Andrews Middle School

Administrative Office
3000 Mystic Valley Parkway
Medford, MA 02155
P: 781-393-2228 F: 781-395-8128
Timothy S. Blake Paul D’Alleva
Principal Asst. Principal

8th Grade Field Trip to New York City

Registration Form
Please return this form with initial deposit no later than Monday, April 25 th

Student Name: _____________________________________

Homeroom #: _____________________________________

Name of Legal Guardian(s): _____________________________________

I give my child permission to attend the New York City trip from Friday June 17th to
Saturday June 18th with the Andrews Middle School. I understand that appropriate
behavior is expected at all times not only during the trip, but also in school so my child
may attend this field trip. Student misbehavior may result in my child’s trip ending early
and arrangement must be made at the expense of the student and/or student’s family for
the student to return home from New York City. Student misbehavior may also lead to
disciplinary action upon return from the trip. I further agree to supply necessary medical
and emergency information when the school supplies forms.

Parent Name (please print): ______________________________________

Parent Signature: ______________________________________

Student Name (please print): ______________________________________

Student Signature: ______________________________________

Initial Deposit: Please include an initial deposit of $50 made out to

Andrews Middle School

Andrews Middle School in partnership with Hallmark Health

“Excellence Through Responsibility and Respect”
Caso necessite de um intérprete para traduzir esta informação, favor contactar o Escritório de ELL pelo número: 781 393-2348.
Si un Interprete es necesitado a traducir esta informacion, por favor contacta la Oficina de ELL en numero: 781 393-2348
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