LAKE COUNTY SCHOOL BOARD FIELD TRIP MANUAL

Transcription

1 LAKE COUNTY SCHOOL BOARD FIELD TRIP MANUAL for clubs/organizations, band/chorus, educational and extracurricular trips including designated middle and high school interscholastic sports. July, 2010

2 NOTIFICATION OF NONDISCRIMINATION Lake County School District is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, Lake County School District will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.

3 LAKE COUNTY SCHOOLS FIELD TRIP COMMITTEE Caroline Burnsed, Principal Tavares Elementary School Aurelia M. Cole Chief of Administration June Dalton, Principal Tavares High School Trish Highland District Athletic Director Linda Shepherd-Miller, Principal Carver Middle School Randy Wells Health & Safety Officer Patty Woellmer Field Trip Secretary

4 PURPOSE The purpose of the Field Trip Manual is to provide information to principals and staff in planning and preparing for field trips. Field trips shall include clubs/organizations, band/chorus, educational and extracurricular trips including all high school and middle interscholastic sports. All field trip requests will be coordinated by the Transportation Department. Timelines have been established for requests, needed forms and information required before approval will be given. Please read the entire manual. When requesting the use of school buses, charter buses, leased vehicles or private automobiles, the enclosed forms must be completed. i

5 TABLE OF CONTENTS Purpose. i Field Trips Overview... 1 Transporting students to and from field trips/student activities in state by chartered bus/public transportation.. 2 Transporting students to and from field trips/student activities out of state 2 Transporting students to and from field trips/student activities in leased vehicles... 2 Transporting students to and from field trips/student activities in privately owned vehicles 2 Volunteer Drivers 3 International Trips.. 3 General Regulations Covering All Field Trips 4 School Responsibilities.. 4 Principal Responsibilities.4 Sponsor Responsibilities 4 Student Responsibilities.. 5 Chaperone Responsibilities 6 Lake County Schools Board Policies... 7 LCSB Policy 4.43 Field Trips.. 8 LCSB Policy Special Use of School Buses... 9 LCSB Policy 8.36 Transportation of Students in Private Vehicles.. 12 Forms Required for Field Trips/Activities. 15 Parent Consent/Liability Wavier/Medical Release Form 16 ii

6 Administration of Prescription Medication Consent Form 17 Administration of NON-Prescription Medication Consent Form 18 Field Trip and Bus Request Form.. 19 Request to Transport Student(s) in Private Vehicle Form. 20 Field Trip Sponsor Forms.. 21 Overnight-Out of County Sponsor Check List. 22 Chaperone Approval Form 24 Overnight Field Trip Room Assignment Form. 25 Forms Required for Middle and High School Interscholastic Sports.. 26 Sports Screening Physical Form 27 Emergency Medical Treatment Card 31 Notification of Risk Form for Middle School ONLY 32 FHSAA EL3 Form for High School ONLY. 33 Overnight-Out of County Sponsor Check List. 35 Chaperone Approval Form 37 Overnight Field Trip Room Assignment Form. 38 Field Trip Medication Handbook for School Personnel.39 Table of Contents.. 41

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8 FIELD TRIP OVERVIEW The Lake county School Board (LCSB) encourages the use of organized off-campus trips which will serve worthwhile educational objectives and further the fulfillment of the district s mission and school goals. The LCSB recognizes that the delivery of varied programs using the field trip as a learning medium requires coordination, safety precautions and financial resources. In order to protect the pupil, teacher and parent, and to distribute opportunities and resources as equitably as possible to all pupils in the district, the Board will periodically issue, in consultation with the Superintendent, administrators and teachers, administrative procedures specifying the LCSB s position. The LCSB will provide the services of a Field Trip Secretary from the Transportation Department who will serve as a liaison for the Superintendent, LCSB, principals and teachers. The LCSB believes that curricular and extracurricular activities involving travel are an important offering to our students. In the interest of student safety, these activities must be carefully planned, executed, and controlled, recognizing that they are an established part of school life and are a vital element in the overall educational program. Such activities must advance legitimate educational goals and must be effectively supervised in a manner to protect the students and the programs. In giving support to the use of field trips as an educational vehicle, the LCSB expresses its concern that the value of any trip must be assessed in the context of the amount of classroom instruction time lost, the potential contribution to student learning and the costs to the individual student, the school district, and the community. It is not the intention of the LCSB to impose rigid restrictions of learning activities which contribute to legitimate educational objectives; rather, these procedures should enable all those responsible for the education of our students to assure themselves that such activities undertaken during the school year: 1. Are directly related to the school district s mission. 2. Have been planned to achieve specific educational outcomes. 3. Cannot be more appropriately undertaken during after school time. 4. Are organized with provision for adequate student supervision. 5. Are conducted in a manner which will not discredit the student, the teacher, the school or the LCSB. Field trips are appropriate for the following reasons: 1. As an adjunct to classroom work directly related to the curriculum. 2. As an adjunct to the purpose and activities of a club or organization. 3. As a reward for desired behavior or accomplishments. Field trips should consist of three parts: 1. Preplanning: Educational benefits, principal approval and district permission, expected behaviors, school calendar posting and availability of transportation. 2. The trip: Organization, detailed itinerary, communication with parents, students, faculty and staff. 3. Follow-up: Review and evaluation of the educational benefits of the trip with suggestions for refinement and improvement. 1

