Name_____________________________________Student ID__________
Class of 2013 Senior Munch:
Medieval Times: Mon. 2/4/13 6:15pm-9:30pm
Universal Studios: Mon. 3/18/13
8:30am-4pm
Senior Munch Ticket Prices:
Dates
Medieval
Price With ASB
Medieval
Price Without
ASB
Universal
Price With
ASB
Universal
Price
Without ASB
01/14 - 01/18
01/22 - 01/25
$36
$39
$39
$42
$50
$50
$55
$55
MEDIEVAL TIMES ONLY: Students may choose to drive themselves to Medieval Times or take the bus.
The bus is completely free of charge. However, if you check the option of taking the bus, you must take the bus
to and from Medieval Times. If you sign up for the bus, but do not ride the bus, you may be excluded from
future senior events. Please plan to be at FHS at 5:45pm if you would like to ride the bus to Medieval Times.
UNIVERSAL STUDIOS: All students MUST take the bus to the event and back to Foothill. If you do not go to, and
return, on the bus you may be excluded from Graduation and subject to disciplinary action. Remember, you need to be
at Foothill by 8:30 AM. We should be back at Foothill around 4 PM. Please plan accordingly with your work, sports,
ROP classes, elementary aide, etc. All FHS rules apply while on a school sponsored trip. It is NOT possible to go late or
leave early. NO EXCEPTIONS!!!
If you have an Annual Pass to Universal Studios: you do not need to buy a ticket. You MUST purchase the bus ticket for
$15. Please check your pass to be certain it will not have expired by, or be blacked out on, the date of the munch.
Students are encouraged to wear their senior t-shirts to these events!
Parent Permission and Agreement of Codes
I hereby agree to all the codes of conduct and expectations outlined on these forms. If I do not meet these expectations in
any way I may face several consequences upon returning to school including, but not limited to, loss of senior privileges,
exclusion from future senior munches, and other consequences to be determined by the administration. By signing my
name below, I and my parent(s) am agreeing to this code.
Student Signature_____________________________________Date________________
Parent Signature _____________________________________Date_________________
TICKET ORDER FORM:
Check here
to purchase
Place an X next to the items you would like to purchase
Event
Medieval Times
Medieval Times with Bus option
Universal Studios (admission ticket + Bus)
Universal Studios bus only ticket (Annual Passholder)
Ticket Sold By_____________________
For office use only
(turn over and complete the Permission and Information form)
PERMISSION AND INFORMATION FORM
TRIP INFORMATION
School:
Foothill High School
Group: Class of 2013
Destination:
MEDIEVAL TIMES
Universal Studios Hollywood
Duration: 6:15 - 9:30pm
Medieval Times
8:30am-4pm
Universal
Date of Trip:
2/4/13 (Medieval)
3/18/13 (Universal)
Advisor: Knowlton & Molina
Activity/Purpose: Senior Munch
Departure: 6:15pm (Medieval) Return: 9:30pm (Medieval Times)
8:45am (Universal)
4pm (Universal)
STUDENT INFORMATION
Name:
Transportation:
Medieval: OWN or Bus
Universal: Bus
Date of Birth:
Street Address:
City/Zip:
Phone: Home (
)
Parent Work:
(
)
Parent/Guardian Name:
Insurance Company:
Policy #:
Allergies/Medications/Medical Condition: If you have any special
instructions, kindly attach an explanation and check the appropriate box.
 Instructions Attached
 No Instructions Attached
EMERGENCY CONTACT (Use a contact other than parent/guardian listed above)
Name:
Relationship:
Street Address:
City/Zip:
Phone: Home (
)
Work:
(
)
STUDENT CONDUCT
The Principal/designee has thoroughly explained the purpose of this trip, safety rules, and rules of conduct. In addition to rules and consequences established by the
transportation provider, facility, or other organizer of this event, all school and district rules apply, including those related to alcohol and drug use. The consequences
for violating those rules will be the same as if the violation were committed at school.
TO THE PARENTS
Please read carefully the information about the trip, itinerary, and other information provided above. Complete the contact and emergency information. Be sure to
check the appropriate box and attach special medical instructions as necessary. Please note that all school rules, including those related to alcohol and drug use will
apply while on this field trip. Your student will be held accountable for behavior as if he or she were at school.
LIABILITY RELEASE
As provided for in California Education Code Section 35330, the parent/guardian waives all claims against the State of California or the Tustin Unified School
District, its officers, employees and agents, for injury, accident, illness or death occurring during or by reason of this trip.
MEDICAL AUTHORIZATION
In the event of any illness or injury, the parent/guardian hereby consents to whatever x-ray, examination, anesthetic, medical, dental, or surgical diagnosis and/or
treatment and hospital care from a licensed physician and/or surgeon as deemed necessary for the safety and welfare of the student. It is understood that the resulting
expenses will be the responsibility of the parent/guardian and the school or district does not provide medical coverage for participants in this activity.
I (we) have been informed about this field trip and agree to the Student Conduct, the Liability Release and Medical Authorization.
Parent/Guardian Signature
_________
___________________
_________
Date
Student Signature
Date
Ticket Sold By_____________________
For office use only