Utica Community Schools/Community Education

Summer Camp Field Trip/Swim Permission Slip and Payment

School Year SACC Building: __________________________ Sumer Camp Site: Rose Kidd

I give permission for my child(ren): __________________________ _____________________________ Child’s Last Name Child’s First Name

__________________________ _____________________________ Child’s Last Name Child’s First Name

To attend/participate in the following UCS Summer Camp sponsored Field Trips/Off-Site Presentation/Swim. I understand that my child will be transported by a UCS School Bus. All Trips are prepaid one week prior to event. Field Trips are Non-Refundable.

Field Trip Fee: $18 per trip (**unless noted)/per child

or pay one-time fee grades K-2 $170 per child / grades 3-6 $185per child

Thursday June 21 Morley Candy @ 9:30 am _______ $______ # Students Total Monday June 25 The New Rink @ 10:00 am (3-6 only) _______ $______ # Students Total Wednesday June 27 Chuck E Cheese @ 11:00 am (K-2 only) _______ $______ # Students Total Thursday July 5 Bowling @ 11:00 am _______ $______ # Students Total Wednesday July 11 Michigan Science Center @ 10:00 am _______ $______ # Students Total Thursday July 19 Jimmy Johns Field @ 10:00 am _______ $______ # Students Total

Tuesday July 24 Joe Dumars @ 10:00 am (3-6 only) **$25 _______ $______ # Students Total Wednesday July 25 Detroit Kid City @ 10:00 am (K-2 only) _______ $______ # Students Total Tuesday July 31 Troy Nature Center @ 10:00 am _______ $______ # Students Total Wednesday August 1 Red Oaks Water Park @ 11:00 am _______ $______ # Students Total Wednesday August 8 Outdoor Adventure Center @ 10:00 am (K-2 only) _______ $______ # Students Total

Thursday August 9 CJ Barrymore @ 11:00 am (3-6 only) **$25 _______ $______ # Students Total

Monday August 13 Parade Company @ 10:00 am _______ $______ # Students Total

Total for field trip(s) $ _____________

Swim $10 per week/per child or pay one-time fee of $45 per child

___________________________________________ ______________ TOTAL CHARGE $_________ Parent Signature Date

_______ _______ ______________________________________ ____________ _______ Cash Check MasterCard/Visa/Discover Exp Date 3 Digit CVV

K-2 Only Goldfish June 28 $ ____ July 9 $____ July 20 $____ July 26 $____

Total for Swim

$ _____

August 7 $____

3-6 Only Macomb Pool June 26 $ ____ July 10 $____ July 18 $____ July 23 $____ August 6 $____