9 Anytime students leave campus for a school sponsored event, via walking or riding, it is considered a field trip. The Transportation Department must be informed of these trips through the same procedure as any field trip. To start this procedure, the field trip request must be submitted to the school principal or designee. When the transportation of students is provided in a vehicle other than a school bus that is owned, operated, rented, contracted, or leased by the LCSB, the following provisions shall apply: (i) the vehicle must be a passenger car or multipurpose passenger vehicle or truck, as defined in 49 C.F.R. part 571, designed to transport fewer than 10 students. Students must be transported in designated seating positions and must use the occupant crash protection system provided by the manufacturer unless the student's physical condition prohibits such use; (ii) an authorized vehicle may not be driven by a student on a public right-of-way. An authorized vehicle may be driven by a student on school or private property as part of the student's educational curriculum if no other student is in the vehicle; and (iii) the driver of an authorized vehicle transporting students must maintain a valid driver's license and must comply with the requirements of the school district's locally adopted safe driver plan, which includes review of driving records for disqualifying violations. In addition to these requirements, the following provisions shall also apply: 1. TRANSPORTING STUDENTS TO AND FROM FIELD TRIPS/STUDENT ACTIVITIES IN STATE BY CHARTERED BUS/PUBLIC TRANSPORTATION The charter company used by the school must be on the district s approved commercial carrier list. 2. TRANSPORTING STUDENTS TO AND FROM FIELD TRIPS/STUDENT ACTIVITIES OUT OF STATE. If transportation is provided outside the state of Florida, it is recommended students be transported by common carriers (vendors who are in the business of providing public transportation for a fee). State law provides limited protection through sovereign immunity against liability claims in case of accidents and injury. However, after crossing state lines, sovereign immunity protection is gone and liability levels are unlimited. Leased vehicles may be used with LCSB approval, only when transporting small groups of students. In no case shall teachers, coaches or parents provide transportation for out-of-state field trips in privately owned vehicles. 3. TRANSPORTING STUDENTS TO AND FROM FIELD TRIPS/STUDENT ACTIVITIES IN LEASED VEHICLES. If transportation is provided within the state of Florida, passenger cars or multi-purpose passenger vehicles (MPV) as defined in 49CFR, Part 571, of the Federal Code for transporting eight students or less may be used or leased. a. The number of students transported in a vehicle shall not be greater than the number for which the vehicle was designed to carry. b. Each student shall be seated in an appropriate seat. c. Each student shall be required to use the vehicle s occupant crash protection system. d. Students under 18 years of age, regardless of seating position, must wear a seat belt. e. If the vehicle is leased, it shall be leased in the name of the school district. f. For each leased vehicle there must be two (2) LCSB employee drivers. 2

