Student & Parent Notification/Consent Form

Student & Parent Notification/Consent Form - Day Trips The Ailey School 2019 Summer Intensive

TRIP INFORMATION AND SCHEDULE

INFORMATION SCHEDULE School The Ailey School 7:30am Call for students departing from Ailey School Address 405 W. 55th Street, NY, NY 10019 8:15AM Departure for Six Flags Date Saturday, July 20st 9:45AM Arrival to Six Flags

Destination Six Flags Great Adventure & Safari 1:30-2:30PM Catered lunch served in Park Pavilion

1 Six Flags Boulevard Event Address 5:30PM Call for students departing from park Jackson, NJ 08527

Transportation Yankee Line Bus Company 6:00PM Departure for The Ailey School

Patrick Piras Contact Email: [email protected] Arrival to The Ailey School 7:30PM Coordinator Phone: (212) 405-9138 Parents pick-up students Fax: (347) 328-5663

DRESS CODE

Proper attire must be worn at all times, including shirts and appropriate footwear. Clothing with rude, vulgar or offensive language or graphics is not permitted (shirts cannot be turned inside out as a solution). Bathing suits are not permitted. Park admission may be denied if clothing is deemed by management to be inappropriate.

APPLICATION REQUIREMENTS

1. PAY ticket fee* 2. APPLY by June 7th, 2019^ 3. EMAIL form & JPEG photo + $95 Regular Entry OR Complete application (p2) and [email protected] $55 Season Pass Holder attach proof of payment. www.theaileyschool.edu/paytrips +Photos should be sent in JPEG OR ^Payment, proof of payment and format. School photos are preferred Money order/certified check consent form required by 6/7/2019. and should accurately represent the payable to THE AILEY SCHOOL Space is limited and allotted on a student’s face. Photos may be taken *All-inclusive package: discounted first come, first served basis. with a smartphone. admission, lunch and transportation.

REFUND POLICY

Students that cancel their reservation for Six Flags Great Adventure after June 7th, 2019, withdraw from The Ailey School Summer Intensive, or get dismissed from McMahon Hall or The Ailey School, will not receive a refund. There will be NO exceptions to this policy.

Please submit form, proof of payment, and photo by June 7th, 2019 by email, fax or mail, ATTN: Patrick Piras. EMAIL: [email protected] FAX: (347) 328-5663 MAIL: 405 W. 55th Street, NY, NY 10019

STUDENT INFORMATION Name: Date of Birth: Age: Program Division: Junior Professional Gender: Male Female Email: Cell Phone: Local Address: McMahon Hall Ludlow Residence Other: Allergies: Season Pass Holder? No Yes PARENT INFORMATION Name: Relationship to student: Email: Cell phone:

TERMS AND CONDITIONS

This trip will include physical and recreational activities. Six Flags Great Adventure offers 15 major coasters including Wonder Woman, The Joker, El Toro, Kingda Ka, Nitro, GREEN LANTERN and Bizarro. Admission includes more than 75 other rides, shows and attractions as well as admittance to the all-new Safari Off Road Adventure. Hurricane Harbor, Six Flag’s Waterpark is NOT included in this trip. Admission to Hurricane Harbor is prohibited for ALL Ailey School students.

a. I understand that there are risks of injury associated with the above-listed activities and I consent to my own and/or my child’s participation in all these activities except for the following: ______b. Please indicate below any permanent or temporary medical or other condition, including special dietary and medication needs, or the need for visual or auditory aids, which should be known about you and/or your child: ______c. I agree that in the event of an emergency injury or illness, the staff member(s) in charge of the trip may act on my behalf and at my expense in obtaining medical treatment for me and/or my child. d. I understand that I am and/or my child is expected to behave responsibly and to follow the school’s discipline code and policies. e. I agree and understand that I am responsible for my own actions and/or the actions of my child. I release the school from all claims and liability that arise in connection with the trip, except if due to the negligence of school officials. f. I understand that I am responsible for getting myself and/or my child to and from the departure and return sites identified above. I understand that I and/or my child shall be accompanied by staff member(s) during the trip, including while traveling from the departure site to the destination site and from the destination site to the return site. g. I understand that alcoholic beverages and/or illegal drugs are prohibited. If I am signing this form on behalf of my child, I have discussed this prohibition with my child. I understand that if my child is found in possession of these prohibited substances, he/she will be subject to school disciplinary procedures and possible criminal prosecution. If I am signing this form on behalf of myself as an adult, I understand that if I am found in possession of these prohibited substances, I will be subject to school disciplinary procedures and possible criminal prosecution. h. I understand that students who violate the school's discipline code may be excluded in the future by the school from participating in a trip. i. In an emergency, the parent/guardian of the student can be reached by phone as indicated above.

ACKNOWLEDGEMENT AND SIGNATURES

I have read and agree to the terms set forth in this form and I For students who are not yet 18 years old, by my signature, I am confirming understand that I am to act on this trip in the same responsible that I am the parent and/or guardian of this student. I give my permission for manner in which I am expected to conduct myself in school. my child to participate in this school trip and I have read and agree to the terms set forth in this form on the student’s and on my own behalf.

Signature of Student Date Signature of Parent/Guardian Date