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Off-Campus Program – “Disco Daze”
I give permission for
Students Grade Parent/Adult
___________________________ _________________________
___________________________ _________________________
___________________________
to participate in a field trip to “Disco Daze” at the North Kitsap Auditorium in Poulsbo on Thursday, April 21st from 12:45 to 3:00 PM.
Number attending: _____ at $ 3.00 each = $ _______
Enrolled students and one adult chaperone are given first priority, others may attend if space is available with Off Campus permission .
The following special health problems should be noted: (i.e.: unusually severe reaction to bee stings, severe allergies, hemophilia, diabetes, and heart disease, etc.)
Parents are responsible for their child’s/children’s behavior while on the field trip and will hold harmless employees of the Central Kitsap School District for accidents and/or damage not the fault of the employee.
Parents must accompany children.
Signed ___________________________ Home Phone: _____________________ Date: ___________________
CENTRAL KITSAP SCHOOL DISTRICT NO. 401
Silverdale, Washington 98383
“Disco Daze”
Date: Thursday, April 21, 2005
12:45 p.m. Meet in front of the North Kitsap Auditorium
(Allow plenty of time for parking)
1:00 p.m. Showtime
Time: Approx. 2 Hours
Limit: 30 seats
Deadline: Thursday, April 21, 2005
Cost: $3.00 per seat
The North Kitsap Auditorium is located across Hostmark Rd. from the high school in Poulsbo.