Spare Time Fun Center for Grades PK – 7
Your child is eligible to participate in a school-sponsored activity requiring transportation to a location away from the school building and grounds. This activity will take place under the guidance and supervision of employees from St. Mary’s Catholic School. A brief description of the activity follows:

Name of Event: Pre K – Gr. 7 students to Spare Time Fun Center – 5434 205 Loop, Temple, Texas 76502
Designated Supervisor of Activity: SMCS Faculty & Staff
Date of Departure: Thursday, May 25, 2017
Time of Departure: 9:30 a.m.
Time of Return: 2:30 p.m.
Method of Transportation: Parent Volunteers & Holy Trinity Catholic High School Bus

Student Requirements:
Students may wear any SMCS T-shirt, sneakers and socks, walking shorts (must be knee length) or capri pants or athletic knee length shorts. For younger students, in order to ensure the safety of your child, please send their booster/car safety seat.

Food:
Pizza and drinks will be provided. Snack bar will be open for additional purchases.

Cost: $20.00/student $5.00/chaperone Due by: Monday, May 15, 2017

By submitting this form you agree to this event. You give consent and release of liability. As Parent/Guardian you remain fully responsible for any legal responsibility which may result from any personal actions taken by the named student.

In consideration for the making of the arrangements for this trip, I/We hereby release and save harmless the St. Mary’s Catholic School, all its employees and the Diocese of Austin from any and all liability arising to my child as a result of this trip. I also agree to allow my child to travel on this trip in a private vehicle.

If emergency treatment is required for my child, I/We authorize St. Mary’s Catholic School personnel to follow area EMS regulations in caring for my child.

Email address
I/We, the Parent(s)/Guardian(s) of (child's name) ______________________ request that St. Mary’s Catholic School allow my child to go to the above mentioned event.
Your answer
Parent/Guardian’s Electrionic Signature
Your answer
Emergency Contact Phone
Your answer
$20 per student/$5.00 chaperone
Required
If you can chaperone and are EIM compliant, please fill out the information below.
I would like to drive and am EIM compliant.
The office has a copy of my car insurance and driver's license.
My car holds _____ plus the driver.
Your answer
Name of the driver
Your answer
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