Travel Release Form 旅游声明表

Q1:Parent Name 家长姓名

Q2:Student Name 学生姓名

Q3:Departure date 离开日期

Q4:Return date 返回日期

Q5:Person responsible at destination 居住地负责人姓名

Q6:Contact number 负责人电话

Q7:Reason for travel 外出原因

Q8:I consent for my child to travel according to the information provided above.我同意我的孩子根据上面提供的信息外出旅游。

Q9:I hereby release United Elite International Education Inc., its homestay coordinator, the custodian, the hostfamily, and Archbishop Carney Regional Secondary School from all liability for injury, damages, or claimsresulting from my childs participation in arrangement.Students may not have adequate medical coverage for travelling outside of Canada and will be expected topay for the additional coverage. Contact your medical insurance agency for assistance.