Where: Olympia, Washington

When:Feb 4th

Depart school around 8:30 am

Return to school around 12:45 (Attend 5th and 6th period)

GUIDELINES

  • This trip is a required element of the 7th grade Social Studies WA State Curriculum.
  • Any student not attending the trip is required to attend school and will be placed in a study hall room completing an alternative assignment. Below is a list of students that fall into this category:
  • a student that fails to pay the trip fee or request financial assistance by the deadline
  • a student that fails to return all accurately completed trip registration papers by the deadline
  • a student that the 7th grade teaching team and administrators perceive to be a potential safety/behavior risk
  • a student that arrives late to school and misses the trip bus
  • A student that is absent-excused the day of the trip will be required to complete the alternative assignment on his or her own time.
  • We will be taking school buses to Olympia. Cost of the trip is $5 per student (non-refundable). Make checks payable to Pioneer Middle School.
  • Students need to provide their own sack lunch. Please pack a light lunch as we will have approx 20 minutes. There are no places to buy food at the capitol.
  • Students will be pre-assigned (by the 7th grade teaching team) to a group of 5-6 students and will have one adult chaperone supervising the group the day of the trip.

WA STATE CAPITOL CHECKLIST

BEFORE THE TRIP

/ Done
On or before Wednesday January 13th2016
Pay $5(or in the parent section indicate your need for financial assistance)
On or before Wenesday January 13th2016
Return Trip Registration Paper and Official Permission Slip
*************************************************
DAY OF THE TRIP / Done
Bring a sack lunch with your name on it. Please pack in a disposable lunch bag.
You will have an assignment to complete after the field trip so be sure to pay attention during the trip.
Dress for Success! We are asking students to dress comfortably but in a respectful manner. All school dress codes apply.
Cameras and cell phones are also allowed on the trip, as long as they are used appropriately. If not, they will be confiscated. Please do not bring a backpack or any music devices such as an i-pod, etc.

*Students are solely responsible for items that are lost, damaged, or stolen. Don’t bring it if you fear any of these could happen!

Do NOT Turn In This Form!

(Keep for your records)

TRIP REGISTRATION PAPER

DO Turn In This Form!

(Along with your money and office permission slip)

OFFICIAL FIELD TRIP PERMISSION FORM

STEILACOOM HISTORICAL SCHOOL DISTRICT #1

510 Chambers – SteilacoomWA 98388

Phone 253-983-2200 – Fax 253-584-7198

My child ______, in grade ______, has permission to participate in the trip to WA State Capitol (location) on Feb 2nd(date/s).

Departure time: 8:30 am Return time: 12:45 pm

This trip provides a learning experience for the students and allows them an opportunity to apply their classroom learning.

MEDICAL INFORMATION

Does this student have any medical condition/diagnosis? No  Yes

If yes, please complete the medical information on the back.

Transportation will be by:  Bus School Van Private Vehicle

In the event of an accident or illness, every effort will be made to contact the parent or guardian immediately. However, if the parent or guardian is not available, I authorize the school district to secure emergency medical care as needed.

Although the school district will make every effort to provide a safe environment, I am fully aware of the special dangers and risks inherent in participating in the activity, including physical injury, death, or other consequences arising or resulting directly or indirectly from the activity.

------

I give my permission for my child to participate in the field trip.

______

Parent/Guardian SignatureDate of Signature

Parent/Guardian Name ______

Home address ______

Phone (day) ______(evening) ______

Emergency contact person, in case parent/guardian cannot be reached:

Name ______Phone ______

(See Reverse)

MEDICAL INFORMATION

Does this child require any medication to be taken on this trip?  No  Yes

If yes indicate name and dosage ______

Does this student require any special medical procedures to be performed on this trip?  No  Yes

If yes, what is the procedure ______

Does your child have any allergies?  No  Yes

If so, please list ______

Please describe their reaction to above allergy ______

______

Students requiring medications or medical procedures during the field trip which are not normally provided at school, or are provided but will need to be provided at different or additional times, must submit additional forms and physician’s orders prior to the field trip. Parents/guardians must contact the school nurse prior to the trip to make arrangements.

I need to contact the school nurse regarding additional medications/doses and or medical procedures that my child will require during the field trip.  No  Yes

Students without the necessary forms may be excluded from the field trip.

IF YOU HAVE PROVIDED MEDICAL INFORMATION, PLEASE RETURN THE ENTIRE FORM.