* 1. What is the student's last name?

* 2. What is the student's first name?

* 3. What is the student's cell phone number?

* 4. What is the full name of your parent or legal guardian?

* 5. What is the cell phone number or emergency contact number of your parent or legal guardian?

* 6. I understand that if I am not at Smedley by 8:45am on Friday, March 24th, the bus may leave without me.  Therefore, I will plan ahead and be on time!

* 7. I understand I need to complete and return a signed permission slip and return it to Counselor Casey Burton (casey_burton@dpsk12.org) by March 20th (the Monday before the field trip).  If I do not complete this task, I will be not be able to go on the field trip.