MDHS%2C%20HOSA%2C%20March%2010-13%2C%202025.pdf

Parent document: School Board Regular Business Meeting-01-28-2025.pdf

Text

Docusign Envelope ID: 447CCB49-6DF5-4F0F-8962-D76730DF338E

AD P-101
~ =v Edmonds Request for Field Trip, Excursion,
== School District oF Outeieor Education

This form is being submitted pursuant to Policies 2320 Field Trips, Excursions and Outdoor Education and related
procedures; 6622 Student Transportation and related procedures.

Instructions
Originator:
¢* Completes form, via DocuSign
¢ Submits to principal for review

Initial
Principal: |
¢ Reviews form for compliance to policies and procedures 2320 and 6622
« Signs at bottom

When complete, principal sends to administrative assistant for elementary (mcgiek280@edmonds.wednet.edu) or secondary
(anderson|i@edmonds.wednet.edu) education three weeks prior (No Exceptions) to the next scheduled board meeting.

Name of school/program: Meadowdale High School
Group: HOSA Destination: Spokane
Date(s) of trip: 3/10/25 - 3/13/2025 Number of students: 16

Number of chaperones:
(min. of 2 chaperones, but must meet 1 per 10 ratio beyond that)

Grade level(s): 10-12 What is the cost per student: 50.00
List all funding sources for trip, including available scholarships: Is this event CTE funded:
Fundraising by HOSA Club, CTE Funds kyYes [JNo

Objective, curriculum and learning activities:
Participate in State CTSO HOSA Annual State Conference and Competition

Transportation (select all that apply):

[_} District bus kk] Van

_] Private vehicle, # of drivers - all drivers must be certified through procedures as outlined in 6622)

_j Watercraft transportation: Other than Washington State Ferry watercraft, compliance with Washington Schools Risk
Management Pool (WSRMP) requirements exist. Please contact Risk Management at riskmanagement@edmonds.wednet.edu
[_] Other (describe):

Name of staff member or adult chaperone who has current first aid and CPR card:

Chris Murphy

Overnight accommodations:
TBD once State HOSA release hotel information

Are there any other organizations, sponsors, or co-sponsors involved with this field trip (e.g. travel agencies, sports
organizations, etc.) contractually or otherwise? KJNO LJYES
If YES, please provide the name(s) of the organization(s) and details of involvement:

none

Signatures below indicate Originator and Principal or Designee have reviewed all related policies and procedures while
planningshis field trip, and that principal or their designee approves this trip:

17972025
1/9/2025

Signature of Originator

Signature of Principal
or Designee

DS
| UA Rev 9/23

Date