St Catherine’s School, Bramley.
Educational Visits Confirmation Details for Residential Trips
Form R2 for trip to
Destination address and telephone number / Party Leader: / MobilePurpose:
Date of leaving / Leaves school at: / ETA at destination:
Date of return / Leaving destination at / ETA at school:
Additional Staff
EH1C required? / Passport required? / Visa required? / Vaccinations required? If yes please specify.
Insurance details to include insurance company name, emergency contact number, policy number
Are any participants with different insurance arrangements? State ‘None’ or detail below;
Exact details of meals required and ordered from Catering Manager
School Medical Centre 24 hour contact: 07789 354664
Emergency Contact at Home: Normally School Administrator
Sheila Kelsall Work 01483 899620, Home 01483 893776, Mobile 07973 249540
Please paste a list of girls including year and house (in alphabetical order or state complete year/house group)
Total number of girls:
Total number of staff:
Transport Arrangements
Method of Travel(include flight no i.a.): / Transport Company with tel no/mobile no:Collection Arrangements upon return: (Consider boarders and day girls.)
Clarion call group name:
Finance
Cost/Method of Payment:Cost of Preliminary Inspection visit i.a. / Contingency sum allowed for trip
Staffing
All Staff / Relevant qualifications, experience and responsibilities relating to this trip / Minibus Driver Y/N/NA / Mobile telephonenumber
Reserve
Risk Assessment: Where appropriate, e.g. mountaineering, skiing, canoeing, trips outside the UK
Prep School should complete the Risk Assessment Review for School Trips
Hazard/Activity/situation /Action required to minimise risks
The following information must also be included. They may be attached separately or copied here.
1. Programme of events
2. Insurance documents
3. Copies of all Form R4 from all pupils’ parents and the annual medical parental consent forms
4. Contact details for all staff accompanying the trip
5. Advice given to girls regarding clothes, spending money, provisions and equipment
6. Copies on any letters sent to parents about the trip
Party Leader’s Declaration
I have submitted meal requests to Catering Manager
I have completed all forms for travel company
I have forwarded names to Business Centre for charging
I have requested cover for all staff for both lessons and registrations
I have organised cover for any staff who will miss duties
I have told BHMs of after school hours
All staff on the trip have watched the Jext-pen (epipen) training film on (Y:)Staffshare/medical-LMG/Emergency Medication/Jextpen? (Y:\Medical -LMG\Emergency Medication\Jext Pen)
Front page of this document including all names has been posted the trips board?
I have given information to the School Office
Do you have first Aid kits and epipens? (Please remember to return to staffroom)
I have organised photocopies of passports and EHICs/other medical insurance
Any DBS requirements for this trip have been met
All staff cars involved have been authorised by the facilities manager
Relevant extract from Critical Incident policy (Appendix 1) - Y/policies/whole school/critical incident management policy September 09 will be carried.
Completed bySignature
After the trip, I will
Complete R5 for School Administrator
Shred copies of passports
Return copies of Annual Medical Parental Consent Form summaries and R4 forms to SIMS Manager for shredding
Submit a report and photographs for whole school Assembly
Transfer photographs to R drive
R2\hbt\20.04.07\SK 17/10/2014