10 g. Lay coaches are not eligible to drive students in a leased vehicle. h. The trip sponsor or coach must take an equipped first aid kit appropriate for the number of students participating in the event. 4. TRANSPORTING STUDENTS TO AND FROM FIELD TRIPS/STUDENT ACTIVITIES IN PRIVATELY OWNED VEHICLES. a. If transportation, as a practical matter, is not available through the use of a district-owned vehicle, students may be transported in privately-owned vehicles driven by adult LCSB employees, parents/guardians of students or regular school volunteers. Students shall not be transported by other students. (Exceptions see h). b. The number of students transported in a vehicle shall not be greater than the number for which the vehicle was designed to carry. c. Each student shall be seated in an appropriate seat. d. Each student shall be required to use the vehicle s occupant crash protection system. e. Students under 18 years of age, regardless of seating position, must wear a seat belt. f. The insurance of the owner of the vehicle shall provide primary coverage in case of an accident. g. The trip sponsor or coach must take an equipped first aid kit appropriate for the number of students participating in the event. h. Each student s parent or guardian shall give prior written consent for transporting a student in a privately-owned vehicle, including a student driving himself/herself or a sibling to a designated school activity. 5. VOLUNTEER DRIVERS a. All persons wishing to become a volunteer driver for LCSB must have an application and background clearance on record before driving to and from an event. b. The volunteer driver must complete the Level II application process as required by LCSB policy. c. Prior to driving for any school event all volunteer drivers are subject to approval from the LCSB Human Resource Department. d. The vehicle must meet the requirements of the Department of Education & Department of Transportation. This information is available at the LCSB website under Risk Management at e. LCSB Policy 8.36 requires the school to have the following; i. A list of names of all drivers. ii. A copy of each driver s license. iii. Proof of automobile insurance with limits of at least $100, per person, $300, per occurrence for bodily injury and $50, coverage for property damage. f. All volunteers must undergo a new criminal background screening every five (5) years. g. There is an onsite Volunteer Coordinator located at each school to assist with the process. h. Students may never transport other students or be allowed to drive a rental vehicle or a chaperone s private vehicle. 3

11 6. INTERNATIONAL TRIPS The LCSB will not endorse (out-of-country) international field trips. A LCSB employee organizing a trip out-of-country, with Lake County students participating, must clearly state in writing that the LCSB is in no way involved in the organization, support or endorsement of the field trip. LCSB employees organizing out-of-country field trips are not allowed to use school facilities to promote such trips. Travel agencies or other private organizations promoting travel study trips shall not be permitted access to the school to promote or enroll students for privately sponsored travel study programs and trips unless a facility use agreement has been completed and authorized. GENERAL REGULATIONS COVERING ALL FIELD TRIPS 1. SCHOOL RESPONSIBILITIES a. If a field trip is canceled on a non-work day with less than twenty-four (24) hour notice and it is not due to a situation beyond the control of the school, the driver shall be paid one half the trip time, but not less than (4) four hours pay. In the event of a situation beyond the control of the school, the driver will receive 1.75 hours at their regular rate of pay. This payment will be the responsibility of the school requesting the field trip. b. It must be noted that if a LCSB bus has been requested for a field trip and needs to be cancelled the cancellation must be made 24 hours prior to the trip. c. The exception to (b) would be cancellation due to inclement weather. The bus must be cancelled to allow for driver notification. If the bus is not cancelled and the driver is at the bus lot ready to depart, the school must pay 1.75 hours at their regular rate of pay. This also applies to summer activities; however, the arrival time pay is 4.5 hours. 2. PRINCIPAL RESPONSIBILITIES a. The school principal must approve the field trip or student activity. b. The school principal must approve the type of transportation to be used. c. The school principal is responsible for familiarizing faculty members with LCSB policies for field trips and transportation of students. d. When student s are suspended or expelled from the bus, they are not permitted to use any Lake County school bus for extracurricular activities or field trips during the suspension or expulsion timeframe. e. The school principal may deny student participation based on his or her discipline record. f. Whenever the Superintendent, Principal or LCSB determines that dangerous conditions exist which may affect the health, safety, or welfare of those traveling on any field trip, the Superintendent, Principal, or LCSB may withdraw approval for the trip. 3. SPONSOR RESPONSIBILITIES a. Anytime students leave campus for a school sponsored event, via walking or riding, it is considered a field trip. The Transportation Department must be informed of these trips through the same 4

