Presbyterian Day School - Register for Cultural Expeditions - National Trip

As a part of our Cultural Expeditions Program at PDS, we believe that giving students the opportunity to explore and grow in their understanding of their own culture, its history, and their nation’s capital is essential to developing their understanding of civic duty, their identity as U.S. citizens, and their ability to think globally. This trip is intended to immerse our students in the functions of our federal government, our nation’s history, and to experience one of the most important cities of the world.

Permission and Waiver for the Cultural Connection Trip to Washington, D.C. and Philadelphia

Student First Name(*)

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Student Last Name(*)

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Birthdate of Student(*)

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Parent First Name(*)

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Parent Last Name(*)

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Address(*)

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City(*)

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State(*)

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ZIP(*)

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Parent Email(*)

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Participation Permission(*)

I am the parent/legal guardian of the traveler, a minor. I hereby acknowledge that said minor is presently under my care, custody, and control. I hereby give my child my permission to participate in the overnight, off-campus school trip. Invalid Input

Medical Information

Has this child had a recent surgery or illness? Please explain:

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Does this child have allergies to food or medication?

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If this child regularly takes medication, will it be with him for this trip?(*)

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If you answered 'yes' to the above question, please list name of medication(s), dosage, time to be given, and any special instructions.

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Prescribing physician's name

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Acknowledgement for Medication(*)

I hereby authorize the staff of Presbyterian Day School to administer the medication(s) listed above to my child while participating on the overnight, off-campus school trip. I understand that no medication will be administered except by PDS staff and that all medication must be in possession of a PDS staff member and not carried by student(s). I understand that all medications must be in the original container, labeled with the child’s name, medication name, and dosage instructions. Prescribed medication must also include the date and name of physician. By agreeing below I authorize and release the school and its staff from all liability. Invalid Input

Add any other necessary medical information

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Medical Consent and Overnight Waiver

I have detailed in the spaces above or on PowerSchool my minor child’s medical information and any physical conditions which may require attention, and I have listed all medications regularly used for said minor. I understand that failure to disclose medical information/conditions may result in cancellation of my child’s trip. In case of my child’s illness, PDS staff will attempt to notify whoever is designated as the emergency contact. In the event that the emergency contact cannot be notified, I authorize the staff of PDS to consent to any X‐ray examination, anesthetic, medical or surgical treatment, or hospital care required by my child. I hereby consent and give my permission to the staff of PDS or any attending physician to make medical decisions for my child if necessary under the circumstances. Invalid Input

Required - Separate Waiver for Bike Tour

The company we are using for our Bike Tour requires a completed bike waiver for each boy. Please download and complete this bike waiver. You can either sign it with Markup on your iPhone or print it, scan it back in, and upload it here.

Biking-Waiver-2023-DC.pdf Popular 94.96 KB	09/25/2023 13:54

Upload Completed Bike Waiver(*)

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General Release and Waiver of Liability

In consideration for being permitted to attend the overnight school trip and participate in the activities planned, I, on behalf of myself, my child, my legal representatives, heirs and assigns, do hereby release, waive, and forever discharge Presbyterian Day School and its officers, employees, volunteers, and agents, of and from any and all loss, damage, claim, demand, action or right of action, of whatever kind or nature, either in law or in equity arising from or by reason of any bodily injury or personal injuries known or unknown, death or property damage resulting or to result from any accident that may occur as a result of my or my child’s participation in the related activities or any activities in connection with PDS, whether by negligence or not. I agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State of Tennessee, and that if any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Invalid Input

Please Sign Using Your Mouse/Trackpad or Finger (Mobile)

Please type your name below if you agree to the aforementioned information.(*)

Sign Above

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Payment Information

The total cost of the trip is $2250 ($2500 if registered after May 1, 2023) covering flights, hotels, charter buses, tour guides, and chaperones. Food costs (except breakfasts) and souvenirs are excluded.

The balance of the trip cost will be added to your PDS account with payment due 30 days before the start of each trip.

All student tuition accounts must be current, as well as payment for the trip must be made in full 30 days prior to departure.

I have read and acknowledge the payment information above. Invalid Input

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Permission and Waiver for the Cultural Connection Trip to Washington, D.C. and Philadelphia

Medical Information

Medical Consent and Overnight Waiver

Required - Separate Waiver for Bike Tour

General Release and Waiver of Liability

Please Sign Using Your Mouse/Trackpad or Finger (Mobile)

Payment Information