Trip - Poland Band Parents

PSHS Marching Band Orlando Trip
December 26, 2015 – December 31, 2015
TRIP INCLUDES: Roundtrip motorcoach transportation and gratuity
3 nights hotel accommodations exterior corridors (quad occupancy)
All meals (5 breakfasts, 5 lunches, 4 dinners)
3-day pass to Universal Studios Orlando and Island of Adventure,
including the new Harry Potter World
STARS Workshop - Sound Design: Music and the Art of Foley
Ticket to Blue Man Group show
$725.00 per person quad occupancy
Should you have fewer than four persons per hotel room the following price(s) will be charged
for those students:
Triple: $775.00/student
Double: $825.00/student
Non-refundable deposit of $125.00 due in May, 2015
Payment 1 of $200.00 due in August, 2015
Payment 2 of $250.00 due in September, 2015
Payment 3 of $250.00 due in October, 2015
Rules and Regulations:
1. The $125 deposit is not refundable.
2. All school rules are in effect for the duration of the trip.
3. Any violation of a school or trip rule may result in the student being sent home at the
expense of their parents. In addition, any student who violates a rule on the trip will face
additional disciplinary action from the PSHS administration upon return home.
4. No drugs, tobacco, or alcohol are to be brought, purchased, or consumed on the trip. If
prescription or OTC medication is needed, they must be turned in at the beginning of the
trip and will be dispersed by trained school personnel.
5. Any updates should be made to emergency medical forms if necessary prior to departure.
Submit a letter to Mr. Olesko with the changes no later than one week before the trip.
Please detach and return with a check payable to Poland Band Parents
----------------------------------------------------------------------------------------------------------------------------- -------------My son/daughter has my permission to travel to Orlando with the Poland Seminary High School Marching Band
from December 26-31, 2015. I have read and understand the rules and regulation as printed above. I understand
that the $125.00 deposit is non-refundable.
Student Name (print)_________________________________________
Student Signature____________________________________________Date_________
Parent or Guardian Name (print)________________________________
Parent or Guardian Signature___________________________________Date________
____ I am interested in chaperoning the trip (do not send any money at this time)
Email address_________________________________
Daytime phone number_________________________
Payment Method (check one)
___
I would like to use $125.00 from my band account
___
I have included a check for $125.00 payable to Poland Band Parents
___
I would like to use $_______ from my band account, and have included a check for $_______
to cover the rest of the $125.00 deposit (amounts must equal $125.00)