Pine Lake

Student Name

First NameLast Name

Student Phone Number

Area CodePhone Number

Parent/Guardian Name

First NameLast Name

Parent/Guardian Phone Number

Area CodePhone Number

*Please Read

Pine Lake is a water park with multiple water slides, jumps, and other features in Berne, IN. The student will need to bring $5 for entry into the water park plus any money needed to eat lunch there at one of the two concessions stands. We will not be stopping to eat on the way there or the way back. Prices are reasonable inside the park. If the student does not bring money, he/she cannot go. By submitting this form you are agreeing that you (the parent) are allowing your son/daugter to attend this trip to Pine Lake Waterpark.