GRADE 7 TRIP Mystic, CT. JUNE 6-7

Student Name: _____________________________________ Homeroom: _______________________________________ Tee Shirt Size: (ADULT SIZES) X-Small Small

Medium

Large

X-Large (Circle one)

Parent e-mail:_______________________________________(please print clearly) Parent Phone Number: ______________________________________ Payment Schedule (you may pay in full $325): Deposit Second Payment Balance

$100 due January 31, 2018 (non-refundable) with Permission Slip $125 due February 28, 2018 NO ADDITIONAL STUDENTS CAN BE ADDED AFTER THIS DATE $100 due May 4, 2018

Payment can be made by check, cash or money order. Checks should be made out to MS 51. Please bring this paperwork and money to Ms. Speth in room 144. Date

Payment Amount

Payment Type

Balance Due

Permission Slip Returned

---------------------------------------------------------------------------------------------------------------------Please only complete if you are available/willing to chaperone if needed. Chaperones do not pay, they give up the time. This is not a vacation, it is really work. We will get back to you as soon as we have a final number in May. Parent Name: _____________________________________________ Parent Tee Shirt Size:_______________________________________ Student Name/Homeroom_____________________________________________