Snake River Canyon Day Hike

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Please fill this form out completely, even if you have completed these forms last year. It is the best way to give chaperones all of your contact, emergency, and insurance information.

We are headed to the Snake River Canyon near the Swan Falls Dam. Please remember that the lottery will occur on Thursday, November 7th and an email stating whether your student will attend or be on a waitlist will be sent that afternoon by 3pm.

Student First Name *

Student Last Name *

Grade *

6th Grade

7th Grade

8th Grade

Parent Name (Full Name) *

Parent (Emergency) Phone Number *

Parent Email Address (Please spell carefully!) *

2nd Parent or Contact (Full Name)

2nd Parent or Contact Phone Number

Does your child have any medical concerns or allergies we need to know about? If so, please explain and fill out Medication Form, if necessary. *

Health Insurance Company *

Primary Name on the Insurance Policy *

Policy Number *

Group Number *

Member ID Number *

Please submit the following to the front desk at Sage *

Signed Risk waiver (will be kept on file for the school year)

Copy of Medcation Form (If you're bringing medications)

If you are selected to participate, please submit $10 to the Sage front desk and put your student's name and "Snake River" in the For line

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