SACAJAWEA MIDDLE SCHOOL
Middle School Matters
SPLASH DOWN TRIPLE PLAY FIELD TRIP INFO
**Congratulations at achieving PLATINUM STATUS. You must maintain this current level all
the way up until the last day of school or end of the year activities could be affected.
Where are we going: Triple Play, 175 W Orchard Ave, Hayden, ID 83835
When: June 13th - Buses leave Sacajawea at 9:10 and return to Sac at 3:00 you will go to 6th
period when you return. (So make sure you have dry clothes.)
DUE Tomorrow BEFORE you get on the bus.
1. _______ IMPORTANT - If you have a health care plan AND self- carry your meds. We
must see the medication before you will be allowed on the bus.
2. ______ IF you want to rent a locker please bring $1. 59
3. ______ With the change in venue we are encouraging you to purchase lunch at the
concessions…..if you bring a sack lunch Mr. Weed will be meeting students at 12:00 to
eat together outside of the facility.
Items to pack for the field trip…..
Swimsuit that is comfortable – IF you want go in the water park.
LOTS more to do at Triple Play….Rock climbing, Go Carts, Miniature Golf, Video Games,
Laser Tag etc…
Dry clothes for the end of the day.
Towel
Money (if purchasing lunch)
SACAJAWEA MIDDLE SCHOOL
Middle School Matters
Parent/Guardian Instructional Field
Trip Permission Form
Name of Student (Please Print)
Name of Parent/Guardian (Please Print)
I, the undersigned parent or guardian of the above named student, give my permission for my student to
participate in the instructional field trip described as follows:
Date of trip:
Tuesday, June 13, 2017
Destination and activities:
Triple Play Family Fun Park/Raptor Reef
Medical Information and Release
The following special health problems concerning my student should be noted – if none, please check “none”;
Heart condition
Allergy (specify below whether food, bee sting, etc.)
Hemophilia
Asthma
Diabetes
Other
None
Describe condition noted above with particularity, including any medications or other instructions:
In the event of a medical emergency, I hereby authorize the teacher/chaperone attending to my student on the trip to
secure medical attention or hospitalization for my child.
My child’s physician is:
, at
Physician’s phone number
My phone numbers are:
home
work
cellular
Alternative emergency contact:
name
phone
I understand the School District does not provide medical insurance for my student for purposes of this trip, and I
am solely responsible for providing such insurance and for payment of any medical treatment expenses for my
student that are not covered by insurance.
I have read the foregoing information, verifying its accuracy, and agree to the statements made above:
X
Parent/Guardian Signature
Signed Original:
Form 32-0019
Rev. 4/03
To be filed with principal/designee prior to departure of trip(s) Copy:
Teacher/Coach/Advisor
Web Form 32-0019W
Date Signed
SACAJAWEA MIDDLE SCHOOL
Middle School Matters