Class of 2028 - 6th Grade Retreat - September 19, 2025

* Required

STUDENT NAME*required

First Name

Last Name

PARENT/GUARDIAN 1 NAME*required

First Name

Last Name

PARENT/GUARDIAN 1 PHONE NUMBER*required

PARENT/GUARDIAN 1 EMAIL ADDRESS*required

PARENT/GUARDIAN 2 NAME*required

First Name

Last Name

PARENT/GUARDIAN 2 PHONE NUMBER*required

PARENT/GUARDIAN 2 EMAIL ADDRESS*required

I/We certify that all medication and allergy information is up to date in the Magnus Health Portal. The school nurse is authorized to provide necessary medical information to the lead teacher for this trip.*required

I AGREE

I/We hereby release and save harmless, the school of Norwood-Fontbonne Academy and any and all of its employees from any and all liability for any and all harm arising to my/our son/daughter as a result of this trip. In case of a medical emergency, and where I/we cannot be reached in advance, I/we hereby give permission to Norwood-Fontbonne Academy and/or the named supervising parent/chaperone to secure proper medical treatment for my child as named above. I also certify that my child is covered under the following health insurance coverage:*required

I AGREE

I give my child permission To Go On the 6th Grade Retreat*required

I AGREE

PARENT/GUARDIAN SIGNATURE*required

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