12 procedure as any field trip. To start this procedure, the field trip request must be submitted to the school principal or designee. b. After the principal/designee has approved the field trip the request must be submitted to the Transportation Field Trip Secretary via the Field Trip and Bus Request Form. c. Whenever the field trip sponsor determines that dangerous conditions exist which may affect the health, safety, or welfare of those traveling on any field trip, he/she may withdraw approval for the trip. Prior to departure on a field trip the teacher/supervisor must be made aware of, and heed to any travel advisories. d. A field trip for one (1) day shall be limited to a radius of 100 miles from the school unless otherwise approved by the LCSB. All out-of-state field trips must be LCSB approved. e. The school, district and board will assume no liability for reimbursement of costs or expenses incurred by the cancellation of any trip. Prior to the trip, parents must be made aware of this condition in writing. f. The school sponsor must inform parents in writing all travel arrangements, student financial obligations, student expectations and student responsibility of missed school work for overnight trips. g. The sponsor must provide to the school administration a contact list for all students participating in the field trip or student activity prior to leaving the school site. h. The trip sponsor must have a copy of all student permission slips prior to the date of event. i. The trip sponsor or coach must review school bus rules with students prior to the trip. j. All students participating in the school field trip or student activity are under the direction of a teacher and/or chaperone. LCSB employees are responsible at all times for the supervision of students on trips. i. There shall be no less than a one (1) to ten (10) ratio of chaperones to student. At least one (1) chaperone on each bus shall be an instructional staff member. Exception to the 10-1 ratio would be middle and high school designated sports. ii. There must be structured check in times when touring theme parks and/or museums. iii. Students are not allowed to move in groups of less than 3 for touring any park and/ or museum. iv. A home base must be established so students may know how and where to contact a teacher and/or chaperone. k. The field trip sponsor or coach shall be responsible for ensuring adequate supervision while on the bus; this includes the front and back of the bus as well as enforcing student rules while on the bus. l. No student will be excluded from participation because of legitimate financial reasons. m. No children, including siblings, relatives or friends, may attend a field trip or student activity unless they are part of the group for whom the trip was arranged. n. When a parent or guardian elects to transport his/her own child to an event, he/she is not deemed to be a volunteer driver. Therefore no other child may travel with that parent, either to or from the destination. All students may only travel in the manner arranged for by the school, or travel with their parent/guardian. o. The LCSB Supervisor of Transportation must approve all field trips. p. Bus drivers are not to be used as chaperones. q. Bus drivers will not pay for any tolls. Tolls must be paid by the school. 5

13 4. STUDENT RESPONSIBILITIES a. Students are responsible for all school work missed. b. The school field trip or student activity is sponsored by the school and all students on the trip are under district rules, policies and Code of Conduct. c. Students must keep all body parts and belongings inside the bus windows. d. Students must keep from littering, throwing, or propelling objects inside the bus. e. Students must obey the driver, monitor, volunteers, field trip sponsor and coaches at all times and follow the standards of conduct while riding the school bus. Students must report promptly to the principal/designee when instructed to do so by the driver and or trip sponsor. Bus infractions may result in an out of school suspension. f. Students must keep from throwing or propelling items outside the bus windows. Behavior that violates this rule/expectation may be classified as a felony. The student and the parent/guardian shall be held responsible for any damages that result from such an act. g. Students must keep from defacing or vandalizing a school bus. Restitution will be required for any damages sustained to the bus. h. Students must observe classroom conduct rules at all times (except for ordinary conversation). Silence on the bus shall prevail while the bus is stopped for railroad crossings or for discharging students. When the bus is in motion, only talk to the driver if it is absolutely necessary and be absolutely quiet when the driver turns on the dome lights, raises hand, etc. One of these signals will be used at railroad crossings. i. The students use of profane or objectionable language or engaging in any other objectionable conduct is prohibited. There shall be no pushing, fighting or any other type of misconduct at anytime. j. At anytime, the student must not use or have any tobacco products (smoking, chewing, dipping) or other mood altering substances. 5. CHAPERONE RESPONSIBILITIES a. All chaperones must have district approval. b. For daily field trips and school functions a chaperone must have Level I clearance by the Human Resources Department. Level I chaperones must be within eyesight of a LCSB employee at all times. c. For overnight trips a chaperone and/or a volunteer/lay coach must have Level II clearance by the Human Resources Department. d. Chaperones are not allowed to discipline students. All discipline concerns shall be directed to the appropriate LCSB employee that is on duty, with the exception of verbally and politely requesting the students attention. e. At anytime, the chaperone must not use or have any tobacco products (smoking, chewing, dipping) or other mood altering substances. 6

