Routine Field Trip Experience Form Educational Purpose and Objectives of this Field Experience:*Routine Field Experiences must begin and end on the same day. This form must be completed and submitted to your school’s principal (or designate) for approval at least 30 days in advance.Logistical InformationSchool*Is this single day or recurring Trip?* Single Day Recurring Trip Date of Field Trip* MM slash DD slash YYYY You are submitting a date that is within 30 days of your fieldtrip and may not be able to be processed in time. Departure Time* : Hours Minutes AM PM AM/PM Return Time* : Hours Minutes AM PM AM/PM Dates (Multiple)* Departure Time* : Hours Minutes AM PM AM/PM Return Time* : Hours Minutes AM PM AM/PM Destination (within 100km of Burnaby):* SupervisionSponsor Teacher:*Other Teachers:Other Adult Supervisors/Support Personnel:Total Number of Adults*Total Number of Students*Grade(s):*Supervision Ratio:Your Calculated Ratio is 1:This field calculates the ratio of Adults to Students. Please fill out the fields below.Your Calculated Ratio is 10 or over. Please ensure you have a low enough ratio to accommodate any unexpected absences. K-3 (minimum ratio of 1:10)*Gr 4-12 (minimum ratio of 1:15)**A minimum ratio of 1:8 is required for overnight trips and/or if there is potential for injury. Is this Walking Field Trip?* Yes No TransportationHow are students traveling?* Together With Supervisors Individually Are you using a District Sanctioned Bus/Van* Yes No If so, company name*:**Before booking transportation, check with Administration to ensure the carrier has been sanctioned by the School District for safety certification and liability coverage.Are you driving a Privately-Owned Vehicle?** Yes No Driven By:**If private transportation is being used, appropriate liability forms must be completed and submitted by all drivers in advance of the field experience. Staff member Coach Student Parent Are you using Public Transportation?* Yes No CostsEstimated Cost Per Pupil :*Amount to be Charged to Each Student:*TTOC Required* Yes No Is the TTOC required for: Full day coverage Half day coverage Estimated TTOC Costs (if applicable)Date TTOC is Required:* TTOC Costs Funded by:NOTE: Please book your TTOC through the ADS system once your trip has been approved by your administrator. Sponsor Teacher Contact:Destination Tel #*Sponsor Teacher Cell #*Supervision: Detailed supervision plan for entire trip attached.*Max. file size: 16 MB.Times during trip that students will not be directly supervised:* Potential for InjuryNote any anticipated or potential risks of injury to students (hiking, etc.):*Steps taken to minimize injury risks:* Education Planning DetailsAlternative activities for non-participants:*Have you previewed or previously taken students on this trip?* Yes No Are the field trip activities and exercise prepared?* Yes No Not Yet Are the follow-up activities prepared?* Yes No Not Yet Parent Information Letter and Parent Consent FormPlease upload a draft copy of your information letter for parents that describes the field experience, as well as the required parent consent form.*This letter must include detailed information regarding the purpose of the experience, cost of the trip, mode of transportation, special clothing requirements, meal arrangements, scope of supervision for the trip, and student behavioural expectations, as well as the parent permission section/form Drop files here or Select files Max. file size: 16 MB. SubmissionFirst Name*Last Name*Email* If this is a trip at a secondary school, have you notified your department head? (answer if applicable) Yes No Please Choose Your Principal:*Please SelectAmelia PoitrasAndrew LeeAngela BasranAngela FerraroAnthony YamBeth ApplewhiteBlake BriscoeBrad WinterlikBruce CornellBryan TesanCatherine BennettCeri BrophyCesare MartinoChristy RedmondChristopher PhillipsDan AdrainDana HerdmanDaryl GoesonDavid GreveDave MacleanDavid HeardDawn AshtonDiana SakicDino KlarichErin McGinleyEva YoungFonda PapathanasiouFrancine GiacomazzaFrankie De VitaGrady HunterGuy HamiltonHeather KimmieHeather SkuseHeather WatsonHelena ReadmanJas KoonerJeff HuttonJennifer CarsonJennifer GriffinJennifer ZuvicJenny WongJill McqueenJody MossKelly ChowKim ClarkKurt GurneyLindsay HollidayLisa Hartman MinukLisa PittMaria NicolidakisMaria PerezMark HardingMary-Ann BrownMichael NielsenMimi LimNadia VolpeNadine StackNick ChristofedesReg LaplanteRob RalphRob SmythScott HodgesSean GasterSheri BrattstonSonia MaglioTanis AndersonTeresa VeltriVicki Moro