Senior Cruise Trip to Headliner Infot

Visible image transcription: Brooklyn Technical High School David Newman Principal 201 Furman Street - Brooklyn, New York 11201 - Telephone (718) 804-6400 - Fax (718) 804-6470 www.bths.edu * Must be notarized * $125 - NON-Refundable* NOTE: Additional trip information may be sent to the team based on the unique circumstances of a particular trip. All other modifications require approval of the Office of Legal Services. Due Oct+8 Page 1 of 2 PAARENT NOTIFICATION/CONSENT FORM DAY TIME Name: School (for additional trip approvals when applicable): Blythe Tech H.S. Class: 2027 Trip Date: 11/02/26 Trip Coordinator: Mrs. Robinson-Brown (Mrs. R.) Destination: Per: 15-78 South Street, NY 10038 - Headliner Infot Departure Site: Per 15 Departure Time: 6pm Return Site: Per 15 Return Time: 10pm Mode of Transportation: Purpose of Trip: Senior Cruise - FUN!! Specific Clothing/Equipment Required for this Trip: Dancing This trip will include the following physical and sports activities (e.g., swimming, horseback riding, ice skating, skiing, boating, etc.): a) I understand that there are risks of injury associated with the above-listed physical and sports activities and I consent to my child's participation in all these activities except for the following: b) I agree to believe 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 your child. Allergies?? Please provide info 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 my child. d) I understand that 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 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 my child to and from the departure and return sites identified above. I understand that 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 and have discussed this prohibition with my child. I understand that if my child is found in possession of these substances, he/she 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 I can be reached at: Day: ( ) Evening: ( ) Additional Contact: Name: Day: ( ) Evening: ( ) j) I give my permission for my child to participate in this school trip. (Signature of Parent/Guardian) Notary: (Date)

· image:email-image-34