Chaperone Request Form - Monroe County School Safety Patrol

MONROE COUNTY
SCHOOL SAFETY PATROL PROGRAM
www.monroecountysafetypatrol.org
Dear Safety Patroller Parent/Guardian;
Please complete the “Safety Patroller Registration and Consent” form and “Safety Patroller Reservation”
form and in addition the “Request to be a Chaperone” form if you wish to serve as a chaperone for your
child’s trip to Washington, D.C. If the forms did not accompany this letter they can be downloaded at the
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website [www.monroecountysafetypatrol.org]. The dates of the trip are Thursday, April 16 , 2015 to
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Monday, April 20 , 2015. Please review the forms, complete, and return them to me as soon as
possible. If you decide that your child will not be participating, please send the forms back to the school
so that someone else can have the opportunity to go on the trip.
The cost for the 2015 trip is $626.00 per child. This cost covers all expenses for the five-day trip, with the
exception of spending money for souvenirs, snacks, etc. I will need to have an initial deposit of
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$313.00 on or before December 20 , 2014. The balance of $313.00 will be due on or before March
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10 , 2015. Because of the large number of students involved and the payment schedule required by our
travel agency, I do need to hold firmly to these deadlines. Failure to make payments by the scheduled
dates may result in the seat being given to someone else. No refunds can be provided after March
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26 , 2015.
The cost for adult chaperones will be $735.00. Please DO NOT send me a deposit or full payment for
the trip until you receive confirmation of your selection as a chaperone. I will first be working on
getting students arranged onto buses before I start with chaperones.
I will be setting dates for the chaperone meetings and informational meetings with the safety patrollers
and parents/guardians in the very near future. These dates will be relayed to you through the schools
and posted at our Website [http://www.monroecountysafetypatrol.org] and Facebook Page
[https://www.facebook.com/monroecountysafetypatrol].
Mail completed forms to:
Monroe County Safety Patrol
Cedric Schnitzler
7239 Farmland Ave.
Sparta, WI 54656
Sincerely,
Cedric Schnitzler
School Safety Patrol Program Coordinator
(608) 269-5228
Attachment(s)

Safety Patroller Registration and Consent Form

Safety Patroller Reservation Form

Chaperone Request Form
Rev.10/03/2014
Cedric Schnitzler, School Safety Patrol Program Coordinator  7239 Farmland Ave., Sparta, WI 54656  (608) 269-5228
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