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Appendix

FCSC Policy Form 4.24-A





Fayette County School Corporation

Connersville, Indiana





Student School Trip Parent/Guardian Permission Form

The Eagles Team will be visiting Chicago this year on Wednesday, May 7th. Our current plans are:

 Traveling on Illini Swallow 55 seat Buses with TV’s & Restrooms.

 One chaperone for every five students. (Chaperones will also have to pay in advance as do each

of the teachers. If you are not chosen to go, you will receive a refund.)

 A Wendella Boat tour of the city and one museum.

 The Navy Pier for lunch. (Good place for souvenirs)



Due to the need for deposits on the buses and boat, we need to collect the money as soon as

possible. The field trip will cost $35 and is payable to CMS. We prefer checks but will accept exact

amounts of cash. All money needs to be paid by Friday, March 14th and must accompany this

permission form. Do not write a permission form of your own.

The Eagles Team can not guarantee a spot after the due date. Students will need to bring some

extra money for lunch and souvenirs. A full itinerary as well as rules for the trip will be sent home at

a later date. Please remember that this is a school field trip and that all school rules will apply.



Thank You,



The Eagle Staff





Student Name: __________________________________________________





Parent Name & relation: _________________________________________________





I am interested in being a chaperone for this trip. ___________





School: Connersville Middle School Teacher in Charge: Page, Litton, Miller, Harris



To the Principal/Director:



As a parent or guardian of the above named student, I hereby certify that I have given permission for



said student to go on a school trip to Chicago, Illinois on May 7, 2003 (Wednesday). The students will



be leaving the school at 5:30 AM and will return around 9:30 PM. I understand that



transportation will be provided by Illini Swallow Lines and that all school bus rules apply.





_________________________ _______________________________________________

(Date) (Signature of Parent/Guardian)



If you have any questions, please contact Mr. Page at 825-1139 ext. 304 or page@fayette.k12.in.us.



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