December Trips 2013: School Vacation Trips, Kindergarten - Sixth Grade

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December Trips 2013

School Vacation Trips, Kindergarten - Sixth Grade

Monday, December 23
Indoor Water Park
Coco Key | NJ
Members: $55
Non-members: $60

Friday, December 27
Bowling at Paradise Lanes
& IMAX Movies | NY
Members: $55
Non-members: $60

Monday, December 30, 2012


Castle Fun Center
Chester | NY
Members: $55
Non-members: $60

AAll participants must bring lunch. A snack will be provided. Participants may be dropped off between 8:00am-9:00am.
Bus will depart for trip at 9:00am. Participants must be picked up by 6:00pm or late fees of $20 for the first 15 minutes
and $1 for each additional minute will be charged. All trips subject to change.

December Full Day Trips Registration Form 2013

Return in person to Mosholu Montefiore Community Center: 3450 Dekalb Ave. Bronx, NY 10467
Childs Full Name_______________________________________________ Grade________ School______________________________________
Address___________________________________________________________________________________Apt______ Zip_________________
Parents Name________________________________________________ Cell Phone # __________________________ Work #________________
Parents Name ________________________________________________ Cell Phone # __________________________ Work # _______________
Emergency Name & Phone # _______________________________________________________________________________________________

check here ( ) for Dec. 23

check here ( ) for Dec. 27

check here ( ) for Dec. 30

Total Member Amount Enclosed $_______ (Members have already paid the $245 Family Membership fee)
Total Non-member Amount Enclosed $_______
I give permission for my child to participate in all activities and receive emergency medical care, if needed.
There will be no refunds.
Known Illness/Allergies______________________________________________________________________

Please check here if you


want your child to walk
home.
____________Intial Here

Parents Signature__________________________________________________________________________
Please indicate who is allowed to pick up your child _______________________________________________

Mosholu Montefiore Community Center | 3450 Dekalb Avenue Bronx, NY 10467


(718) 882-4000 www.mmcc.org

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