Boyertown Middle School East

 2020 Big Road

Gilbertsville, PA 19525

6th Grade Field Trip - Endeavor and Odyssey Teams

Wednesday, October 25, 2023

Hawk Mountain

Dear Parents and Guardians of 6th grade students on the Endeavor and Odyssey Teams,

    On Wednesday, October 25, 2023, our 6th graders will have the opportunity to take a field trip to Hawk Mountain Sanctuary. During the trip, students will participate in a program to learn about the different raptors and see some of the birds up close. They will also get to hike the North Lookout Trail to do some bird watching and learn about the Appalachian ecology. There is a South Lookout Trail that is ADA accessible and a shorter hike for students if needed. We will be leaving school at 8:45 am approximately, eating lunch at the sanctuary, and will return for normal dismissal.

   On the day of the trip, students will need a water bottle and disposable lunch (see more information below). It is suggested that students bring a small backpack (similar to their drawstring gym bag) to carry their lunch and water bottle.

Other expectations:

● Cell phones will not be permitted on the trip and should be kept locked in lockers at school or left at home.

● Students should dress appropriately for the weather and physical activity. Sneakers must be worn and the MSE dress code will be enforced.

● All school rules will apply. Students are representing MSE and the Boyertown Community. We expect students to be courteous and respectful.

● The school reserves the right to exclude students for disciplinary reasons and no money will be refunded.

● In case of inclement weather, the trip will be cancelled and not rescheduled.

  The cost of the trip is $10. If you need assistance with the payment, please reach out to your child’s homeroom teacher. Please complete the form below and permission slip and return it to school with payment by Monday, October 2, 2023. Payment can be made in cash or check made payable to “East Activity Fund”.

.......................................................Tear Off & Return.......................................................

Student Name: ____________________________________________________________________________________

Homeroom teacher:_________________________________________________________________________________

         Yes my child will participate in the field trip on Wednesday, October 25, 2023.

         No my child will not participate in the field trip.

_______ Yes, my child will need a brown bag lunch provided by the district.

_______ No, my child will be bringing their own lunch

 Parent/Guardian Signature: __________________________________________________________________________

BOYERTOWN AREA SCHOOL DISTRICT

FIELD TRIP AUTHORIZATION FORM

(PLEASE COMPLETE ALL SECTIONS OF THIS FORM)

Child's Full Name___________________________________________________________________Date Wednesday October 25 , 2023

Teacher____________________________________________________Cost $10.00

Place Hawk Mountain Sanctuary                         Location Kempton, PA

Departure date/time 8:45 am                                  Return date/time 2:00 pm

*If you wish to allow your child to participate in this trip, please sign the form below, detach it, and return it to the sponsoring teacher by Thursday, 4-20-2023. If you do not wish to have your child participate, simply do not sign the form. The child will then attend all classes as regularly schedule on the day of the trip. ________________________________________________________________________________________________________________

AUTHORIZATION

____________________________________has my permission to participate in the educational field to ________________________________________________________________on___________________________________. 

I understand that reasonable precautions will be taken to safeguard my child while on the trip.  If my child would need professional medical attention while on this trip, please act on my behalf.  Therefore, I hereby authorize medical treatment for my son/daughter,  _________________________, in case of an emergency and in the event I cannot be contacted. 

MEDICAL HISTORY (PLEASE NOTE “NONE “, IF THIS DOES NOT APPLY TO YOUR CHILD)

**Please list any allergies (food/drug/environmental) or medical conditions of your child.

______________________________________________________________________________________

______________________________________________________________________________________

*MEDICATION: Includes prescribed, over-the-counter, and supplemental medications that are either daily medications, as needed medications (inhalers, allergy related medication,etc.) and/or emergency medications (Benedryl, Epi-pen, etc.). Choose one of the following:

____________My child WILL NOT need medication during this trip

____________My child WILL need medication during trip hours

       Medication Name_______________________________

 The parent will be responsible for providing all medications required for the trip. The Authorization for School Medication Administration form must be completed and on file in the nurse’s office.

