Group:

Boiling Springs High School

Sponsors:

Destination:

Departure Date: Return Date:  

Mode of Transportation:

Date Request Filed: (See date guidelines for school approval)

How many school days to be missed?

Number of Students:  

Number of Chaperones: (Must have Form 3 on file for each chaperone prior to trip.)

Chaperone form completed on all chaperones? Yes No

Purpose of trip:

Cost per person: Cost per chaperone:

Funding Responsibility:

Will student funds be used to pay for the chaperones' or any other person's expenses?  No Yes

If yes, explain:

Each student's parent or guardian must sign Form 2, Field Trip or Extra-Curricular Permission Slip.  This must be on file with the principal before a student can participate in any of the proposed activities.

Approved by principal:_________________________Date:________________