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1st & 2nd grade permission slip

1st & 2nd grade field trip

Location: Animal Adventure Park, Harpursville, NY

Date: September 22, 2026

Departure & Return times: Leaving school at 8:30 a.m. and arriving back at school at 2:45 p.m.

Cost: $14 per person (includes a cup of animal food) The cost for the trip is to be paid by cash or check made payable to Canaan Christian Academy OR there is the option to pay by debit or credit card at the bottom of the form.

Lunch: Students are to bring a bagged lunch.

Dress Code: Casual - long pants, t-shirts, sneakers (no shorts)

Transportation: Bus

Chaperones: The trip will be chaperoned by Mrs. Jones, Mrs. Brock, and Mrs. Lee

Emergency Phone numbers: Mrs. Jones (570) 729-7017 and Mrs. Lee (716) 353-1665

PERMISSION SLIP AND MONEY ARE DUE NO LATER THAN

SEPTEMBER 16TH.

Student First & Last Name*

Answer required for "Student First & Last Name"

Parent/Guardian First & Last Name*

Answer required for "Parent/Guardian First & Last Name"

Parent/Guardian Phone Number*

Number Required

Emergency Contact Name*

Answer required for "Emergency Contact Name"

Emergency Contact Phone Number*

Number Required

Family physician*

Answer required for "Family physician"

Family physician phone number*

Number Required

Special medical conditions:

Answer required for "Special medical conditions:"

Student ticket by credit or debit

Answer required for "Student ticket by credit or debit"

$14.00

Adult ticket by credit or debit

Answer required for "Adult ticket by credit or debit"

$14.00 - Adult ticket

Adult cup of animal food by credit or debit

Answer required for "Adult cup of animal food by credit or debit"

$3.00

Payment

Answer required for "Payment"

I prefer to pay by cash or check to the school

$14 student

$14 adult

$3 cup of animal food for parent

I give my consent as the parent or guardian of the above named student to participate in this event. In doing so, I agree to the following:

In case of a medical emergency, I grant the chaperones the right to authorize medical care, if none of the persons named above can be reached.
I agree to pay the expenses of returning my child home before the end of the event if he or she does not adhere to the established standards of conduct.
The school is not responsible for damage or loss of property personally owned by my child.

Parent/Guardian Signature*

Signature Required

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"