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Field Trip Registration
Prof. Egghead – Ultimate Science Event
Step
1
of
3
33%
STUDENT DETAILS
STUDENT NAME
(Required)
First
Last
Grade Level
(Required)
1
2
3
4
5
PARENT/GUARDIAN DETAILS
PARENT/GUARDIAN NAME
(Required)
First
Last
Email
(Required)
Phone Number
(Required)
How did you hear about this event?
My student
Social Media
School Newsletter
Teacher
Friend/Family Member
Other
6. Permissions & Agreements
Learning Funds Release Authorization
(Required)
I acknowledge that by submitting this registration form, I am authorizing Epic California Academy to process and release the required learning funds for my student’s participation in this field trip. I understand and agree that once funds are released, they are committed to the vendor and refunds cannot be guaranteed for any reason, including but not limited to student absence, illness, schedule changes, or trip cancellation.
Acknowlege
Parent/Guardian Intials
(Required)
Media Release Authorization
Epic California Academy may photograph, film, or record students during this field trip for use in school publications, social media, websites, or other promotional materials. By completing this form, you acknowledge and grant permission for your student to be included in such media.
I DO NOT authorize Epic California Academy to use my student’s name, image, or likeness for the purposes stated above.
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