Name of Participant(s) Under 18 Years of Age:____________________________

________________________________________________________________

Address:_________________________________________________________

Chaperone Accompanying Child(ren):___________________________________

Recreation Activity and Date: April 21, 2012 Bus Trip to the Cloisters and the Metropolitan Museum of Art

I, the undersigned, as legal guardian for the participant(s) listed above, grant
permission for participation in the aforementioned event. The chaperone listed
above assumes responsibility for the listed child(ren) during the event.

____________________________       _________________________
   Signature of Parent or Guardian                     Date

____________________________
     Signature of Chaperone
 (if different from parent or guardian)

Parental/Guardian Permission Form is to be signed by the legal guardian of each participant under 18 years of age. Each person 18 years or older participating in the above mentioned event must complete and return a Participant Recreation Form.