Cedar Point Trip Payment Form Cost: $80 no later than May 27th I will be at the band banquet

SENIORS must pay with a check but will receive the check back if they attend. Cannot use student account for seniors Student Name: Cash Enclosed

Cash Amount: $

Check Enclosed* Check Amount: $ *All checks payable to: HFII IMB Student Account Deduction:

Check #

Deduction Amount: $

Parent’s Signature: (REQUIRED FOR STUDENT ACCOUNT DEDUCTION)

Received by:

Date:

Send forms and payments to: Debbie Zielinski 15310 Brandy Ln Macomb MI 48044 ([email protected] for questions) or give them to her at the Band Banquet. They can also be given to Mr. Schoenherr.

*This form must be turned in with the Trip Authorization Form*

Cedar point trip payment form_2016.pdf

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