Field Trip May 10th – Headwaters Academy

Activity: Field Trip to Stone Mtn State Park

Description: 6th-10th grade classes will be traveling to Stone Mtn State Park

Location: 3042 Frank Parkway, Roaring Gap, NC 28668

Date: May 10th (May 17th rain date)

Time: 8:30am – 2pm

Cost: Free

A permission form is needed for each student in these grades.

A few more details:

We will be leaving the school at 8:30am in our church bus driven by Pastor Scott or another qualified driver. We will arrive approx 1hr later.

We will hike, eat lunch and have a bible study before returning to school by 2pm.

For those that have the monthly lunch plan or have prepaid for this day to eat a school lunch, a bagged lunch consisting of a PBJ crustable, ham sandwich or ham rollup, chips, veggie or fruit.

Water bottles will need to be taken on the field trip.

For those that have not signed up for a school lunch that day, they will need to pack their lunch in a plastic or paper bag with their name on it, with everything being able to be thrown away after we are done eating.

Please let me know if you have any questions.

Child's Name*
First Last
Field Trip Days*
Please provide your permission to attend May 10th field trip and the alternate day of May 17th, if we have to reschedule due to rainy weather.
- My child will attend field trip on May 10th
- My child will attend field trip on May 17th if rainout on May 10th
Emergency Contact Name*
First Last
Emergency Contact Phone*
Parent/Legal Guardian's Name*
I give permission for my child to take part in this activity.
First Last
Parent/Legal Guardian Signature*
I am fully aware that my child will be transported to and from this activity and that there will be ample supervision. I have previously completed a Medical/Liability Release Form for my child. By signing this permission slip, I am confirming that the information on his/her Medical/Liability Release Form is current and up to date. I understand in the unlikely event of an accident or emergency that my child will receive adequate care based upon the information given. I assume all risks, hazards and incidentals involved in the conduct of the activity. I do hereby release, indemnify and hold harmless Headwaters Educational Enrichment and South River Baptist Church from any and all loss, injury or other damage arising out of this activity. I understand that the child will be transported to and from the offiste activity and I also understand the inherent risks in any travel, and agree to waive any and all liability on behalf of the referenced organizations for those risks.
Email*
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Date*
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