Fair Lawn High School

FAIRLAWNHIGH SCHOOL

FAIR LAWN, NEW JERSEY

CLASS TRIP NOTIFICATION FORM

This form MUST be completed, signed, and returned to the teacher in charge before the student may take the trip with the group.

Date: ______Student’s Full Name: ______

(please print neatly)

A trip to Point Pleasant Beach and Boardwalk in Point Pleasant, NJon Saturday, June3rd, 2017has been planned by THE CLASS OF 2020, which is a recognized organization. Your child will depart from Fair Lawn High School at 9:00 amand return at approximately 5:00 pm. Transportation will be provided by the Fair Lawn Board of Education. No special responsibilities can be assumed by the sponsor other than to keep the group together until they return to the school. All students must go and return with the group.

Mr. Garrett Van Curen, Class Advisor (Teacher in Charge)

______

(Parent Signature) (Emergency Phone)

TICKET OPTION

□$25 – This cost includes transportation and admission. (Food, Drinks, etc are responsibility of student)

--- CASH ONLY! NO CHECKS ACCEPTED! ---

Due by MAY 5th, 2017 to Mr. Van Curen in room D-109

In order to be in compliance with the directive from the State Commissioner of Education, and the Fair Lawn Board of Education, certain information is necessary for any student who is scheduled to go on a class trip. The directive reads:

“…when a child receiving medication during the school day is scheduled for a class trip covering the time the medication is due to be dispensed, the child’s parent (or guardian) should be requested to accompany the class and to perform this task. In the event that the parent (or guardian) is unable to accompany the group, a substitute may be hired to perform this duty.”

PLEASE TURN THIS PAGE OVER AND COMPLETE THE OTHER SIDE

Please complete this portion of the form:

Medication: ______Dosage: ______

When Given (Time): ______Purpose of Medication: ______

Date: ______

(Signature of Parent or Guardian)

If no medication is to be monitored, please INITIAL below:

NO Medication Needed ______

The Student and the Parent/Guardian Understand and Accept that:

Any damage to property associated with my child will be the responsibility of the parent and child for the financial burden to repair or replace said property.

All school rules and Fair Lawn Board of Education policies remain in full force.

Violation of any school rule/policy will be handled as a disciplinary action as well as any legal recourse which may apply with regard to local, state and federal regulations.

A student will be barred from future school related activities if a serious disciplinary infraction occurs

Please Read Before Signing

I understand that if my child misbehaves in a manner which will embarrass or endanger himself/herself or any member of the group, I will be notified and required to come and take my son/daughter home. If I am unable to pick up my child, the school will transport my son/daughter in the presence of a chaperon back to Fair Lawn and I will be responsible for all expenses associated with returning my child to Fair Lawn.

My child and I understand all of the procedures, rules, and regulations provided above. We understand that these regulations are applied regardless of the student’s age.

Our signatures below grant permission for our son/daughter to attend the class trip (as named on the first sheet) and that the student agrees to adhere to all policies as they relate to school rules and Board of Education policy.

I am aware that my child______can swim.

______cannot swim.

I hereby give permission for my son/daughter to take part in this class trip.

Signature of Parent/GuardianDate