Good Citizens Day Form

Good Citizens’ Day!
On January 23, F.R. Haythorne will be presenting Good Citizens' Day. All students who have been consistently behaving and working well
will have the opportunity to spend the day at West Edmonton Mall. Students will pay $25.00 for the trip (cheques payable to F.R.
Haythorne). The list of non-eligible students was confirmed to those students by January 9. Students may be removed from the list up to
and including January 22 for making poor choices.
** REFUNDS WILL NOT BE ISSUED **
This is a regular attendance day for ALL students. Students will arrive/depart school at regular times, on their regular buses.
Non-Eligible Students: Students not going on the trip will remain at school working on core subjects using a modified schedule. They
should have their regular materials on hand including their physical education equipment.
Eligible Students
All eligible students will leave the school by school bus after morning attendance has been taken. They will need:
1.
2.
3.
$25.00 to the OFFICE by Thursday January 15. This covers the cost of the Choice Pass and transportation.
Signed permission form to the OFFICE by Thursday January 15.
Bagged lunch or money to buy lunch. There are long lines for food in the Waterpark. A bagged lunch is not allowed in
the Waterpark but students may leave to eat in the Food Court.
Students going to the Waterpark will need:
1.
2.
3.
4.
5.
$8.00 for locker rental (exact change).
Towel (or towel rental is available with a $5.00 deposit - $2.00 is returned for a net fee of $3.00).
Bathing suit
$5.00 if they wish to rent a tube for the wave pool
Life jackets ($2.00). Rental is optional
Students will not be allowed to leave WEM between 10:00 am and 2:00 pm. At 2:00 pm ALL students will leave WEM by school bus to
return to F.R. Haythorne in time for regular buses.
**This Permission Form must be returned by Thursday January 15, late forms will not be accepted as tickets need to be
purchased and transportation must be arranged .**
**ALL students, eligible and non-eligible, MUST return this permission form by January 15. Refunds will NOT be issued.**
Student Name __________________ Home Room Teacher_________________
Will attend:
_____ Waterpark
_____ Galaxyland
PERMISSION TO ATTEND GOOD CITIZENS DAY AT WEM.
PARENT: (Check mark one)
_____ Permission is granted for my son/daughter to participate in the WEM GOOD CITIZENS' DAY field trip. I have included the fee of
$25.00 for my child to attend. If paying for siblings, please submit a form for each child with one total payment attached.
Students will NOT be permitted to stay past 2pm at WEM and all students must return to FR Haythorne on the school bus. I
understand that if my child misses the 2:00 pm bus, I will be responsible for the costs associated with supervision/
transportation from WEM.
My son/daughter is NOT eligible to participate and WILL be AT SCHOOL on January 23, 2015.
My son/daughter is eligible to participate, but will not be going and WILL be AT SCHOOL on January 23, 2015.
X
Parent Signature
________________Date
STUDENT: I wish to participate in the WEM field trip on January 23 and will behave in a manner that represents F.R. Haythorne in a
positive way. I will meet the buses at 2:00 pm to return to FR Haythorne.
X
Student Signature
_____________Date
Emergency Contact Information :
Contact name: __________________________________________
Primary phone number(s): _________________________________
_______________________________________________________
If your child has any allergies or medical conditions which require
special consideration, that the school is not already aware of, please
contact the school at 780-467-3800.
Freedom of Information and Protection of Privacy – Notification of Use
The information collected on this form is for the purpose of coordinating a field trip within EIPS, including tracking permission and maintaining accurate emergency contact information. This personal information is collected pursuant to the provisions of the School
Act and Regulations thereto, and the FOIP Act, section 33(c). If you have any questions
about the collection and use of the information, please contact Elk Island Public Schools’
FOIP Coordinator, 683 Wye Road, Sherwood Park, AB T8B 1N2, 780-417-8204 or your
school principal.

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