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CHARLOTTE-MECKLENBURG SCHOOLS
CLASS TRIP STUDENT PERMISSION FORM

Date: 4/17/17

Dear Parents:

A class trip has been approved to the Booth Playhouse, 130 N. Tryon St. on Friday, April
21, 2017

Purpose: The students will attend a performance of Star Gazer: A Trek Into
Outer Space that blends videography with dance and circus arts on a journey
through our solar system.

The signature of a parent/guardian is required in order to allow your child to participate

in this off-campus trip. Please sign the bottom portion of this form and return it to the
teacher.

Listed below is a description of the trip and how it represents a part of the curriculum.

Sincerely,

Ms. Fernandez

Mode of travel: X School/Activity Bus [ ] Car(s)[ ] Other

Cost of trip:
Time of departure from school: 9:00 Time of return to school: 12:45
Additional information about the field trip:
***Students will need to bring money for food to eat.

I have read the field trip description.

I give permission I do not give permission

for to go on this trip sponsored by the
Students full name
Charlotte-Mecklenburg schools. Cash or check enclosed, if applicable.

Date Parent/Guardian