Good News Christian Academy 13735 US HIGHWAY 64 DULCE, NM 87528 TELEPHONE 575-759-1390

Washington, D.C. 2012

What is my room assignment? How much money should I bring? Who is my chaperone?

Where do we eat?

What are the rules? Is there a curfew?

Dear Parents,

CAN I BRING A CELL PHONE?

What if Im sick?

The answers to these and many more questions will be addressed when Good News Christian Academy presents a Tour Preview on Thursday evening, September 22, 2011 at 6:00 p.m. at GNCA. Trip packets will be available for pick up beginning at 5:45. ALL students and their parents MUST attend this MANDATORY informational meeting. If you have any questions or concerns, this is your opportunity to express them. The success of the trip is dependent on your attendance and participation. In His Service,

Christian Epling DC Tour Coordinator ______________________________________________________________________________ Please sign and return to Christian or GNCA staff by Friday, September 16, 2011. ____ Yes, we will be attending the Washington, D.C. informational meeting. ____ No, we will be unable to attend. (Please call Christian at 575-209-9330)

____________________________________ Student Name

______________________________ Parent/Guardian Signature

Good News Christian Academy 13735 US HIGHWAY 64 DULCE, NM 87528 TELEPHONE 575-759-1390

Washington, D.C. Tour, 2012 Good News Christian Academy Medical Release Form Date ___________________ Dear Parent/Guardian, (We, I) hereby grant permission to Good News Christian Academy to secure such medical care as (name of student) _______________________________________ may require for the period from April 19-28 2012, including examination, treatment, and X-Rays. This permission is conditional upon the understanding that in the event of serious illness or the need for surgery, the Washington trip chaperones will use all reasonable efforts to contact me. However, failure in such efforts should not prevent rendering of necessary emergency treatment.

__________________________________________ Parent/Guardian Signature

__________________ Phone Number

__________________________________________ Parent/Guardian Signature

__________________ Phone Number

Good News Christian Academy 13735 US HIGHWAY 64 DULCE, NM 87528 TELEPHONE 575-759-1390

FIELD TRIP CONSENT FORM

STUDENT NAME: _____________________________________ D.O.B. ____________ GRADE: ________ YES I Would like to have my child named above take advantage of the field trip that you are planning. I understand the children will be visiting: Place: Washington, D.C. Metropolitan Area & Williamsburg, Virginia Date: _____________________

In the event of an emergency during which we cannot be reached, we hereby give permission to the bearer(s) of this form to allow any doctor or medical facility to administer and perform such emergency procedures as may be necessary for our child. We hereby release and hold harmless the Good News Christian Academy, its agents, servants, chaperones or employees from any liability and/or responsibility for any damages or injuries sustained by our child while under your care, not caused by the lack of due care by Good News Christian Academy, its agents, servants, chaperones or employees duly authorized. y VERY IMPORTANT!!! The following information must be completed in full in order for the child to participate. Please be sure to indicate all telephone numbers requested as well as the insurance information and policy numbers!!!This information will be the only information traveling with the group on the field trip.

Home Address: ______________________________________ Home Phone: _____________________ Father s Name: _________________________ Work Phone: ______________ Cell: ________________ Mother s Name: ________________________ Work Phone: ______________ Cell: ________________ Emergency Contact (other than parent) Name: _______________________ Phone#: _______________ Name: _______________________ Phone#: _______________ y y Health Ins. Co. ________________________________ Policy # _______________________ Date of last Tetanus Shot (DTP, Tdap or Td): ___________________ Month/Year

Any Allergies? To Medications: ___________________________________ Other: _____________ ************************************************************************************* LIST ANY SIGIFICANT HEALTH PROBLEM YOUR CHILD MAY HAVE OR ANY REGULAR MEDICATIONS YOUR CHILD TAKES: _____________________________________________________________________________________ _____________________________________________________________________________________

Good News Christian Academy 13735 US HIGHWAY 64 DULCE, NM 87528 TELEPHONE 575-759-1390

FIELD TRIP CONSENT FORM (cont.)

Please check the appropriate need: _____ It is not necessary for my child to take ANY medications on this field trip. _____ My child may have his/her medication administered by GNCA agent, servant, chaperone or Employee, which is placed in a labeled prescription container or original store package. My child may _____ may not _____ receive Non-Aspirin (Tylenol)

Parent/Guardian Signature ____________________________________________ Date ______________ Parent/Guardian Printed Name ___________________________________________________________

Complete & sign ONLY if your child will be taking medication on the trip.