Elevate Bridgeport

Bridge Academy Senior Trip

Class of 2025

Thursday, May 29th, 2025

Student's First Name

Student's Last Name

Student's Phone Number

Student's Email

Parent/Guardian Full Name

Parent/Guardian Phone Number

Emergency Contact Name

Emergency Contact Phone Number

I hereby grant Elevate Bridgeport permission to use the above names student's likeness in a photograph, video or other digital media in any and all of it's publications and social media

Yes

No

I give permission to my child to go with Elevate Bridgeport Staff on the Senior Trip to Funplex in East Hanover New Jersey.

Yes

No

I understand the cost of the trip is $25 and will send additional monies for food and beverage.

Yes

No