All District Choir Field Trip Form

Secondary School Student Trip Information and Permission Form

Date of trip: February 8^th and 9^th (alternate weekend February 15^th and 16^th)

Destination: Fluvanna County High School

Educational Objective(s): To attend All District Choir

Departure time from school:  8:00am Friday           and 8:00am Saturday                             

 Return time: 6:30 pm Friday and 4:30pm Saturday

Nonrefundable cost to be incurred by the student: $10 music

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:

            See information sheet  

 

 

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 ________________Fluvanna County High School__in Culpeper, VA on ______Feb. 8^th and 9^th or Feb. 15^th and 16^th __________ (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_______________