Childrens Museum Field Trip Kindergarten Students.pdf - Retsd.mb.ca

Wayoata Elementary School605 Wayoata Street,Winnipeg, Manitoba, CanadaR2C 1J8Phone: (204) 958-6840Email:way@retsd.mb.caPrincipal: Mrs. K. CressallWeb Site: http://www.way.retsd.mb.ca Fax: (204) 222-5053PARENTAL INFORMED CONSENT FOR OUT-OF-SCHOOL ACTIVITIES Page 1 of 2Name of Program/Activity:Description of Activities:Destination:Students Participating:Purpose of Program/Activity:Date & Time of Departure:Date & Time of Return:Staff Members in Charge:Mode of Transportation:Paper, Trees, and MeTrees are our best friends as we explore the paper making process from startto finish. This program includes creative dramatics, a story, and hands-on funas we explore trees, paper, and the role of recycling. Students will createtheir own environmentally- friendly piece of paper! And we will have a selfguided tour before and after our program.Manitoba Children’s Museum/The ForksAll Kindergarten StudentsSupport scientific inquiry and the design process in relation to the ManitobaKindergarten science curriculum.Monday, June 10, 2103 at 9:30 a.m.Monday, June 10, 2103 at 2:30 p.m.Ms. Johnson and Miss MooreRiver East Transcona School Division BusCost of Activity: $7.25Date Permission Slip and Money Due: Friday, May 31, 2013Other Information:ALL KINDERGARTEN students will attend school on June 10, 2013 forthe whole day, from 8:30 a.m. to 3:15 p.m.Students may wear runners or sandals - but no flip flops, or shoes thatmay ‘fall’ off.Students should dress for the weather, as we plan to spend a portion of ourday outside. Safety Guidelines For Physical Activity in Manitoba Schoolsrecommends that students should be suitably protected against the sun, heatand insects. Depending on the sunscreen, it is recommended that sunscreenbe applied up to two hours before taking part in outdoor activities. Pleaseapply sunscreen and insect repellent before sending your child(ren) toschool. Students may bring sunscreen to school so that it may be re-appliedduring the day.Items student is required to bring:Cancellation Information:Students need to bring a lunch, drinks and snacks to last the day. Studentsshould have the items that they need (lunch, drink(s), refillable water bottle,hat and sunscreen) packed in their back packs, as they will be responsible forcarrying these items.We will be going on this field trip regardless of the weather.

PARENTAL INFORMED CONSENT FOR OUT-OF-SCHOOL ACTIVITIES Page 2 of 2Board Responsibilities:The board will make every reasonable effort through the application of its policies andprocedures, to provide for thorough preparation and planning and implementation of out ofschool activities undertaken by its employees, agents and officers.Informed ConsentActivity Title:Paper, Trees, and MeChildren’s MuseumDate of Activity: June 10, 2013Name of Student (please print): ________________________________________________I/We, the undersigned, hereby acknowledge that certain risks of injury are inherent in the participation insports, recreational activities and other off-school site programs. These types of injuries may be minor orserious.I/We understand that, in case of emergency medical or hospital services being required by the above-listedparticipant, and with the understanding that every reasonable effort will be made by the school/hospital tocontact me, my signature on this form authorizes the board, through its employees, agents, and officers, [to]secure such medical advice and services as they deem necessary for my child’s health and safety, and that Ishall be financially responsible for such advice and services.I/We understand that the Rules and Regulations pertaining to this activity are designed for the safety andprotection of participants.I/We acknowledge my right to obtain as much information as I require about this program or activity andassociated risks and hazards, including information beyond that provided to me by the school.I/We acknowledge that it is my responsibility to advise the school of any medical and/or health concerns of mychild that may affect his/her participation in the stated program or activity.I/We understand that the choice to participate brings with the individual the ASSUMPTION OF RISK which ispart of those activities.I/We understand and agree that this is a part of the school program. I/We also understand that as a result ofparticipating in this program that the participant is expected to follow the school procedures and code ofconduct and that any deviations from these may result in consequences from the school administration.I/We declare having read and understood the above INFORMED CONSENT AGREEMENT in its entirety andhereby consent to participate being aware of all the foregoing.Parent/Guardian SignatureDateIn order for your child to participate in this event, this signed consent form must be receivedat the school before the event.