7th Grade Six FlagsMath and Science Day Field Trip

Friday, May 13, 2016

Student Name_________________________________

Science Teacher________________________________

We are happy to announce that the 7th graders are invited to attend a field trip on Friday, May 13, 2016, to Six Flags Over Georgia for Math and Science Day. We will leave the school at approximately 9:00 am and will return back to school around 7:00 pm that evening. It will be the responsibility of the parent/guardian to make certain that your child is picked up from the school when we return.

The cost of the trip is $55.00 (payable with cash, check, or money order) for students and chaperones which includes: admission into Six Flags, a catered lunch which includes a sandwich, chips, cookie, fruit, and drink, a FREE Bounce Back ticket to Six Flags White Water (valid through June 30, 2016), and transportation. Any other food/drink, game, locker, photo, or souvenir purchases will be the responsibility of the student. 2016 Six Flags Season Passes CANNOT be used for this event.

Any student receiving an office referral resulting in ISS or OSS, from the date of this permission slip (2/8/16) until the day of the field trip (5/13/16), will not be eligible to attend and will only receive a full refund as long as the spot can be filled by another student. Students not attending the field trip will have a normal school day.

We will need chaperones for this trip, so if you are interested, please fill out the information on the back of this form, and email Ms. Foster (mfoster@henry.k12.ga.us) ASAP so that you can complete all required paperwork prior to the field trip. ALL chaperones must have a current background check in place and must sign the Mandated Reporter form. All chaperone paperwork must be received no later than Friday, April 22, 2016, in order to be processed in time for the field trip. Chaperones must be 21 years of age or older.

PLEASE SIGN AND RETURN THIS FORM BY FRIDAY, APRIL 22, 2016.All money and forms should be returned to your child’s science teacher. Please fill out the information on the back of this form and return with your payment. If sending a check as payment, the following must be on the check: Name, current address, current phone number. Please also include the student name and “Six Flags” on the memo line. Feel free to make payments until the trip is paid in full; however, final payment must be completed by Friday, April 22, 2016 – NO EXCEPTIONS!

If you have questions, please contact Ms. Foster at mfoster@henry.k12.ga.us or 770-957-6055.

FIELD TRIP PERMISSION SLIP

Teacher/Grade: Foster/Franko/Heath/7th Grade ScienceDestination: Six Flags Over GeorgiaDeparture Date/Time: Friday, May 13, 2016 @ 9:00 am Return Date/Time: Friday, May 13, 2016 @ 7:00 pm

Donation Amount: $55.00 per student or chaperone (no student will be denied access to a field trip for monetary reasons; however, if donations do not cover the cost of the trip, the outing may be cancelled).

Chaperones Requested: Yes __X___ No ______Lunch: Lunch is provided in the cost of the field tripTransportation will be provided by: HCS bus transportation

To be filled out by parent/guardian Please complete and return by: Friday, April 22, 2016

Student Name: _________________________________________________________________________

______ My child has permission to attend the field trip.______ My child does not have permission to attend the field trip.______ I would like to be a chaperone

***Chaperone paperwork is due by Friday, April 22nd - all chaperones must be 21 years of age or older***

Name______________________________________________________________________

Contact # __________________________________________________________________

_____ My child has medication which should be administered during this trip.Please provide the following:

Name of medication:____________________________________ Dosage:____________________________

Parent name:__________________________________________ Contact #:_________________________

Emergency Contact Information: Please provide two different contacts in the event of an emergency:

Contact 1 Name:_______________________________________ Contact #:__________________________

Contact 2 Name:______________________________________ Contact #:__________________________

CONSENTIf any emergency medical procedure/treatments are required by the student during the trip, I consent to the trip’s supervisor taking, arranging for, or consenting to the procedures or treatment at his or her discretion.  I further release and waive any claim which I or any other person, firm, corporation, or entity may have or claim to have, known or unknown, directly or indirectly, from any losses, damages or injuries arising out of, during, or in connection with the student’s participation in the activity, any trip associated with the activity, or the rendering or emergency medical procedures/treatment, if any.  I further agree to indemnify and hold harmless and reimburse the Henry County School District, the Board of Education, its successors and assigns, its members, agents, employees, and representatives thereof, as well as the trip supervisor from and for any and all claims and losses.

___________________________________________________ ______________________Signature(s) of Parent(s) or Guardian(s) Date