Field Trip Form

Field Trip Form

Parent Name_______________________________________

Address___________________________________________

Phone____________________________________________

Email_____________________________________________

Field Trip Name_____________________________________

1. Child Name__________________________ Age_____

2. Child Name_________________________ Age_____

3. Child Name_________________________ Age_____

4. Child Name _________________________ Age____

5. Child Name__________________________ Age____

Total Cost for all the children_______________

Total Cost for adults _____________________

Please mail a check to:

Geoff Lloyd
3267 Lafayette Road
Jamesville, NY 13078

*****Please indicate on the check the field trip you are attending.*****

Please remember, NO REFUNDS, unless I cancel the program. I am sorry, but due to extensive planning and reservations, this is my policy. Thank you for understanding.