Editing previous response:

Please fix the highlighted areas below before submitting.

6th Grade 11/20/24 Field Trip to Atrium Movie Theater

Location: Atrium Stadium Cinemas, 680 Arthur Kill Rd. Staten Island, NY 10308.

Red One

Date: Thursday, October 31st. Bus depart at 9 AM and return before 1 PM

Cost: $16 for ticket and snack pack

All families must complete a physical field trip consent form. This form is for payment only.

Student Last Name*

Answer Required

Student First Name*

Answer Required

Parent/Guardian First Name*

Answer Required

Parent/Guardian Last Name*

Answer Required

Parent/Guardian Email Address*

Answer Required

Parent/Guardian Phone Number*

Number Required

Emergency Contact Name*

Answer Required

Emergency Contact Email*

Answer Required

Emergency Contact Phone Number*

Number Required

Important medical information that we should know

Answer Required

I am the Parent or Legal Guardian of the student named and give permission to participate in this field trip.

Bus, Movie, Snack Pack Fee*

Price: $16.00

Confirmation Email

Confirmation Email *

Email Required