to the date of the upcoming field trip.

Departure Time

Estimated Return Time

Length of Travel Time

Destination, including length of travel time each way

Type of transportation:

Center vehicle Parent/volunteer vehicle Contracted vehicle Public transportation

I authorize the child care center / day camp listed above to take my child on a field trip or other off-premises activity on the date(s) indicated.

Parent/Guardian Signature

Clear Signature

Submit Application