MB 4th Grade Field Trip-Madison

Minimum Quantity: 1
Pay by March 15, 2020:
Student First Name:
(Max 25 Characters)
Student Last Name:
(Max 25 Characters)
Student's Teacher:
Parent First Name:
(Max 50 Characters)
Parent Last Name:
(Max 50 Characters)
Phone number day of field trip:
(Max 25 Characters)
Interested in Chaperoning?:
(Max 25 Characters)
Name of Potential Chaperone:
(Max 25 Characters)
Medical/Health concerns specific for this trip: Information
(Max 200 Characters)

Where:  The State Capitol Building and the Henry Vilas Zoo

When:  Wednesday, April 15, 2020

What to bring:  Warm clothes, bag lunch

Time: 7:30 AM to 5:30 PM

Cost:  $23.00

For this field trip your child will need to bring a bag lunch and school appropriate beverage / or indicate on the electronic form if your student requires a school breakfast and / or lunch .

*In the event of sudden illness or injury, appropriate medical care will be obtained.*


By signing my child up for this field trip, I acknowledge that I understand and agree to all of the terms and conditions of this field trip.


Please utilize this form for students only; a separate form will need to be completed for all chaperones who have been approved by the District. If you express interest in attending with your child - a form will be sent home with your child.


Thank you,


Mrs. Geiser, Ms. VanDenPlas, Mrs. Berg, Mrs. Bauknecht and Mrs. Tousignant