Field Trip Check List - DOC - DOC by F05fLA

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									                                           Field Trip Checklist & Authorization
                                                         Form #1

School:         Staff member in charge:

Today’s date:         Trip Name:

Authorization
Teachers should not discuss plans with students/parents or prepare the trip application until they have approval from their
principal.

Application Package
In the tables below you will see which Forms and Required Documentation you need to complete and submit to your
school administration. If you have questions regarding the application process please contact your administrator or the Off-
Site Review Committee Chair at the Department of Education (867) 667-5607. Please see the sample field trip application
packages for your reference.

There are three categories of trips. Please check one:
  Simple                                        Complex                                        Out of Territory

Your trip is considered Complex if it includes any of the following:
 The trip is overnight
 Students are canoeing or kayaking
 Students are off a main highway and beyond 30 minutes from medical attention
 Temperatures may drop below –30° Celsius
 A risk assessment identifies risks that need to be managed with identified mitigation strategies

Simple
(Submit to school principal at least 1 week prior to the trip date)
           Done     N/A                              Forms and Required Documentation
                           Form #2 Simple Field Trip Consent
                           Form #7 Volunteer
                           Form #8 Use of Private Vehicles
                           Participating Student List attached
                           Are First Aid and/or other certifications required? See Policy Pg 4. Attach photocopies

Complex
(After your principal has reviewed the application submit to school council and superintendent at least 2 weeks prior to the
trip date. You are only required to submit your application to school council if your trip greater than one day)
            Done N/A                                 Forms and Required Documentation
                           Form #3 Complex Field Trip Consent
                           Form #4 Risk Analysis
                           Form #5 Medical Form signed and completed by a Parent/Guardian
                           Form #6 Contingency Plan
                           Form #7 Volunteer
                           Form #8 Use of Private Vehicles
                           Form #9 Billeting
                           Form #10 Firearms
                           Form #13 Travel Detail
                           Form #14 Travel Authorization and Claim
                           Equipment List attached
                           Participating Student List attached
                           Camping? Canoeing? Kayaking? Hiking? Cycling? Cooking? Skiing & Snowboarding?
                           Please review each appendix relevant to your trip and attached to your application
                           First Aid and other certifications required? See Policy Pg 4. Attach photocopies
                           Travel in possible avalanche terrain? Contact Offsite Review Committee 667-5607
                           Culture Camp? First Nations Perspectives Review Committee review required. Contact
                           FNPP 456-6752
Out of Territory
(After your principal has reviewed the application submit to school council and your superintendent at least 3 weeks prior to
the trip date. You are only required to submit your application to school council if your trip is greater than one day)
            Done N/A                                  Forms and Required Documentation
                            Form #3 Complex Field Trip Consent
                            Form #4 Risk Analysis
                            Form #5 Medical Form signed and completed by a Parent/Guardian
                            Form #6 Contingency Plan
                            Form #7 Volunteer
                            Form #8 Use of Private Vehicles
                            Form #9 Billeting
                            Form #10 Firearms
                            Form #13 Travel Detail
                            Form #14 Travel Authorization and Claim
                            Form #15 Application for Extended Coverage Outside Canada
                            Equipment List attached
                            Participating Student List attached
                            Students will require travel medical insurance for travel outside of Canada
                            Camping? Canoeing? Kayaking? Hiking? Cycling? Cooking? Skiing & Snowboarding?
                            Please review each appendix relevant to your trip and attached to your application
                            First Aid and other certifications required? See Policy Pg 4. Attach photocopies
                            Travel in possible avalanche terrain? Contact Offsite Review Committee 667-5607
                            Culture Camp? First Nations Perspectives Review Committee review required. Contact
                            FNPP 456-6752
                            You need written parent/legal guardian permission to take a minor across an
                            international border. Students will also require a passport

Regardless of the type of field trip you are planning, please fill in the information requested below:

Grade(s):        Trip date(s):      to

Names of other teachers and participating employees:

Male/female chaperone (required for overnight):     Yes          Not required

  I have printed off and packed blank Incident Report Forms #12 (all trip types) and blank Daily Trip Log Forms #11(only
multi day trips).

Trip Authorization
Principal                   Date:        Signature _____________________________ (Simple, Complex & Out of Territory)


School Council              Date:        Signature _____________________________ (Complex & Out of Territory)


Superintendent              Date:        Signature _____________________________ (Complex & Out of Territory)


Final approval by Principal:
Complete the day of, or the day prior to departure. Destination temperature    wind-chill
   Due to unforeseen circumstances and/or unmanageable risks I do not give permission for this trip to proceed.


Signature _________________________________________                    Date

                                                     Have a great trip!
                           Full Field Trip Policy: www.education.gov.yk.ca/policy/field_trip.html
                      Off-Site Review Committee Chair at the Department of Education (867) 667-5607

								
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