Utica Community Schools/Community Education

Summer Camp Field Trip/Swim Permission Slip and Payment

School Year SACC Building: __________________________ Sumer Camp Site: Beacon Tree

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/per child or pay one-time fee of $155 per child

Thursday June 22 Blake’s Orchard @ 10:00 am _______ $______ # Students Total

Tuesday June 27 Adventure Park @ 10:30 am (3-6 only) _______ $______ # Students Total

Wednesday June 28 Jeepers @ 10:00am (K-2 only) _______ $______ # Students Total

Thursday July 6 Cranbrook @ 10:00 am _______ $______ # Students Total

Thursday July 13 Zap Zone @ 10:00 am (K-2 only) _______ $______ # Students Total

Friday July 14 The Rink @ 10:00 am (3-6 only) _______ $______ # Students Total

Thursday July 20 Jimmy Johns Field @ 10:00 am _______ $______ # Students Total

Wednesday July 26 Red Oaks Water Park @ 11:00 am _______ $______ # Students Total

Friday August 4 Emagine Theater @ 10:00 am _______ $______ # Students Total

Wednesday August 9 LEGOLAND @ 11:00 am (K-2 only) _______ $______ # Students Total

Thursday August 10 Barrymores (3-6 only) _______ $______ # Students Total

Monday August 14 U of M Dearborn Nature Center @ 10:30 am _______ $______ # Students Total

Total for field trip(s) $ _____________

Swim $10 per week/per child or pay one-time fee of $35 per child

___________________________________________ ______________ TOTAL CHARGE $_________ Parent Signature Date

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

K-2 Only Goldfish June 29 $ ____ July 12 $____ July 18 $____ August 1 $____

Total for Swim

$ _____ 3-6 Only Macomb Pool June 26 $ ____ July 3 $____ July 11 $____ July 21 $____