14 LAKE COUNTY SCHOOL BOARD POLICIES

15 CHAPTER CURRICULUM AND INSTRUCTION 4.43 D TRIPS F FIELD TRIPS POLICY: Any trip which is directly related to a unit of instruction being studied by a particular group of students shall be considered an educational field trip. A field trip will be approved only when related to the instructional program of the school. The teacher shall direct the request for a field trip to the principal. The request shall include an outline of the trip and shall show how the field trip will be of benefit to the students. (1) A field trip for one (1) day shall be limited to a radius of 100 miles from the school unless otherwise approved by the School Board. All out-of-state field trips must be Board-approved. (2) Transportation costs for field trips shall normally be paid through the transportation budget provided that schools or organizations shall provide for reimbursement of such costs. (3) The parent or guardian shall be notified prior to any field trip. Such notice shall state the place to be visited, the date of the trip, the time of departure, and the time of return to the school. Any student making a trip shall present a note from his / her parent or guardian giving permission for him / her to make the trip. (4) The Superintendent shall develop procedures to be followed relating to educational field trips. (5) A trip which is not directly related to the instructional program but which is related to a school-sponsored or connected activity shall be considered an extracurricular trip. (6) The Superintendent shall develop procedures to be followed relating to extracurricular field trips. Lake County Revised 9/15/02 CHAPTER CURRICULUM AND INSTRUCTION 4.43 EMCS Page 2 of 2 Lake County Revised 9/15/02 STATUTORY AUTHORITY: ; , F.S. LAWS IMPLEMENTED: ; ; , F.S. STATE BOARD OF EDUCATION RULE: 6A HISTORY: ADOPTED: REVISION DATE(S): FORMERLY: EEAD 8

16 CHAPTER AUXILIARY SERVICES POLICY: SPECIAL USE OF SCHOOL BUSESUSES OF SCHOOL BUSES School buses may be used for educational field trips or for special school-connected or sponsored events provided any such trip is approved by the principal and is under the supervision of an instructional staff member of the school. Such trips may include educational field trips and extracurricular trips relating to athletics, band, choral music, clubs, or organizations sponsored by the school. (1) An educational field trip is any trip directly related to a unit of academic instruction being studied by a particular group of students and an extracurricular trip is any travel for a schoolsponsored or school-related activity, but is not associated with any instructional program activity. (a) Requests for educational and extracurricular use of school buses shall be made by the school principal to the Superintendent or designee not later than two (2) weeks prior to the time of the scheduled trip; exceptions to the deadline may be granted on an individual basis. The request shall identify the type of bus which is needed. The Transportation Supervisor shall approve or disapprove such use in accordance with this Rule and State Board of Education rules. (b) The school principal shall immediately notify the Transportation office when a trip is canceled or postponed. (c) Any request to change the type of bus shall be received in the Transportation office at least twenty-four (24) hours prior to the scheduled trip. (d) The Transportation Supervisor shall transmit the appropriate District form to the Director of Finance following each educational or extracurricular field trip to detail expenditures. (2) All out-of-state trips shall be approved in advance by the School Board. (3) A vehicle operated by a commercial line may be used for an educational or extracurricular trip or other approved school trip provided advanced approval is obtained from the Superintendent or designee. CHAPTER AUXILIARY SERVICES EMCS Page 1 of 3 Lake County Revised 9/15/02 9

17 (4) The following rules shall apply to any special use of a school bus for school trips. (a) Only a regularly employed bus driver approved by the Transportation Supervisor or a special driver who is fully qualified and approved by the School Board may be used for special trips. Eight (8) hours shall constitute a minimum day when a trip requires an overnight stay. Drivers on trips requiring an overnight stay shall be entitled to regular travel expenses as approved by the School Board. (b) Scheduling of a bus for a special trip shall be the Transportation Supervisor s responsibility. Such a trip shall in no way alter, interfere with, or disrupt the operation of a regular bus route transporting students to and from school. (c) It shall be each principal s responsibility to provide chaperones for each scheduled trip and to properly instruct chaperones before departure on the rules governing transportation with special emphasis on school bus behavior and safety. There shall be no less than a one (1) to ten (10) ratio of chaperones to student. At least one (1) chaperone on each bus shall be an instructional staff member. (d) Authorized passengers for field trips include students who are participating in the activity, chaperones, and School Board employees who are supervising the activity. The principal is responsible for approving any other passengers who ride a school bus on an educational field trip or an extracurricular trip. (e) Written permission of the parent(s) or legal guardian of each student participating in a special trip shall be on file in the principal s office of the participating school. f) The principal shall be responsible for handling of the collection for damages due to vandalism on a special trip in which the school participated. (g) Any school bus used for an extracurricular activity or an educational field trip shall be operated on the highways in strict compliance with all Florida Statutes, State Board of Education rules, and the School Board rules. (h) The driver on the bus trips shall clean the bus after each trip and shall have the bus in proper order for the regular bus route the following morning. (i) Luggage, band instruments, ice chests, or any package of material shall not be piled or placed in the aisle or entrance of the bus and in front of emergency exit windows. (j) Large boxes, packages, or band instruments shall be secured in such a way that a sudden stop would not cause the item to move and possibly cause injury to a passenger. CHAPTER AUXILIARY SERVICES EMCS Page 2 of 3 Lake County Revised 9/15/02 10

