Enrichment Activity – Offsite Permission Form for PKs

Activity: Field Trip to Lazy 5 Ranch

Location: 15100 HWY 150 East, Mooresville, NC

Date: April 19th, 2023

Time: 8:30 am – 11:30am (PKs must arrive by 8:30am to participate in the Wagon Ride)

Cost: Free for Headwaters students, $15 for parent or guardian. Limit is one parent or guardian per child and no siblings due to group size allowed on wagon ride.

You can send a Check (made to SRBC), Cash or the Online Payment Link below for the ONE Adult that will be bringing your child – cost is $15 (payment must be received by 11:30 on April 13th to be included in the group activities) > https://onrealm.org/headwaters/give/fieldtrip

Description: Our Pre-k students will need to travel with their parent or designated guardian to Lazy 5 Ranch. There, they will be meet up with the rest of their class. Our wagon ride is promptly at 9am, so please make sure you arrive at 8:30am so that you won’t miss that activity. We will be able to enjoy the rest of the ranch together until 11:am when we will have a short bible study in the shelter area. We do not have a scheduled lunch time together, so if you plan to stay you are welcome to bring your lunches and stay the remainder of the time they are open.

  • I give permission for my child to take part in this activity and I or someone that I appoint will be attending the activity with them.
  • 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 Christian Academy and South River Baptist Church from any and all loss, injury or other damage arising out of this activity.
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  • This field is for validation purposes and should be left unchanged.