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Honor Society trip (Longwood)

Location: Longwood Gardens & IKEA

Date: April 20, 2026

Departure & Return times: Leaving school at 7:30 a.m. and arriving back at school between 7 & 8 p.m.

Cost: $17 plus money for food

Dress Code: casual clothes

Transportation: School vans

Chaperones: The trip will be chaperoned by Mrs. Musser, Mr. Musser, and Mr. Brown

Emergency Phone numbers: Mrs. Musser (570) 856-0773

Student First & Last Name*

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Student First & Last Name

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Parent/Guardian First & Last Name*

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Parent/Guardian Phone Number*

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Emergency Contact Name*

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Emergency Contact Phone Number*

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Family physician*

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Family physician phone number*

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Special medical conditions:

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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.

$17 per student (debit or credit)

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I will pay by cash or check made payable to CCA by 4/17

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$17.00

Parent/Guardian Signature*

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Note for teacher:

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Confirmation Email

Confirmation Email *

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