EMERGENCY CONTACT INFORMATION

(MOTHER) HOME(    )_________________WORK (     )____________________CELL(    )___________

(FATHER) HOME(     )_________________WORK(     )____________________CELL(     )___________

PARENT/GUARDIAN SIGNATURE_____________________________DATE_____________________

*Please refer to the student handbook for detailed medication policy.  Authorization Form for Medication Administration can be found at http://www.boyertownasd.org/UserFiles/File/forms/Health/Medication_Request_Form.pdf or contact the school nurse or copy back of permission form.                                                                                                                                  

COMPLETE THIS SIDE ONLY IF STUDENT REQUIRES MEDICATION TO BE ADMINISTERED DURING FIELD TRIP

BOYERTOWN AREA SCHOOL DISTRICT

AUTHORIZATION FOR SCHOOL MEDICATION ADMINISTRATION

Child's Full Name: _________________________________________  Grade/Homeroom: ________________________

Date of Birth: _______________________ Allergies: ______________________________________________________

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PHYSICIAN'S REQUEST

Name of medication (OTC, Prescribed, Vitamins):_______________________________________________________________

Reason: __________________________________________________ Route: __________________________________

Side Effects: _______________________________________________________________________________________ Time and dose(s) to be given at home ___________________________________________________________________ Time and dose(s) to be given at school: __________________________________________________________________

Medication is to be administered:

1._____ until completed.   Date: _______________

2._____ entire school year:   daily _____ prn _____

3._____ other: _____________________________________________________________________________________

___*   I believe this child is able and responsible to carry and self-administer his/her inhaler and/or Epi-Pen during school, on field trips, and at extra-curricular activities upon clearance by their physician, parent and school nurse.  S/he has permission to do so and has been instructed on how to self-administer (Gr. K-12).

___** I believe this child is able and responsible to carry and self-administer the medication on certain field trips and at extra-curricular activities. S/he has permission to do so and has been instructed on how to self-administer (Gr.6-12 only).

_____________________________________________       _________________________________________________

PHYSICIAN'S SIGNATURE                                        PRINTED NAME

_____________________                                                       _________________________________________________

DATE                                                                                              PHONE NUMBER

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PARENT REQUEST

I, the parent/guardian of ______________________________ request that the Boyertown Area School District nurse administer the above named medication as prescribed by my child's physician. My signature on this document constitutes a complete waiver of liability claim in any and all respects against the Boyertown Area School District and its Board of Directors and all employees unless the District is negligent with regard to any claim for injury in connection with administration of the prescribed medication.

Additionally, I agree to hand deliver the medication to the nurse's office in the original pharmacy or physician labeled container. I also accept responsibility to provide a physician's note and my written instructions if the medication is to be changed or discontinued. I give permission for the school and physician to communicate regarding this medication and medical condition.

____*   I believe my child is able and responsible to carry and self-administer his/her inhaler and/or Epi-Pen during school, extra-curricular activities and on field trips.   I give my permission for him/her to do so (Gr. K-12).

____** I believe my child is able and responsible to carry and self-administer his/her medication on certain field trips and at extra-curricular activities. I give my permission for him/her to do so (Gr.6-12).

_______________                     ________________________________________________________________________

DATE                                           PARENT/GUARDIAN SIGNATURE

List all medications currently being taken by this child: __________________________________________________

In accordance with Boyertown’s Medication policy:

*Students in Grades K-12 may carry and self-administer his/her inhaler and/or Epi-Pen during school, on field trips, and at extra-curricular activities upon clearance by their physician, parent and school nurse.  Your initials indicate that the child is capable of proper medication administration.

** Students in Grades: 6-12 ONLY may carry and self-administer his/her medication on certain field trips and at extra-curricular activities upon clearance by their physician, parent and school nurse. Your initials indicate that the child is capable of proper medication administration.

All medication forms must be completed and on file in your child’s school health room before medication can be administered.

______Clearance to carry and self-administer an inhaler and/or Epi-pen has been given by the school nurse  

Revised 5/2007