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Information Request
Please answer these brief questions
* Indicates required question
Email
*
Your email
Name (please use Last, First format)
*
Your answer
T-Shirt Size
*
S
M
L
XL
XXL
Other:
Cell Phone number of phone you will have with you. (Use xxx-xxx-xxxx as the format)
*
Your answer
What are you most looking forward to on this trip?
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Your answer
Is there anything that makes you nervous that we are doing on this trip?
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Your answer
Are you fearful of heights? Example: we are going to the top of a very tall building in New York. Will this make you anxious?
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Yes
No
Are you fearful of being on the water in a boat?
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Yes
No
Do you get motion sickness when riding long distances?
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Yes
No
Don't know
Have you ever been away from your parents for an extended period of time before?
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Yes
No
Will you be able to bring cash for meals, souvenirs and some for any emergencies that arise?
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Yes
No
Not as much as I think I will need
Of the adults traveling on the trip with us, who do you feel most comfortable with if you need to be with an adult for any reason?
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Mr. Campbell (band director, marching band director)
Mr. Mick (high school choir director)
Mrs. Judy Hackett (mom of Logan Hackett)
Ms. Cindy McMillan (mom of Ryan Burgardt)
Mrs. Joan Frerich (mom of Maria Frerich)
Mrs. Stephanie Gibbs (mom of Isabel Gibbs)
Mrs. Jennifer Julius (mom of Catherine, Elizabeth and Margaret Julius)
Mrs. Pamela Liebl (mom of Lauren Liebl)
Mrs. Leeann Nelson (mom of Erin Nelson)
Mrs. Kristine Symanietz (mom of Lydia Symanietz)
Mr. Robert Johnson (step-dad of Aaron Reichard)
Mr. Dave Heid (dad of Mikaela Heid)
Miss Brianna Koester (colorguard instructor)
Mr. Eric Dylla (drumline instructor)
Mr. Justin Frerich (marching instructor)
Required
Is there anything that you would like Mr. Campbell or Mr. Mick to know that you are concerned about on this trip before we leave?
Your answer
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