Metrocon
www.AnimeMetro.com
Date: July 18-20 (Friday-Sunday)
Leaving: 6:30am Friday
Returning: 7:00 pm (approximately)
Meeting place: Countryside High School
Location: Crowne Plaza Hotel
10221 Princess Palm Ave.
TAMPA, FL 33610
Local Phone: 0001-813-6236363
Number of people per room: 4
Chaperones: 3
Cost: $77 (all money will be reimbursed when enough money is made from fundraising)
What to bring: - Clothes for 2 days
- Toiletries
- Spending and food money
- Camera
- Art work
- Costumes
Note: If someone who is not in the Japanese Club at Countryside High School, however old or young they are, is interested in going on this trip, they just need a copy of this form to fill out and then they can send it and the money to me. Sarah Michael, 20 Village lane, Safety Harbor, FL, 34695. They may also participate in fundraisers.
Form and money Due June 4th. We will be registered to go by May 20th. After that date if you would still like to go, call me, Sarah Michael, at (727) 725-2425, and I will let you know if we still have room.
Name (first & last):__________________________________ Home Phone: (_____)__________
Street Address: ___________________________________________ Gender: M___ F___
City:______________________________________ State:___________ Zip Code:__________
Guardian�s Name:__________________________________ Work Phone: (_____)___________
Guardian�s Name: _________________________________ Work Phone:(_____)____________
Emergency Contact:
Name: _______________________________________ Phone Number: (_____)____________
Health Problems:
______________________________________________________________________________
Medication:
______________________________________________________________________________
Special Needs:
______________________________________________________________________________
Comments:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
The Metrocon trip is not through the school because Countryside High School will not acknowledge our club so late in the year. This form is simply to ensure the safety of your child if an accident does occur. We encourage that the members of the Japanese Club use common sense and safety precautions during the trip. Individual members shall be responsible for their own actions. The Japanese Club will not be held liable.
I herby give consent for my child to attend this event:
Signature:___________________________________________ Date:________________
Student Signature:_____________________________________ Date:_________________
Yes! I am interested in chaperoning [] No. I am not interested. []
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