Off Campus Trip Planning Form printable pdf download

OFF-CAMPUS TRIP PLANNING FORM

(Must be submitted to Principal with Field Trip Approval Form)

Teacher Sponsoring Trip:_____________________ Initial Plan Date________________

Destination(s) Knoxville Symphony Orchestra – Tennessee Theatre__________

Departure and Return Date(s)February 26, 2013_________________________________

Itinerary/Schedule: (Provide a complete listing of all routes, times, events, and locations

as well as a phone number for each designation)

_____ AM: Depart from ___________________________________Elementary/Middle

9:00 AM Arrive at Tennessee Theatre, 604 Gay Street, Knoxville, TN 37902

9:30 AM: Knoxville Symphony Orchestra 2012 Very Young People’s Concert: High-

Low! Fast-Slow!

10:30 AM Depart from Tennessee Theatre

_____ Return to __________________________________________ Elementary/Middle

Risk Assessment:

I. What hazards are present? (Heavy traffic area, water, large crowds, etc.) Students will

unload in front of the Tennessee Theatre on Gay Street and load busses to travel back to

school behind the Theatre on State Street these two streets have downtown walking as

well as driving traffic____

II. Who will be affected by hazards? (Students, Chaperones, Teachers, etc.) Bus Drivers,

Teachers, Students and Chaperones___________________________________________

III. How can risk be eliminated or reduced? (Avoiding certain areas, extra supervision,

etc.) Bus Drivers will be directed by traffic police to drop off student for the

performances and then proceed to parking. Reloading of busses will occur one bus at a

time and be supervised by traffic police, ushers, Tennessee Theatre staff, and KSO staff.

Teachers are provided with seating charts for their group in advance of the concert so that

they can guide the group in the theatre and directly to their seats aided by Tennessee

Theatre ushers, staff, KSO staff, and volunteers. To aid in supervision all groups are

encouraged to bring 1 chaperone for every 10 students (and this chaperone is admitted

free of charge).___________________________________________________________

Emergency Plans

What steps will be taken in the event of an emergency? (Who will be contacted, how will

communication be handled, who makes decisions, etc.?) Any emergency that occurs

while schools are located in or on the premises of the Tennessee Theatre will be handled

by the Tennessee Theatre ushers and staff, which includes an officer trained to handle

emergencies. The head usher and KSO Director of Education & Community

Partnerships will make decisions. The principal of schools affected by an emergency will

be contacted by the teacher in charge or by the KSO Director of Education & Community

Partnerships.

Off Campus Trip Planning Form