Ski/Snowboard Trip Permission Slip

Plattsburgh City School District

I give permission for (PRINT STUDENT’S FULL NAME)_____________________________

to attend the ski/snowboard trip to Titus Mountain on any or all Friday’s the 2/05/10, 2/12/10, 2/26/10, 3/05/10, 3/12/10. I understand that the cost for a lift ticket is $12.00 (no checks), tickets must be prepaid, and tickets are non-refundable if my child does not participate (discount rate and bus service is contingent on number of participants, if under 20 sign up cost will be $16.00).

I have discussed with my child that ALL SCHOOL & SKI AREA RULES AND REGULATIONS ARE TO BE FOLLOWED. If a cancellation is made due to low participant sign—up or inclement weather, money will be refunded.

Proper school bus etiquette will be strictly enforced during the ride, and students will be responsible for the cleanliness of the bus prior to being dismissed at the end of the trip.

The bus will leave from behind the Stafford Middle School at 3:30 PM.

The bus will depart the ski resort by 9:00 PM for the return trip, estimated (depending on road conditions) arrival time of approximately 10:30 PM.

I understand that skiing, snowboarding and related activities are HAZARDOUS and that injuries are common and ordinary occurrences during these activities. I AGREE FREELY AND VOLUNTARILY ASSUME ALL RISKS for my child,

including the risk of death, injury or damage associated with being permitted to use the ski area and its premise

Parent/Guardian (Signature) __________________________________

Emergency Telephone(s) _____________, ______________, _______________

Is there a medical concern regarding the student? Yes No

If yes, please also contact the school nurse at (518) 563-3170

Ski Rental $13.00 Snow Board $22.00 Lesson’s $6.00

Questions please talk to Mr. Given or Mr. Puschak

Keep the lower portion for your information

Titus Mountain Friday Evenings

The bus will leave from behind the Stafford Middle School at 3:30 PM

The bus will depart the ski resort by 9:00 PM and return at approximately 10:30 PM