6153 - Field Trips, Recreational Trips

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 1 of 8

FORM A - TEACHER REQUEST FOR SCHOOL SPONSORED TRIPS

Date of Field Trip Request_________________________Teacher Sponsor:______________________

1. A “Request for School Sponsored Trips” form is to be completed in full by the teacher and submitted to the building principal in duplicate at least three (3) weeks prior to a day trip; ten (10) weeks prior to an overnight trip, and four (4) months prior to a school sponsored trip out of the country.

2. School sponsored trips should support and enrich curriculum-related goals. If a majority of a grade level is planning a trip, it should be open to all students at that grade level.

3. Upon principal’s approval, the teacher will contact the bus company and make arrangements for the transportation. Arrangements should be made well in advance of the trip for students with disabilities to be transported with their peers. Smyth Bus Company is the district’s contracted carrier (623-2211 or 623-8775). Arrangements with carriers other than Smyth Bus are allowable and follow the same procedure. Costs associated with any trip should be determined in advance by contacting the carrier directly.

4. Bus transportation for all field trips is paid through the Windsor Locks School Activity Account. A yellow disbursement form must be completed and submitted to the Business Office for payment.

School:

Grade(s):

Destination/Location:

Purpose/Curriculum Connection:

Desired Date:

Alternative Dates:

2.

3.

Time of Trip

From: To:

Total Number of Students Attending:

All school buses must return to school by 1:30 p.m. unless other arrangements have been made.

Indicate # of students who will be missing each lunch. Notify Food Service

Lunch 1:

Lunch 2:

Lunch 3:

Chaperone in Charge:

Chaperone certified to distribute medication:

Chaperone List: Ratio - Grades K-8 1:10 Ratio - Grades 9 –12 1:15

Arrangements for Students with Disabilities:

Transportation:

Other:

Cost per Student (include transportation and all other fees):

Name of Bus/Transportation Company

Approval of Principal:

Section: INSTRUCTION Definition: POLICY

Title: Field Trips, Recreational Trips and Other Number: 6153

Trips Sponsored by the Schools

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 2 of 8

FORM B - TEACHER SPONSOR CHECKLIST

ALL items on this list must be supplied to the Principal, Superintendent,

and Parent/Guardian prior to departure for all field trips.

1. TRANSPORTATION INFORMATION

NAME OF COMPANY

ADDRESS

PHONE NUMBER

CONTACT

PHONE NUMBER

2. INDIVIDUALS PROVIDING TRANSPORTATION AND APPROVED TO TRANSPORT STUDENTS

Students are NOT permitted to transport students

A list of approved drivers is located in your school office.

3. TRAVEL AGENT INFORMATION (IF USED)

NAME OF COMPANY

ADDRESS

PHONE NUMBER

CONTACT

PHONE NUMBER

4. ACCOMMODATIONS (IF OVERNIGHT)

NAME OF HOTEL

ADDRESS

PHONE NUMBER

CONTACT

PHONE NUMBER

5. SITE INFORMATION

LOCATION

CONTACT

PHONE NUMBER

DATE

TIME

6. CANCELLATION DEADLINES

1.

2.

3.

4.

Section: INSTRUCTION Definition: POLICY

Title: Field Trips, Recreational Trips and Other Number: 6153

Trips Sponsored by the Schools

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 3 of 8

FORM C - PARENT/GUARDIAN REFUND INFORMATION AND VERIFICATION

I _____________________________________understand that I may sustain a financial loss of funds

(Name of Parent/Guardian)

invested in this field trip to________________________________on______________________

(Destination) (Date of Trip)

if the trip is cancelled for any reason by the Superintendent and Board of Education

Chairperson.

Acknowledgement of understanding of the possibility of the loss of funds invested in the above field trip due to cancellation.

_________________________________ _________________________

Signature of Parent Date

Please print or type name___________________________________

Section: INSTRUCTION Definition: POLICY

Title: Field Trips, Recreational Trips and Other Number: 6153

Trips Sponsored by the Schools

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 4 of 8

EDUCATIONAL FIELD TRIP

FORM D - PARENTS/GUARDIANS PERMISSION SLIP

My child______________________________________________________________________________

(Print Student’s name)

will be visiting ___________________________on ______________ from ___________to ____________

(Place) (Date) (Time) (Time)

My signature acknowledges receiving this notification. I have reviewed with my child the student responsibilities (for middle and high school students) attached to this permission slip and the attached rules and regulations, which will govern this trip.

In order to ascertain how much transportation is needed, please complete the following:

Check One: ____ My child will travel (CIRCLE ONE OR BOTH) to / from the field trip on school sponsored vehicles.

