NOCA Spirit Day @ Urban Air Permission Form

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We are pleased to announce that the NOCA PTO is partnering with Urban Air Adventure Parks for the 2nd year to host a private NOCA SPIRIT DAY Event. If you plan to have a student(s) attend, please completed this form ASAP so that we can better prepare for the event.

*Non-NOCA students, such as younger students, are permitted but, MUST be accompanied by a responsible adult.

Event Details:

Date: Thursday, March 16th from 12:00 PM to 3:00 PM (*No School)

Location: Urban Air Toledo (5243 Airport Hwy, Toledo, OH 43615)

Phone: (419) 205-8372 (office)

Cost: $22 per participant (3 Hour Access to the entire park, includes socks)

$5 for a lunch option (see below)

Email *

Parent Name *

Parent Cell Phone Number *

I understand that I must complete an Urban Air waiver for each of my children prior to participating the Urban Air Adventure Park. I understand is it best to complete this prior to minimize the wait time at the event. Urban Air Waiver (online) *

Yes

I understand that any participant, 5th Grade or younger, must be accompanied by a responsible adult. *

Yes

Adult Supervision *

I will volunteer to help at the event

I will attend to supervise my children (5th grade and lower)

I will not attend and have listed the guardian responsible for my children below

I will not attend and my students are 6th grade and above.

Name of Guardian responsible for my 5th grade and younger children.

Reply NA in not applicable.

Phone Number of guardian listed above (if not me).

*Reply NA in not applicable.

Number of participants ($22 ea. and/or paid with gift card or membership)

*Free vouchers are not acceptable.

Number of Lunches Packages Required ($5ea.)

*Lunch includes (2) slices of pizza and unlimited drink refills

Total Payment to Submit ($)

# of participants x $22

+ # of lunches x $5

- # of participants with approved Gift Card or Membership x $22

= TOTAL

Payment Method *

Cash or Checks are preferred and will allow for quicker access to the park on the day of the event.

Payments via check and cash MUST be received by Friday, March 10th.

Checks to be made out to: NOCA PTO and add Spirit Day to the memo.

Please include payment in an enveloped marked, "PTO- Urban Air" and included Student(s) Name(s). Envelopes should be given to your student's homeroom teacher.

Cash

Check

Pay at Urban Air via CC, Gift Card or Membership

Full Name Participant #1 (start with eldest) *

Full Name Participant #2

*siblings can be included, just list include (sibling) after their name. i.e. Johnny (sibling)

Full Name Participant #3

Full Name Participant #4

Full Name Participant #5

Full Name Participant #6

Full Name Participant #7

Full Name Participant #8

Full Name Participant #9

Full Name Participant #10

A copy of your responses will be emailed to the address you provided.

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