Return completed form and payment to Mr. Neill in room 318

SenecaValleySchoolDistrict

TracyL.Vitale, Ed.D.

SuperintendentofSchoolsAdministration Center

124SenecaSchoolRoad

Harmony, PA 16037-9134

PHONE:(724)452-6040

FAX:(724)452-6105

FIELD TRIPPERMISSIONFORM

Student’s Name: Student Cell Phone # Date(s)ofFieldTrip: _June 5, 2018 ____ Depart: __6 AM____Return: 9 PM

NameofOrganization/ Class:PhysicsCostof FieldTrip:$95plus breakfast, non-refundable_

PurposeofFieldTriporActivity: Study the physics of amusement park rides at Cedar Point______

Period / Teachers Signature / Yes,workcanbe
completedprior to/followingthis activity / No,Workor
class activity cannotbe rescheduled / DescriptionofActivity
1
2
3
4
5
6
7
8
9

Pleasehave your parent/guardianreviewthisformandhave allthe requestedinformationcompleted before yourequesttheir signature ofapproval.

Myson/daughterhasmypermissiontoparticipateinthefieldtrip

To Cedar PointonJune 5, 2018atacostof $ __95.00 _ non-refundable _

I understandthatmyson/daughterwillberesponsible forall classworkassignedorcompletedonthisdateand thatallstudentparticipantsaresubjecttoallSchool Districtpolicies andprocedures.

Signature of Parent/Guardian:Date:

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FieldTripMedicationForm

Schoolhealthpersonnelaregenerallynotinattendance onfieldtrips.Medicationandtreatmentsshouldbe administeredprior todeparture oruponreturntoschoolwhenever possible.If astudent requiresmedication

ora treatmentinordertoparticipateintheprogram,theschoolnursewillassistwithplanningfortransportof the appropriatedoseofmedicationorequipment.Thestudentwillbeprovidedwiththe opportunitytoself-administer

the medicationorperformthetreatmentatthedesignatedtime.If thestudentisunabletoself-administerthe

medicationortreatment,thestudent’sparentwillbeinvitedtoattendthefieldtrip.

Pleasecompletethefollowingif yourchildreceivesa medicationortreatmentatschoolonadailyor“asneeded” basisthatwillberequiredduringthefieldtrip.

willrequire

Name of StudentMedicationorTreatment

whileparticipatinginthisprogram

Signatureof Parent:

FIELDTRIPINFORMATION

TheSenecaValleySchoolDistrictrecognizes thevalueandencourages theopportunitiesforstudents toparticipateinpre-plannedfieldtrips andeducationalexperiences duringthe regularschoolyear.The pre-approvalformonthebackofthis sheetmustbe returnedtotheschool-approvedadultsupervisor priortothis trip.

Ifaproposedtriphas beenapprovedbytheprincipal,writtenpermissionfromaparentorguardian mustbeobtained.This permissionmustindicateunderstandingofthedate,time,cost(ifapplicable) andpurposeofthis trip.Pupilparticipants aresubjecttothesupervisionoftheschool-approvedadults, whomayrequireadress codefortheoccasion.Atalltimes theschoolcodeofconductwillbe enforced.

Thefacultymustreceiveatimelylistofparticipants approvedforthis educationaltrip.Students who areabsentfromanyoftheirregularly scheduledclasses becauseoftheirinvolvementinafieldtrip mustfollowtheseprocedures:

1.Formonreversesidemustbecompletedpriortothefieldtripandreturnedtothesponsorofthe fieldtrip.Students whofailtoreturnthis completedformmaynotparticipateintheactivity.

2.Students areresponsiblefornotifyingtheirteachers thattheywillbemissingclasses and completingallworkthatismissed.Thismustbedonepriortotheplannedabsence.

3.Becausefieldtrips andspecialactivities arevaluableeducationalexperiences,classroomteachers shouldattempttoaccommodateandsupportstudentparticipationintheseactivities.Iftheplannedclass activities thatastudentwouldmiss toparticipateinthefieldtripcannotbecompletedearlyor followingthetrip(ex:labexperiments ordemonstrations,groupreports,etc.),thestudentis tobe notifiedofthis typeofclassroomactivityatthetimehis/herfieldtriprequestis presentedtothe teacher.Thestudent,withtheassistanceofthesponsoroftheactivityandthestudent’s parent/guardian, mustevaluatetheappropriateness ofhis/herparticipationinthefieldtriporspecialactivitybasedon thisinformation.

4.Parentalapprovalforastudenttomiss classroomactivities toparticipateinafieldtriporspecial activityisindicatedbythesignatureofthestudent’s parent/guardianonthebottomofthecompleted form.

5.Astudentwithexcessiveabsences willnotbepermittedtoattendschoolsponsoredfieldtrips or activitiesiftheactivities requireadditionalabsencesfromregularly scheduledclasses.