____ My child will travel with me (CIRCLE ONE OR BOTH) to / from the field trip.

_______________________________ _____________________________ _______________________

Teacher Parent/Guardian Student

MEDICAL / EMERGENCY INFORMATION

I give my permission to the teacher-in-charge of the trip to_____________________on______________ to

seek emergency medical attention for ________________________________and I ask that I be notified as

(Student’s Name)

soon as possible. I accept the responsibility for any expense incurred for that medical treatment.

_______________________________________ _____________________________________________

Insurance Company Insurance ID Number

Emergency telephone numbers where I can be reached during the trip (include date, time for each):

_____________________________________________________________________________________

Any unusual conditions (allergies, daily medications, etc.): _______________________________________

_____________________________________________________________________________________

____________________________________________________________

Signature of Parent/Guardian

Section: INSTRUCTION Definition: POLICY

Title: Field Trips, Recreational Trips and Other Number: 6153

Trips Sponsored by the Schools

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 5 of 8

FORM E – CHAPERONE RESPONSIBILITIES

A chaperone is every adult supervisor attending the field trip including the Teacher-in- Charge. Chaperone supervision responsibilities are designated by the Teacher-in-Charge. Chaperones are expected to supervise students assigned to them at all times for the duration of the field trip.

During the field trip, all chaperones are expected to follow the published itinerary and field trip rules established by the Teacher-in-Charge (and approved by the building principal) prior to the trip.

Chaperones are expected to model appropriate behavior at all times and ensure that all students maintain appropriate behavior as designated in the student handbook. Inappropriate behavior should be dealt with immediately and reported to the Teacher-in-Charge as soon as possible.

Any consumption of alcoholic beverages and/or other controlled or illegal substance is prohibited.

Chaperones are expected to enforce all Board of Education policies including the prohibition of student use of tobacco products, alcohol and other controlled or illegal substances.

Chaperone Responsibilities

I have reviewed and understand my responsibilities as a chaperone.

_______________________________________________________________ _____________________________

Signature of Chaperone Date

Section: INSTRUCTION Definition: POLICY

Title: Field Trips, Recreational Trips and Other Number: 6153

Trips Sponsored by the Schools

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 6 of 8

FORM F – STUDENT RESPONSIBILITIES

FOR HIGH SCHOOL AND MIDDLE SCHOOL STUDENTS

All students participating on the field or recreational trip are expected to follow the published itinerary. Any student(s) deviating from the planned program will be referred to the administration.

Appropriate behavior is expected at all times. Anyone observed engaging in inappropriate behavior will be removed from the area and referred to the administration.

While we realize that dress is an individual responsibility, we urge you to dress for comfort and the appropriateness of the occasion. Any questions concerning proper attire should be directed to the Teacher-in-Charge prior to the day of departure. Any student scheduled to take part in the field or recreational trip who arrives at school on the day of departure dressed inappropriately, will not be allowed to participate.

Any consumption of alcoholic beverages and/or other controlled or illegal substances cannot and will not be tolerated. Anyone observed indulging or suspected of indulging will be referred to the administration.

Smoking or chewing tobacco will not be permitted on the field or recreational trip. Anyone observed smoking or chewing tobacco or suspected of smoking or chewing tobacco will be referred to the administration.

All student rules shall be in effect on the field or recreational trip. Disregard of any of the rules stated above or in the handbook may result in the student being sent home early from the field trip at parent expense.

Student Responsibilities

I have reviewed and understand my responsibilities as a student.

___________________________________________ ________________________

Signature of Student Date

Section: INSTRUCTION Definition: POLICY

Title: Field Trips, Recreational Trips and Other Number: 6153

Trips Sponsored by the Schools

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 7 of 8

ADMINISTRATIVE PROCEDURE

The Board of Education policy of “Field Trips and Recreational Trips” (#6153) provides that staff or parents may drive students on field trips, recreational trips or other trips sponsored by the school. If such is to be the case, the following requirements must be met:

1. The staff member or parent must be informed in writing that, in the event of an

accident, town insurance would respond only in excess of the staff member’s or

parent’s own personal insurance.

2. The staff member or parent must submit to the Board of Education a certificate of insurance indicating liability insurance coverage of no less than $100,000/$300,000.

3. A photocopy of the driver’s license of the staff member or parent must be on file in the Board of Education office. The driver’s license must have a valid State of Connecticut Public Passenger Endorsement/Restriction/Permit. (Please note: It takes a minimum of two weeks to obtain a Public Passenger Endorsement/Restriction/Permit on a driver’s license from the Department of Motor Vehicles.)

4. The staff member or parent must have a driving record without offenses (e.g. DWI), and without violations that have occurred within the previous five years. A motor vehicle report must be submitted for the staff member or parent who will be transporting students to an activity.

The above requirements are listed on the application form (copy attached to this policy) and must be met

at least one calendar week prior to the activity to which students will be driven. This information will be

kept on file in the Central Office and must be updated on an annual basis. Central Office will supply an

updated list of approved drivers to the school offices annually.

