CUSD Permission for School Sponsored Voluntary Activity and Consent to Medical Treatment - Minor 

Destination:  Pleasant Valley High School 

Date:  Thursday, February 15, 2024

Time:  8:30 am to 12:30 pm 

AS STATED IN CALIFORNIA EDUCATION CODE SECTION 35330, I understand that I hold Chico Unified School District, its elected or appointed officials, employees, agents, and volunteers harmless from any and all liability or claims, which may arise out of or in connection with my child’s participation in this activity.

           I FULLY UNDERSTAND that participants are to abide by all rules and regulations governing conduct during the trip. Any violation of these rules and regulations may result in that individual being sent home at the expense of his/her parent/guardian.

           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 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.

A SPECIAL NOTE TO PARENT/GUARDIAN:  IMPORTANT MEDICAL INFORMATION FOR YOUR STUDENT SHOULD BE SENT TO COUNSELORS IN ADVANCE OF THE FIELD TRIP FOR SPECIAL ARRANGEMENTS.