Secondary School Student Trip Information and
Permission Form
Date
of trip: November 10th, 2012
Destination:
William Monroe High School in Greene County, VA
Educational
Objective(s): To audition for All District Choir.
Departure time from
school: To Be Announced (hope to be
morning) Return time: TBA
Nonrefundable cost to be incurred by the
student: $7
Nonrefundable cost to be incurred by the attending
adult:$0
Make
checks payable to: Eastern View High School Choral Boosters
Other
important information including: use of electronics, student dress, souvenir
shops, supplies needed:
Students need to dress in CCPS
dress code appropriate clothing.
Depending on the time, students may need to bring money for lunch or
pack a lunch. Further updates will come
out. Bathroom breaks may be needed in
route and back for students.
Keep the top half for your
information. Return the bottom half to
the appropriate teacher or staff member.
.
Please
list any serious allergies or medical
conditions of your child:
_______________________________________________________________________.
My child, ______________________________ has permission to attend
the trip to ___Williams Monroe High School _______________ (site) in ____Greene
County, VA __________________________ (city/state) on ____Nov. 10th,
2012____________ (date).
I give prior permission for
any emergency medical treatment of my child where a delay could cause
significant harm to his or her health.
________________________________ __________
Parent/Guardian’s Signature
Date
Parent
and Emergency Contact Name__________________________ or
__________________________
Phone
Numbers: ________________ or ___________________ or_______________
