Arizona Tour Permission and Medical Form
Junior High Arizona Tour
April 26-27 2023

Terms and Conditions

Heritage Academy Junior High Arizona Tour Rules and Regulations

This tour is a school activity. All policies and regulations set forth by Heritage Academy apply to this trip. Each scholar is responsible for the integrity of this tour. Please make wise decisions.

1) You are expected to be LADIES AND GENTLEMEN at all times. Since we represent Heritage Academy, good personal conduct is imperative. ALL school rules (including dress code, language, public displays of affection, etc.) are all in effect for the duration of the tour.  Scholars will be required to wear Heritage uniform polos for both days of the tour.

2) You must be in your rooms at the scheduled bed check time. You may not leave your room after that time. If you are found out of your room after bed check, you will be sent home at your own/parent's expense. Contact your director or chaperone if for any reason you find it necessary to leave your room after bed check.

3) Members of the opposite sex are not permitted in each other's rooms.

4) Rooms must be kept orderly. All rooms must be left in order and clear chaperone approval before checkout. You will be required to pay for any room damage.

5) You are not permitted to use, or be in possession of tobacco, alcohol, vaping products and paraphernalia or illicit drugs of any kind. All prescription medications must be listed on the medical release form. Violation of this rule will result in your being sent home at your own/parent's expense.

6) Scholars agree to abide by all rules and regulations as outlined by venue and tour company.

7) Any scholar who violates any of these rules can be sent home at their own expense.
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Email *
Arizona Tour Permission to Attend *
I support this opportunity and give permission for my scholar to participate in the Heritage Academy Arizona Tour.  My scholar and I have read the rules and regulations and agree to abide by them. By checking the box, I give permission for my scholar to attend the tour and agree that the rules and regulations for attendance will be abided by both of us.
"No Pass, No Play" *
This is a "No Pass, No Play" activity. Scholars with excessive log entries will not be permitted to attend. Scholars with any grade below a "C" at the end of 3rd Quarter (March 10) may not be permitted to attend. Scholars who are deemed ineligible to attend the tour due to behavior or grades are not guaranteed a refund. By checking this box, I agree to the "No Pass, No Play" policy regarding grades and log entries and I understand that I may not receive a refund of the moneys I paid.
Failure to Follow Rules *
Failure to follow any of the rules set forth within this agreement will result in the scholar being sent home at their, or the scholar's family's own expense. By checking this box, I agree to and show I understand this condition for attending.
Scheduled Payment and Refund Policy *
The total cost of the trip is $370.  Tour cost is based on 4 scholars to a room.
Registration and 1st payment of $123.33 is due by 11/01/2022.
2nd payment of $123.33 is due by 02/01/2023.  
Final payment of $123.34 is due by 03/01/2023.                                                                                                                                   
Refund policy will be as follows: Full refund until 12/15/2022.   
From 12/16/2022 - 3/23/2023  - Refund except $100. 
No refund after 03/24/2023.
Parent/Guardian Signature *
PLEASE READ COMPLETELY BEFORE SIGNING: By adding your name below, you are giving Heritage Academy and its proxies permission to transport your child to locations listed in the tour.  There are risks of physical harm or injury that could result from participating in this trip. I voluntarily elect my minor child to participate in this trip and assume the risks of harm or injury that could result from participation. On my own behalf and that of my personal representatives and heirs, I hereby release Heritage Academy, its officers, employees, and agents from all liability for any injury or harm to my minor child as a result of participating in any authorized activity. I further release the use of my minor child's likeness, voice, and words in video, film, and print to Heritage Academy. In recognizing that Heritage Academy only provides simply topical general first aid supplies, I hereby authorize Heritage Academy staff to assist my minor child in securing emergency medical services if such a need arises. I also hereby authorize emergency medical or surgical care by licensed medical care providers. PLEASE SIGN NAME BELOW.
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