PERMISSION SLIP West Jackson Middle School 400 Gum Springs Church Road Jefferson, GA 30549 (706) 654-2775 www.jackson.k12.ga.us/wjm
Return this completed form to Mrs. Jones by November 10th.
Place To Visit:
Sips n Strokes – Paint Studio 55 Freedom Parkway Suite 111 Hoschton, GA 30548 706-988-6902 (In the shopping center with Laguna Mexican Restaurant)
Dates of Trip:
Thursday, November 12th, 2015
Time of Departure:
3:45 p.m. from West Jackson Middle School
Time of Pick Up:
6:15 p.m. from Sips n Strokes (We are NOT returning to the school.)
Cost of Trip:
$25.00
Transportation:
Bus – The bus is only taking us to Sips n Strokes. Parents are responsible for picking up their child from Sips n Strokes.
Approximate Mileage:
1 mile one way
Sponsoring Teachers:
FCCLA Advisor - Kathy Jones (706) 255-4060 FFA Advisor - April Davis (706) 401-1111
If you give permission for your child to participate in this trip, please sign below and complete the other information as it pertains. Regardless of the precautions taken by sponsors and school authorities to assure student safety, accidents will occur. Therefore parents are encouraged to assure that their children are properly insured. Student Name: ___________________________________________
Grade: _____________
Parent Name (Print): _______________________________________________________________ Emergency Contact Phone #: ________________________________________________________ ___________________________________ (Parent Signature Here)
“I also do hereby, on behalf of named student, absolve and release school officials and teacher from any claims for personal injuries which might be sustained while he/she is present during the trip.”
___________________________________ (Parent Signature Here)
My child will be picked up promptly at 6:15 p.m. from Sips n Strokes in Hoschton.