Field%20Trip.pdf

Parent document: Regular School Board Meeting 5_00 pm-07-11-2024.pdf

Text

Todaw’s Date: 7-3-2024

BREMERTON SCHOOL DISTRICT

FIELD TRIPS AND EXCURSIONS REQUEST FORM

NAME OF SCHOOL: Bremerton H.S.
NAME OF TEACHER(S): AD Amber Plummer (Sub Volleyball Coach)
DATE(S) OF TRIP: Friday 7/12/2024 - Sunday 7/14/2024

TIME LEAVING SCHOOL: 3°™ (am/pM) TIME OF RETURN TO SCHOOL: 3PM (amPM)
DESTINATION: NW Sports Hub - 701 Allen Ave, Centralia, WA 98531

EER

PURPOSE: (clearly define, add relationship to Essential Learnings)

The BHS Volleyball Player will be traveling and staying overnight for a 2 Day Volleyball
Tournament to compete in Experience Level games vs at least 5 teams from the 64 teams

PARTICIPANTS: (class/grade, group. specify who and how many)
7 - 9 BHS Volleyball Players — Tiana Butler 9th, Jodey Garrett 9th, Kailey Balajadia 9th,
McKinley Lindeke 9th, Macie Rudner 9th, Rylee Fletcher 11th, Jaiden Pruett 11th., Eulanh

Kina 11th and/or Nika Fincher 11th.
ADULT SUPERVISORS": (List adult supervisors, staff, and/or volunteers)

*All adult supervisors, staff, and/or volunteers must adhere to Bremerton School District policies
during the entire trip/excursion.
AD Amber Plummer

POTENTIAL RISK OR DANGER: (Example: Water, mountains, woods, etc.)

Identify risk factors surrounding this excursion.

Drive will be in BSD Vans, so typical highway challenges with traffic. The tournament comes
with typically sports related dangers. An ATC will be on site and student emergency info
can be easily accessed.

SAFETY ASSURANCE: Describe strategies and plans for safety assurance of the above-
mentioned potential risks or dangers.
We will travel with a First Aid Kit and AED, in addition to emergency and medical information

STUDENT COST FOR THE TRIP:

2/ Breakfast, 2/Lunches/ and 2 Dinner Meals will be provided by the team as ASB approved meals
for the trio. Students are responsible to purchase their own snacks.
SUBSTITUTE NEEDED? If so, for whom and for which people?

None



2320F-1
Page 2 of 4

ARRANGEMENTS: The recommended mode of transportation for field trips should be the
school district vehicles or vehicles belonging to a commercial carrier contracted by the district.
If a private vehicle is used for transportation on a field trip, the owner of said vehicle must sign a
transportation Letter of Awareness form. Field trip arrangements will be made at the building
level by the building administrator. A request for transportation must be sent to the
transportation supervisor two weeks prior to out-of-town trips and one (1) week prior to in-town
trips.

Mode of Transportation BSD Van

Transportation request sent to Steven Brewer 6/10/24
(Name) (Date)

OUT OF STATE AND OVERNIGHT TRIPS: Out of state and overnight field trips must also

SS

include the itinerary, housing plans and District/student costs and how trip is being funded.
Board approval is required. Requests should be sent to the Superintendent at least two (2) weeks

prior to the Board meeting before departure. (Board approval required before funds are solicited
for any trip/excursion).

Lodging: Hotel Name: ON SITE Accomodations provided by the Club
——— eae ee
Private Homes
Other: NW Sports HUB ~ Room / Space Indoors for Team

How is trip funded? ASB Account [ | Field trip account
[ | Co-curricular [ | Federal grant

[ _]Private monies [ ] Other

PARENT APPROVAL: Participating students must have written parental permission for each
field trip and be under the direction of a certificated or professional District employee.

Permission slip sent to parent(s)

7151202 + (Date)

BUILDING ADMINISTRATOR APPROVAL:

Cd

BOARD APPROVAL: (For out of state or overnight trips)

(Signature) (

TIM { ay
(Date)


2320F-1
Page 3 of 4

STUDENT TRAVEL EXPENDITURES AND REVENUES
Revenue Source |
applicable
_ Transportation (¢.g., |$50 Athletic Transpo
| bus. van, ferry,

Budget
Registrations/ $500
entry fees
Hotel $250 ASB - Volleyball

was Approved 6/7/24
Meals $560 ASB - Volleyball

was Approved 6/7/24
—e Pf
oe ae eS

$20 - $30

ASB - Volleyball
was Approved 6/7/24

Total out of pocket cost to individual student:
Please check all that apply:

Waivers/scholarships are provided for students who cannot afford the student portion of
¥ this travel

All chaperones/drivers have valid driver’s license

All chaperones/drivers have valid vehicle insurance coverage

Bremerton Schoo! District
April 15, 2004