Student Travel Application

Student Name*

Student's Email*

Student's School*

City of Destination*

Country of Destination*

Select mode travelled by:*

Destination Address*

Date and Time of Departure*

Date and Time of Return*

Trip Supervisor Name*

Trip Supervisor Address*

Trip supervisor's mobile phone number*

Trip Supervisor's email*

Trip supervisor's relationship to student*

Additional Notes (optional)

For any travel outside of British Columbia overnight, or without the host family, please have natural parents complete the following:

Natural Parent's

Select the tick box to agree to the following statement:I certify that I am the parent or guardian of the above-mentioned student.

Select the tick box to agree to the following statement:I will ensure that I will check all travel advisories issued by the federal government of Canada as well as other governments in the destination. All disruptions and associated costs are the responsibility of the student.

Select the tick box to agree to the following statement:I hereby give permission for my child to travel according to the above information. I fully understand that this trip is not part of Mission International Student Program and supervision during the trip is only as indicated above. As such, I fully understand and acknowledge that there are inherent risks to allowing my son or daughter to travel. I hereby release and hold harmless Mission International Student Program, its officers, employees, and the host family of any liability or responsibility for my son or daughter during the duration of this trip.

Select the tick box to agree to the following statement:Mission International Student Program does not recommend students be absent during the school term. I understand that my child’s daily attendance at the secondary school level is critical to their success. The course content and the rapid pace of instruction make it difficult for a student to catch up on missed work. Certain classroom assignments, projects, and scheduled government exams may not be completed if missed.