Lagoon Permission Form

GUIDELINES:

  • Only graduated 1st grade and older children and at least 46" tall will be able to attend.

  • If you choose to not have your child attend Lagoon, you will need to find alternative care for the day.

  • We need chaperone's. You will need to drive yourself and pay for yourself.

  • NO MONEY may be brought on the field trip.

  • No Extra fees apply due to receiving a grant for this year.

  • Children must stay with an A to Z Team Member at all times. 

  • If a child is struggling to follow directions a parent must come and pick the child up. 

  • Ratios: 2 Adults for every 10 children.

  • CHILD(REN) INFORMATION

    Child 1(Required)
    Child 2
    Child 3

    EMERGENCY CONTACT INFORMATION

    Please list someone other than the person completing this form.
    Name(Required)

    CHAPERONE INFORMATION

    We are needing chaperone's on this field trip and would like to have as many as we can get. As a chaperone, you must be with an A to Z Building Blocks team member at all times. The team member and you will be assigned to a group of 10 children. We cannot allow additional siblings or children that are younger or not registered with our facility to attend. You will need to drive yourself to Lagoon and pay for the admission.
    Will you or someone else be chaperoning?(Required)
    Name

    SIGNATURE AND CONSENT

    I certify that I am the parent or guardian of the above-named child(ren). A to Z Building Blocks has my full permission to allow my child(ren) to attend Lagoon. I agree to hold harmless and release from liability A to Z Building Blocks or any employee or representative thereof, for any action, claim, or damage that may arise as a result of my child's participation. In the event my child needs emergency or medical treatment, every attempt will be made to contact us, the parent/guardian. In the even I/we cannot be contacted, my authorized signature below gives my/own permission to A to Z Building Blocks to secure prompt treatment.
    My child and I agree to this form(Required)
    Parent/ Guardian Name Signing Form(Required)
    MM slash DD slash YYYY