Burlington Prison Museum
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Parent Name
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First Name
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Additional Adult (Optional)
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Last Name
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Phone
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Parent Attendance
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I will not attend and request a chaperone
Trip
Land of Make Believe
Number of Attendees
Students attending trip
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Student Summary
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Terms and Conditions
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NOTE: For payment, please ensure that you adjust the quantity of students and adults to accurately reflect the number of participants attending this trip prior to checking out.
Photos.
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I grant permission for my student(s) photo/video to be taking during this field trip for community-related use including The Field Trip Society website, App, social media pages, and promotional materials.
I do not grant permission for my student(s) photo/video to be taken during this field trip.
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Burlington Prison Museum
Pricing
$5.00
$
5.00
Quantity
Price
All (Members Only)
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$5.00
$
5.00
Non-Members
1
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$8.00
$
8.00
Chaperone (If Requested)
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10
$5.00
$
5.00
Item subtotal:
$0.00
$
0.00
Payment Methods
Credit Card
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Google Pay
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Cash App Pay
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ACH Bank Transfer
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