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5th-6th grade field trip (Steamtown)

Location: Steamtown Trolley Museum & Excursion

Date: October 2, 2025

Departure & Return times: Leaving school at 9:00 a.m. and arriving back at school at 2:30

Cost: $8

Lunch: Bagged lunch

Dress Code: Jeans, t-shirt (not white), sweatshirt or hoodie and comfortable shoes for walking. no large sayings on clothing. CCA spirit wear is fine.

Transportation: Bus

Chaperones: The trip will be chaperoned by Mrs. Hughes and Mrs. Brown

Emergency Phone numbers: Mrs. Hughes (570) 418-5112 or Mrs. Brown (570) 470-1544

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*

Number Required

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*

Number Required

Special medical conditions:

Answer required for "Special medical conditions:"

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.

$8 per student (debit or credit)

Answer required for "$8 per student (debit or credit)"

I will pay by cash or check made payable to CCA by 10/13

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$8.00 one student

$16.00 two students

Parent/Guardian Signature*

Signature Required

Note for teacher:

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Confirmation Email

Confirmation Email *

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