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2024-25 Middle School Field Trip Release & Payment

Please complete the form below. Required fields marked with an asterisk *
One form per student, even if multiple students are participating from the same family.

By signing this form, you are consenting that your student may travel on school sponsored field trips with Arendell Parrott Academy (APA) during the academic calendar year, 2024/2025. Your consent applies to all school sponsored field trips during the school year. Students will be accompanied and supervised by an APA employee.

Student Last Name*

Answer Required

Student First Name*

Answer Required

Parent/Guardian First Name*

Answer Required

Parent/Guardian Last Name*

Answer Required

Parent/Guardian Email Address*

Answer Required

Parent/Guardian Phone Number*

Number Required

Emergency Contact Name*

Answer Required

Emergency Contact Email*

Answer Required

Emergency Contact Phone Number*

Number Required

Important medical information that we should know

Answer Required

I understand and will pick up my student in the event he/she develops diarrhea, vomiting, fever 100.4 or greater, or suspected pink eye.

I give permission for the chaperone to administer Tylenol, Advil or Pepto Bismol if needed.*

Answer Required

Yes

Release statement*

Answer Required

I am the Parent or Legal Guardian of the student named and give permission to participate in this field trip.

I do not wish for my student to attend field trips.

Field Trip Fee*

This fee is paid directly to APA. Other payments may be listed below.

Answer Required

$0.00 - 6th Grade - $115 fee payable via Emerald Student Travel

$0.00 - 7th Grade - $135 fee payable via Emerald Student Travel

$140.00 - 8th Grade

$0.00 - NOT ATTENDING

Confirmation Email

Confirmation Email *

Email Required