S:\LearnAreas\SCIENCE\BIOLOGY\BIO301\2016 Admin\Trip Request form 2015-Orana park.doc

Trip Request

This form is to be given to MLY at least two weeks before the trip date.

Planning for Class Trips, Camps, ‘Trips within school'

Trip To:Orana Park

Date of trip: Tuesday 1st Marcj

Class(es) InvolvedX3 Bio301 Number of Students: Approx 90

All trip requests must be approved by the appropriate HOD/TIC.

HOD/TIC Signature: ______WTO ______

RISK MANAGEMENT ASSESSMENT
Circle appropriate risk level for your trip. / LEVEL ONE
‘Trips’ within school.
No Safety Action Plan needed but permission required. / LEVEL TWO
Trips out of the school grounds. Complete attached Safety Action Plan. / LEVEL THREE
For trips with a high level of physical risks. More detailed Safety Action plan is required.
Teacher-In-Charge: WTO
Relief Required including Form/Duty:All day
Other Staff Going: KLE, BHR
Relief Required including Form/Duty: WTO (P1-2), KLE (P1-5), BHR (3-4)
______

Departure Time: 9am Time of Return: 2.45pm

Method of Travel: Bus Cost per Person: $17

A cellphone must be taken on the trip. Cellphone number: 02108110078______

Please note: Students must have paid by the day before the trip departs.

Planning Notification

Teacher Checklist

1.  Complete the Safety Action Plan for Level Two or Three trips. If an outside provider is being used then the ‘Using an Outside Provider’ form needs to be completed.
2.  Give the form and permission letter to MLY at least two weeks before the trip date. The letter must include the statements about uniform and fee refunds. (See details in Staff Handbook/Trip Guidelines.)
3.  Letter and permission slips home to Parents/Caregivers. Do not do this until you have received this form back confirming the trip is approved.
4.  Give copy of letter to Office so they can set up account.
5.  Check with office the day before trip to ensure that all students have paid. Check that you have all permission slips. (Consult MLY if viability in doubt due to students not paying.)
6.  Arrange Senior LeadershipTeam member to talk to students just prior to leaving, if required.

Overnight Trips

The Overnight Trip Proposal must be completed and approved by the Principal. This should be done at the start of the year. (See Appendix 4 in Trip Guidelines manual in Staff handbook on StaffNet.) The safety action plan will need to be more detailed than for a day trip. In particular, it needs to cover how evenings will be managed.

Checklist for day of trip

Action / Completed
List of students on noticeboard opposite staff pigeon-holes
Before you leave a list of students present must be given to
Jbe (office) this must be a printed list from Kamar
Student medical information taken on trip
First aid kit taken, if required
Cellphone taken on trip and turned on
Member of Senior Leadership team talk to students, if required
Check in with Deputy Principal when return from trip.

S:\LearnAreas\SCIENCE\BIOLOGY\BIO301\2016 Admin\Trip Request form 2015-Orana park.doc

Safety Action Plan

Activity:
The following generic risk management procedures apply (see last page):
Transport Public areas In or around water
What could go wrong? / What could cause it to go wrong? / What will we do to prevent it from going wrong? / What will we do if it still goes wrong?
Students left at Orana park / Students not listening to instructions about departure time / They are yr 13’s so less likely, make sure all students are paying attention. Complete a head count once on the bu / Students will need to be collected. Contact and arrange pick up from caregivers or I will collect them
Students requiring special consideration
/
What we will do to avoid problems?
Health (From Kamar and permission slips):
Behaviour:
Year 13’s Nil
Other:
Nil
I will ensure that all staff going on the trip are aware of:
·  students with health issues
·  the safety action plan including relevant generic risk management procedures as noted above.
Signed (Teacher in charge): BHR
Staff with current First Aid certificate:
BHR
Staff health issues:
NIL

S:\LearnAreas\SCIENCE\BIOLOGY\BIO301\2016 Admin\Trip Request form 2015-Orana park.doc

Risk Management – Common Situations

The following details can be included in the Safety Action Plan, where relevant.

Transport

Where possible, students are transported by bus. If transport is by van or car then:

·  Drivers have a full licence.

·  Seatbelts are worn.

·  Road rules are followed.

·  Drivers of the school vans have driven the van before taking students for the first time.

·  If students are transporting other students then parental permission is required for everyone involved.

In the event of an accident:

·  Call emergency services, if required.

·  Ensure non-injured students are kept in a safe area – allocate a staff member to look after them.

·  Contact school.

Public Areas

If a trip is to a place where members of the public are then the following apply.

·  Students are given clear boundaries as to where they can go. Ideally a staff member is within sight of students at all times.

·  If crossing roads, pedestrian crossings should be used. If this is not possible then staff must supervise students.

·  If students are required to interact with the public they are given guidelines on what to say and know where a staff member is at any time.

Trips In or Around Water

These do not include Outdoor Recreation trips where staff must have specialist training and knowledge.

·  All staff must be familiar with the area and potential water hazards.

·  Students are given clear boundaries as to where they can go.

·  Students are always within sight of a staff member.

·  Students do not go into deep or fast-flowing water.