Camp Permission slip - Okinawa Christian School International

Okinawa Christian School International
Student Activity Permit
The High School is going to Camp at Tokashiki Island on Wed. October 2, to Fri. October 4, 2013.
Please fill out and sign the section below, indicating your student has your permission to attend
High School Camp at Tokashiki Island.
Please have your student return the bottom section to their homeroom teachers by
Wednesday, September 25th.
Secondary Principal 高等学校校長
******************************** Please cut here 切り取り線 ********************************
To: Okinawa Christian School International
This is to certify _________________________ has my permission to participate in
この用紙をもって 生徒名 は、 下記の活動に
HS Camp at Tokashiki Island on Wednesday, October 2, to Friday, October 4, 2013.
活動名 場所
日付 参加することを許可します。
I understand that the Okinawa Christian School International’s insurance plan applies to this activity.
Should injuries occur during this activity, I agree to accept the coverage of student insurance as full and
complete settlement for damages.
Signature of Parent or Guardian
Home Phone Number _____________________ Cell Phone Number _____________________
携帯電話番号 Transportation: Please fill out.
Please check one choice below for Wed., Oct. 3:
Please check one choice below for Fri., Oct. 5:
☐ My Child will be at Tomari Port @9:15 am
☐ My Child will be at school by 8:15 am
(OCSI bus riders do not need to arrive early)
☐ My child will leave directly from Tomari Port
☐ My child may be dropped off on Rt. 58
☐ My child must ride back to OCSI
For Medical Information please see the back of this form.
Okinawa Christian School International
Medical information.
If your student has allergies or medical conditions, please list:
What, if any, medications that are need at camp, and when do they need to be taken?
Ms. Hadley will dispense any medications that are needed.
In the event of a medical emergency, please list the steps or procedures you would like us to take.