Field Trip Annual Consent Form - Sturgeon School Division printable pdf download

9820 – 104 Street, Morinville, Alberta T8R 1L8 Tel: (780) 939-4341 Fax: (780) 939-5520

Field Trip Annual Consent Form

(Low Risk Activities)

I/We understand that the Sturgeon School Division #24 (the Division) arranges for students within the Division to participate in

field trips, which, in the opinion of the Division, have definite educational, athletic, or cultural value and are considered in the

category of low risk activities. These day trips are very common and happen quite regularly throughout the school year. This

form is not intended to request your approval for field trips that are considered high risk or overnight activities. A separate

permission form will be sent home for high risk or overnight field trips.

I/We understand that any medical information requested would be collected for the purpose of student safety during field trips,

including student athletic events (which are generally considered to have an inherent element of risk of injury despite all safety

precautions).

(the “student”) consent to the

I/We, being the custodial parent(s) or guardian(s) of

student participating in any such field trips arranged by the Division, and we authorize the participation by the student. It is

understood that my/our consent and authorization are subject to the following conditions:

(1)

The Division, through the relevant school, will advise me/us in writing of the following particulars of any field trip two

weeks, if possible, and at least three school days, at

minimum,

prior to the intended date of the field trip:

(a) destination;

(b) arranged supervision;

(d) transportation plans;

(e) associated risks that should be highlighted regarding the field trip;

(f) costs, if any; and,

(g) a telephone number through which additional information on the field trip may be obtained.

(2)

I/We acknowledge my right to obtain as much information as I require about the program(s) or activity(ies) and

associated risks and hazards, including information beyond that provided to me by the school or Board.

(3)

I/We freely and voluntarily assume the risks/hazards inherent in the program/activity and understand and acknowledge

that my child may suffer personal injury due to an unforeseeable event associated with his/her participation. I consent

that the Board, through its employees, agents and officers may secure such medical advice and services as they deem

necessary for my child’s health and safety, and that I shall be financially responsible for such advice and services.

(3)

I/We have the right to advise the Division, through the relevant school, in writing, at least two school days before the

commencement of any particular field trip, that I/we do not consent to the student participating in the field trip, in which

event my/our consent and authorization will be considered as withdrawn for the particular field trip and the student shall

not be allowed to participate in such field trip.

I/We have read, as per the reverse, the students’ responsibilities, have discussed these with my child, and will comply

(4)

with the parents’/guardians’ responsibilities.

(5)

This consent, authorization and waiver shall be in effect for the current school year only.

DATED at

, Alberta this

day of

_____________________________________

____________________________________

Signature of Custodial Parent/Guardian

Print Name

“…where great things are happening”

January. 2015

Field Trip Annual Consent Form - Sturgeon School Division

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