Section: INSTRUCTION Definition: POLICY

Title: Field Trips, Recreational Trips and Other Number: 6153

Trips Sponsored by the Schools

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trips Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

Regulation Page 8 of 8

FORM G - APPLICATION FOR PERMISSION TO TRANSPORT STUDENTS

To: Windsor Locks Board of Education

From: ____________________________

Re: Student Transportation

I intend to use my personal or rented vehicle for the purpose of transporting Windsor Locks Public School students to and from various activities. I hereby certify that I maintain a personal liability insurance policy on my automobile with liability coverage of not less than $100,000/$300,000 and that my insurance carrier will provide primary coverage to the actual policy limits, after which the liability insurance policy of the Board of Education will assume additional coverage, if necessary. I have provided verification I currently hold a valid State of Connecticut Public Passenger Endorsement/Restriction/Permit. The vehicle is will use to transport student will display a “Carrying School Children” placard and be equipped with a safety kit which shall include a first aid kit, fire extinguisher and an “Emergency” road triangle.

My automobile liability insurance coverage is described as follows

(A copy of the certificate is attached):

1. Name of Insurance Company

2. Policy Number

3. Name of Insurance Agent

Telephone Number:

4. Limits of Liability Coverage

$

5. Automobile Registration

State:

Tag Number:

6. My Diver’s License Number

(Attach photocopy of license)

State:

I certify I have no serious convictions (e.g. DWI) and no violations on my driving record in the past five (5) years. I have furnished a copy of my driving record obtained from the Department of Motor Vehicles and I understand the Windsor Locks Board of Education may verify this through a records check with the Department of Motor Vehicles.

Signature:____________________________________________ Date:___________________________

_____________________________________________________

Typed or Printed Name

Windsor Locks Board of Education

Manual of Policies, Regulations, and Bylaws

Policy 6153 Field Trips, Recreational Trips and Other Trip Sponsored by the Schools

REGULATION/PROCEDURES/FORMS

EDUCATIONAL FIELD TRIP FOR RISE TRANSITION ACEDEMY

PARENTS/GUARDIANS PERMISSION SLIP

Dear Parent(s)/Guardian(s):

Due to the experiential nature of our program, we may sometimes leave the school grounds for short field trips within a 75-mile radius of the school within Connecticut. These trips are a part of the educational program and exist to encourage transition and community participation goals and objectives. Prior to any short trip, notification will be sent home to parents or guardians regarding the date, time, and place of the trip. If for any reason you do not want your child to participate in the event, please notify your child’s teacher or principal in writing. If the school is not notified of any objections, school staff will understand that the student has your consent to participate in the event. Additional permission slips will be required for any trips beyond the scope of those contemplated in this agreement, including but not limited to overnight trips.

My child__________________________________________ will be visiting Community Sites during the

(Print Student’s Name)

______________ school year. I understand that I will be informed about each trip that takes place.

My signature, below, acknowledges that I have received this notification and agree to its terms. I further acknowledge that blanket permission is necessary for my child to participate in these community field trips, and that a permission form will not need to be signed by me each time that my child leaves school grounds to participate in one of these trips.

Additionally, I understand that by signing this permission form, I agree to indemnify and hold harmless the school, the school district, the Windsor Locks Board of Education, the individual members thereof, and all district officers, agents, employees, and volunteers from any liability, lawsuit, cost, expense, or claim of any type whatsoever (including legal fees) for any harm, injury, or death arising out of my child’s participation in the Community Site field trips contemplated by this agreement.

I have reviewed with my child the student responsibilities (for RISE Transition Academy students) attached to this permission slip and the attached rules and regulations, which will govern these trips.

____RISE Transition Academy________ _____________________________ _______________________

Special Education Teacher Parent/Guardian Student

[CONTINUED ON NEXT PAGE]

EDUCATIONAL FIELD TRIP FOR RISE TRANSITION ACEDEMY

PARENTS/GUARDIANS PERMISSION SLIP

PAGE 2 CONTINUED

MEDICAL / EMERGENCY INFORMATION

I give my permission to the teacher-in-charge of the trip(s) to Community Sites during the 2021-22 school year to seek emergency medical attention for ___________________________.

(Student’s Name)

If emergency services are needed for my child, I request to be notified as soon as possible. I accept the responsibility for any expense incurred for that medical treatment.

_______________________________________ _____________________________________________

Insurance Company Insurance ID Number

Emergency telephone numbers where I can be reached during the trip (include date, time for each):

_____________________________________________________________________________________

Any unusual conditions (allergies, daily medications, etc.): _____________________________________________________________________________________

_____________________________________________________________________________________

RISE form adopted: November 18, 2021

____________________________________________________________

Signature of Parent/Guardian