1st Grade - Riley's Farm

5th Grade - Riley's Farm

FIELD TRIP PERMISSION SLIP
Date of Trip

MonthDayYear
Date 03/21/2025
Location: Riley's Farm
Event Date: Friday, January 16, 2026
Start Time: 8:30am
End Time: 2:50PMpm
Details: Please provide a sack lunch, water, and money. There is a bakery onsite if you wish to purchase lunch for an additional cost. You can visit their site to pre-order. Pre-ordering is recommended.

Students must wear their Bethel Maroon polo and bring their Bethel Field Trip Backpack. You may purchase a backpack at the front office for $10.00.

Bus will depart at 8:30am.

Cost Per Child: $32
Cost Per Chaperone: $32
Due Date: Thursday, January 15, 3:00PM
Student Information
Student Name*

First NameLast Name
Teacher*
Parent Information
Parent Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number
Will you be participating as a Chaperone? (select one)*

No. I cannot attend.Yes (I am an approved chaperone through Bethel).Yes (But I need to complete the Bethel volunteer/chaperone application process).
Emergency Contact Information
Name
Relationship
Phone Number
Medical Information
Important Medical Information The Supervisor Should Know
Payment Information

Order Information (select all that apply)

Student$32.00

Cost of Chaperone$32.00

Bethel Field Trip Bag$10.00

Check only if your child does not have a Bethel Field Trip Bag. Bag will be sent home with your child if purchased.

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Terms & Conditions
**All drivers please provide: Completed driver form, valid driver’s license, current insurance and registration.
By my signature I indicate that I am aware that during any field trip or excursion away from the school, certain dangers may occur including, but not limited to, the hazards of accidents or illness in places without medical facilities, hazards created by the forces of nature, and hazards of travel by air, train, bus, automobile, and other means, including walking.

Further, in the event of illness or injury, I do hereby consent to whatever x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care are considered necessary for the individual in the best judgment of the attending physician, surgeon, or dentist and performed by or under the supervision of a member of the medical staff of the hospital or facility furnishing medical or dental services.

I understand and do hereby assume all of the above-mentioned risks and will hold Bethel Christian Schools and its representatives harmless from any and all liability whatsoever which may arise out of or in connection with a trip or participate in any activities arranged for the participant by Bethel Christian Schools. The terms hereof shall serve as a release and assumption of risk for my heirs, executor and administrators and for all members of my family.

(If this is a pre-paid Field Trip we may not be able to refund if your child does not attend.)
Authorization Signature
By signing below, I acknowledge that I have read, understand, and agree to the Terms and Conditions listed above.Furthermore, I certify that I am the Parent or Legal Guardian of the student named above and that all the information provided is true and correct to the best of my knowledge.
Parent/Guardian Signature*

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Bethel Christian Schools | 2425 Van Buren Boulevard, Riverside, CA 92503 | (951) 359-1123
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5th Grade - Riley's Farm

Student Information

Parent Information

Emergency Contact Information

Medical Information

Payment Information

Terms & Conditions

Authorization Signature