1. TRIP DETAILS
      2. LEARNING OUTCOMES OF TRIP
      3. PRE-TRIP ORGANIZATION, PLANNING, MEETINGS, PREPARATION (Dates)
      4. POST-TRIP FOLLOW UP / EVALUATION OF EDUCATIONAL VALUE
      5. COSTS
      6. TRANSPORTATION COSTS (if not using a Tour Company)
      7. ACCOMMODATION / HOTEL COSTS (if not using a Tour Company)
      8. TOUR OR TRAVEL COMPANY COSTS
      9. SUBMISSION CHECKLIST
      10. APPROVALS


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      NIAGARA CATHOLIC DISTRICT SCHOOL BOARD

      REQUEST FOR OVERNIGHT FIELD TRIP,

      EXTENDED OVERNIGHT FIELD TRIP

      AND EXCURSION

         
      This form applies to any trip scheduled during the school year, organized and/or supervised by a teaching staff member for students (some or all) from that teacher’s school that involve overnight accommodation.


      (Education Field Trip Policy 400.2)
       
      REQUESTED BY ORGANIZING TEACHER

       

       

       
      SCHOOL DATE

       

       
      TYPE OF TRIP

       


      Overnight Field Trip

      (Up to 3 nights)
       

       


      Extended Overnight Field Trip


      (4 or more nights)

       

       
       

       


      Excursion


       
      DESCRIPTION OF THE TRIP

       

       

       

       

       

       

       
      TARGET GROUP OF STUDENTS

      (Class/Team/Organization)

       

       

       

       

       
      REQUEST FOR SPECIAL ACCOMMODATIONS

       

       

       

       

       

       

       

         



      TRIP DETAILS

       
       

      DESTINATION OF TRIP

       

       
      DEPARTURE DATE DEPARTURE TIME
      ADDRESS RETURN DATE

       

       

       
      RETURN TIME
       TOTAL DAYS

       

       

       
      TOTAL NIGHTS
      NUMBER OF STUDENTS/PARTICIPANTS

       

       

       
      NUMBER OF STAFF NUMBER OF CHAPERONES  

       

       



      LEARNING OUTCOMES OF TRIP

       

       
       

       

       

       

       

       

       

       

       

       

       

       

       

         



      PRE-TRIP ORGANIZATION, PLANNING, MEETINGS, PREPARATION (Dates)

       

       
       

       

       

       

       

       

       

       

       

       

       

       

       

         



      POST-TRIP FOLLOW UP / EVALUATION OF EDUCATIONAL VALUE

       

       
       

       

       

       

       

       

       

       

       

       

       

       

       

         

       

       



      COSTS

       
      TOTAL COST OF

      TRIP PER PERSON

       

      $

       

       

       

       
      COST INCLUDES:

       

       

       

       
      ADDITIONAL

      COSTS

       

      $

       
      ADDITIONAL COSTS INCLUDE:

       

       

       

       

       

       
      TRANSPORTATION MODE TRANSPORTATION CARRIER TRANSPORTATION COST

       

         



      TRANSPORTATION COSTS (if not using a Tour Company)

       
       

      1. Attach three (3) proposals from Transportation Vendors.

      2. Identify below the three vendors and quotes.

      3. Indicate Principal Approved Vendor.

      OFSAA Transportation Requests are to be completed on a separate form.

       

      Vendor #1 $

       

      Vendor #2 $

       

      Vendor #3 $

       

      Principal Approved Vendor #

       

      If not selecting the lowest price Vendor, please provide a rationale:

       

       

       

       

       

         



      ACCOMMODATION / HOTEL COSTS (if not using a Tour Company)

       
       

      1. Attach three (3) proposals from Accommodation / Hotel Vendors.

      2. Identify below the three vendors and quotes.

      3. Indicate Principal Approved Vendor.

       

      Vendor #1 $

       

      Vendor #2 $

       

      Vendor #3 $

       

      Principal Approved Vendor #

       

      If not selecting the lowest price Vendor, please provide a rationale:

       

       

       

       

       

         



      TOUR OR TRAVEL COMPANY COSTS

       
      1. Attach three (3) proposals from Tour or Travel Company Vendors.

      2. Identify below the three vendors and quotes.

      3. Indicate Principal Approved Vendor.

       

      Vendor #1 $

       

      Vendor #2 $

       

      Vendor #3 $

       

      Principal Approved Vendor #

       

      If not selecting the lowest price Vendor, please provide a rationale:

       

       

       

       

       

         



      SUBMISSION CHECKLIST

       
      The following information must be included at the time of submission, unless otherwise deferred by a Superintendent of Education:

       


      Board Forms completed in full

       

      Names of all Principal approved staff and volunteers provided

       

      Airline specific checklist completed (if required)

       

      Tour Company checklist completed (if required)

       

      Insurance checklist

       

      Confirmation of arrangements, if required for students with special accommodations

       

      Confirmation that students will attend an appropriate liturgy if the trip occurs on a Day of Obligation

       

      Confirmation that copies of medical emergency information and plans are on the trip and at the School

       

      Confirmation that prior to departure, students are instructed in appropriate behavior and safety procedures and requirements for a specific trip

       

      Confirmation that all participating staff/chaperones have reviewed and understand the Board’s Education Field Trip Policy 400.2

       

      Confirmation that all participating staff/chaperones have reviewed and understand the OPHEA Guidelines

       

      If there will be any swimming, boating or other water based activities on this trip, proof to be provided that a swim test has been performed for each student and confirmation that any student that does not pass the swim test will wear a properly fastened Personal Flotation Device

       

      Confirmation that high care activities are supervised by certified personnel

       

      Confirmation that valid operators licences are provided for boating excursions

       

      Confirmation that parent/guardian permission forms are complete for each participating student

       

      Principal designated in-charge person

       

      Confirmed number of supervisors as required by Board Policy 400.2

       

      Copy of three (3) written proposals which are specific to a trip

       

      Driver-Authorization to Transport Students forms completed by staff or volunteer drivers, if required by the trip

      Confirmation that staff/volunteer drivers have a minimum of $1 Million in auto insurance, OPCF #44 and will not exceed six (6) students in a vehicle unless properly licenced.  

       
      PRINCIPAL COMMENTS:

       

       

       

       

       

       

       

       

       

       
       

      SUPERVISING STAFF NAME
       

      TYPE OF COVERAGE ARRANGED

       
       

       

         
       
       

       

         
       
       

       

         
       
       

       

         
       
       

       

         
       
       

       

         
       

       

       



      APPROVALS

       
      SIGNATURE OF ORGANIZING TEACHER DATE

       

       
      SIGNATURE OF PRINCIPAL DATE

       

       
      SIGNATURE OF FAMILY OF SCHOOLS SUPERINTENDENT DATE

       

       
      SIGNATURE OF EXTENDED OVERNIGHT FIELD TRIP & EXCURSION SUPERINTENDENT (if required)

       

       
      DATE  

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      Request for Overnight Field Trip, Extended Overnight Field Trip and Excursion