Buchanan Ski and Tubing Club INFORMATION FOR PARENTS: 2005-2006 SKI SEASON (Please Keep and Post) Dear Parent: Your child is planning to participate in a school-sponsored ski club activity. The information listed below is in reference to these trips. Please review the information carefully and keep for your records. If you have any questions, please contact a club advisor. TRIP DATES: (subject to changes due to weather) Thursday Evenings – January 5,12,19,26; February 2, 9 (Makeup dates: FEB. 16 & 23 only if needed) Tussey Mountain Ski Area (near State College) PLACE: DEPARTURE: 2:50 at East Derry; 3:00 at Lewistown; 3:10 at Buchanan ANTICIPATED RETURN: 9:00 PM at Lewistown Elementary only CLUB ADVISORS: Miss Yoder (Buchanan & East Derry), Father Bateman (Sacred Heart), Ms. Raydo & Ms. Perez (Lewistown) OTHER ADULTS PRESENT: Other teachers SUGGESTED DRESS: Layered clothing works best, snow pants are optional, hat and gloves are a must! TRANSPORTATION: School bus OTHER INFORMATION: The bus will return only to Lewistown Elementary. No bus will run to any other elementary school. Park in the faculty parking lot. Do not park in the circle in front of the school. This is for bus parking and unloading only. Please be prompt, as we will try to return your child on time. All money must be turned in by 8:30 AM on the Tuesday preceding the trip. NO MONEY WILL BE ACCEPTED AFTER THE 8:30 DEADLINE. BUS MONEY = $5.00 each trip Prepaid by 11/16. $6.00 if paying each week as we go. All bus money is Non-refundable! This must also be paid separately in cash by Tuesday at 8:30 to reserve a seat. Our club is quite large. If you choose to pick up your child at Tussey, we must have a note in order to care for your child and to arrange transportation. Buchanan 2005-2006 SKI CLUB FORMS: RETURN BY NOVEMBER 16 PARENTS: These forms must be filled out if your child intends to do any skiing with the club this year. Fill out in ink with the signatures written, not printed. Turn in forms by Wednesday, November 16 SORRY, NO SKI CLUB REGISTRATIONS AFTER NOVEMBER 16th. INSTRUCTIONS FOR FORMS: Please read carefully 1. Advance Purchases Multiple lift tickets, rentals, and this year tubing are discounted before November 16 (see price sheet in information packet). Payment by check made out to Tussey Mt. Ski Area must accompany the form to take advantage of the discount package. Meal plans may also be purchased in the same manner. Advance purchase is highly recommended for students intending to ski or tube 4 or more times. Season passes and purchases after November 16 are done directly with Tussey Mountain. Medical and Surgical Consent Three signatures required (Student and both parents, or, student, parent, and adult witness) Carried with advisor at all times 3. Insurance Waiver and Parental Permission Carried with advisor at all times 4. Ski Club Emergency Phone Numbers Carried with advisor at all times Please list another person to contact if you can not be reached 4. Rental Form On file at Tussey Mountain Should be filled out even if student does not intend to rent equipment Must be signed (ink) twice by parents or parent and witness Must fill out parts A,B,C, and D 2. Buchanan Ski Club, 2005-2006 ADVANCE PURCHASES (OPTIONAL) NAME_________________________________________(Print very clearly) TICKET PACKAGES: (Good for Ski or Tubing) 4 Lift Tickets 4 Lift + 4 lessons 4 Lift + 4 rentals 4 Lift + 4 lessons + 4 rentals 4 tubing passes $45.00 $68.00 $76.00 $96.00 $24.00 _____ _____ _____ _____ _____ TUBING ONLY: 4 nightly passes 6 nightly passes $24.00 $36.00 _____ _____ MEAL COUPONS: (see information packet for details) 4 coupons 6 coupons $17.00 $25.50 TOTAL AMOUNT _____ _____ _____ NOTES: 1. Attach to this form a check to “Tussey Mt. Ski Area” for total amount 2. All students are required to take a lesson on their first 3 ski trips MEAL PLAN = A meal plan is still available through Tussey Mt. cafeteria. The meal plan consists of 2 separate choices: 1) 2 slices of pizza, milk or 16 oz. soda; OR 2) cheeseburger, french fries, milk or 16 oz. soda. You do not need to choose a certain meal in advance. Meal coupons are good anytime, transferable and can be shared. They are NON-REFUNDABLE! School: Buchanan MEDICAL AND SURGICAL CONSENT 1. I/we hereby give consent to Alison Yoder, presently responsible for supervising my/our child, ________________________,to arrange for medical or dental care inclusive of diagnostic testing whenever, in the course of such supervision, the advisor or any attending physician or other competent medical professional deems such are to be immediately needed for the safety of the child and time does not permit giving personal notice or obtaining personal consent to proceed. 2. I/we further give my/our consent to all emergency medical and dental procedures which are seemed necessary by the attending physician, dentist, or other competent medical professional to preserve his/her life or to prevent impairment of his/her health in case time does not permit obtaining my/our personal consent to these procedures. 3. We, the undersigned student and parent(s) or lawful guardians do hereby certify that we have read and understand the above consent form and do hereby approve same. Date________________________ Signed__________________________________ (Parent,Guardian) Signed_________________________________ (2nd Parent, Guardian, or Adult Witness) Signed_________________________________ (Student) Address______________________________________ _____________________________________________ Telephone____________________________________ Alternate telephone (cell)________________________ Child’s Social Security number___________________ My child has no known allergies________________________________________________ My child is allergic to ________________________________________________________ Date of most recent tetanus inoculation___________________________________________ Family physician_________________________Family Dentist________________________ INSURANCE WAIVER AND PARENTAL PERMISSION FORM Dear Parent or Guardian: It is our desire to prevent injuries where possible in all student activities. However, we realize accidents do occur and thus we seek your assistance to provide coverage of possible expenses related to such injuries. Student insurance is available through our school. But purchase of school insurance is not essential for student participation in activities. In lieu of student insurance, parents may substitute the name of the company, which provides coverage, and the number of the policy. We must emphasize that no student is eligible for activities of any extracurricular nature unless covered by some form of accident insurance. I. To be completed by parents: I certify that _____________________________________ has school insurance for the current school year, or, has coverage with the ___________________________________insurance company, Policy number ________________________________________, And, if an accident occurs, I grant permission for a school representative to obtain the assistance of a doctor or hospital to treat the resulting injury. I will accept full responsibility regarding expenses of such assistance and waive all liability involving the Mifflin County School District. ___________________________________ Parent’s or guardian’s signature II. To be completed by parent and advisor Permission is hereby granted for _________________________________to participate in Ski Club during the 2005-2006 school year. This activity will be conducted at the Buchanan Elementary School and Tussey Mountain Ski Area. ___________________ Date _________________________________ Advisor’s signature _________________________________ Parent’s signature ____________________________ Date Buchanan SKI CLUB EMERGENCY PHONE NUMBERS Student Name: _____________________________________________________________ Parent’s or Guardian’s Names: _________________________________________________ _________________________________________________ Home phone number: ________________________________________________________ Work phone number: _________________________________________________________ Cell phone number:___________________________________________________________ Emergency Contact (Other then parents): _________________________________________ Their phone number: _____________________________________________ Make sure your son or daughter knows where you can be contacted during the time they are skiing. Some students do get hurt skiing, in most cases, just twisted ankles. When this happens, we bring our students back to Lewistown Hospital for X-rays, but we call the parents from Tussey Mountain first. This gives you time to meet us at the hospital when we arrive.