Night Owls Peter Piper Lock In Permission Slip

Night Owls Field Trip Permission Form
Student Name:
Parent Name:
Parent Contact Number:
Additional Emergency Contact:
By signing this form, you are indicating that the Night Owls program has your permission to attend the Night Owls Peter Piper Lock
In under the Kyrene School District’s staff care during the scheduled dates/times at the scheduled location.
Fri –Sat
Field Trip Information
Peter Piper Pizza
4940 East Ray Road
Ahwatukee, AZ 85044
Parent Pick Up/Drop
Off Time:
Drop Off: 11:00 p.m.
Pick Up: 6:00 a.m.
Parent Signature
Pre-registration and field trip
permission form required 2 business
days before field trip date.
No bus transportation will be
provided for the field trip.
Participants to meet directly at
Please have student dress
comfortably and bring sleeping bag
and pillow for rest/relaxation time.
I understand that the District’s liability coverage only applies to injury if negligence is proved against the District, and if the terms and conditions of the
contractual liability coverage provided in favor of the District have been met. In all other circumstances, the student should seek coverage from his/her
own healthcare insurer, and/or the negligent third party responsible for causing the injury.
Please fax field trip form to 480-541-1815, ATTEN: Night Owls Field Trip.
Field trip form must be received to go on the field trip.