18 (k) A bus which is used for a special trip and is scheduled to return after the regular bus run or at night shall not be used to transport students to their homes, unless an emergency condition exists. CHAPTER AUXILIARY SERVICES EMCS Page 3 of 3 Lake County Revised 9/15/02 STATUTORY AUTHORITY: ; , F.S. LAWS IMPLEMENTED: ; ; ; , F.S. STATE BOARD OF EDUCATION RULE: 6A-1.052; 6A HISTORY: ADOPTED: REVISION DATE(S): 11

19 CHAPTER AUXILIARY SERVICES 8.36 POLICY: ORTING STUDENTS Transporting Students in Private Vehicles (1) The Board will normally use school buses, as defined in Florida Statutes, for all regular transportation of students, pre-kindergarten through grade 12. Regular transportation or regular use means to and from school or school-related activities which are part of a scheduled series or sequence of events to the same location. Regular transportation of students in motor vehicles other than school buses may occur only under the following conditions: (a) When transportation is for a physically handicapped or isolated student and the Board has entered into a written agreement for the transportation of the student. (b) When the transportation is part of a comprehensive contract for a specialized educational program between the Board and a service provider for instruction, transportation and other services. (c) When the transportation of students is necessary or practical in a School Board owned or commercially leased passenger vehicle not to exceed eight students in designated seating positions. (2) Except as provided above, the transportation of students in private vehicles may be authorized by the principal on a case-by-case basis only under the following conditions; (a) When a student is ill or injured and must be taken home or to a medical treatment facility under non-emergency circumstances and 1. The school has been unable to contact the student s parent or guardian, or such parent, guardian or responsible adult designated by the parent or guardian is not available to provide the transportation; 2. Proper adult supervision of the student is available at the location to which the student is being transported; 3. The transportation is approved by the school principal or designee; and 4. If the school has been unable to contact the parent or guardian prior to the transportation, the school continues to attempt to contact the parent or guardian until the school is able to notify the parent or guardian of the transportation and the circumstances. 12

20 (b) When the transportation is in connection with a school function or event in which the school has undertaken to participate and 1. The function is a single event which is not part of a scheduled series or sequence of events to the same location, such as, but not limited to, a field trip, recreational outing, a competitive or cooperative event, or an event connected to an educational program; and 2. Transportation is not available, as a practical matter, using a school bus or school board passenger car; and 3. Each student s parent or guardian is notified in writing about the transportation arrangement and gives written consent before a student is transported in a private vehicle. (c) When Board employees are required to use their own vehicle to perform duties of employment, and such duties include the occasional transportation of students. (3) Any private vehicles used to transport students under this policy shall be currently registered in the state of Florida, be insured for personal injury protection and property damage liability in at least the minimum amounts required by law, and be in good working order. A person wishing to transport students in a private vehicle will request approval by submitting his / her driver s license, vehicle registration and insurance I.D. card, to the principal in a reasonable amount of time before the planned travel. The principal will examine the driver s license, vehicle registration and insurance card, and may, in his or her discretion, gives approval for the transportation of students in the private vehicles as requested. A student who is transported to any activity in a private vehicle approved under this Policy shall return from the activity in the same vehicle, unless the student is released to his / her parents. (4) Student transportation in private vehicles may only be authorized for trips within the state of Florida. When transportation is authorized in a private vehicle, students may only be transported in designated seating positions and shall be required to use the occupant crash protection system provided by the vehicle manufacturer. A student who is transported to an activity in a private vehicle approved under this policy shall return from the activity in the same vehicle, unless the student is released to his/her parent. (5) Employees will be eligible for coverage by the Board s liability program when they are transporting students as part of their assigned or related duties. Benefits due from private vehicle insurance will be primary, except for worker s compensation, in accordance with state law. (6)Notwithstanding any other provision of this policy, in an emergency situation which constitutes an imminent threat to student health or safety, school personnel may take whatever action is necessary under the circumstances to protect students. 13

21 (7) When transporting students to activities coordinated by the Florida High School Athletic Association or the Florida Bandmasters Association, regulations of those organizations shall be followed. (8) Vans utilized for student transportation shall meet federal standards for passenger car safety. STATUTORY AUTHORITY: ; , F.S. LAWS IMPLEMENTED: ; ; , F.S. STATE BOARD OF EDUCATION RULE: 6A HISTORY: ADOPTED: REVISION DATE(S): FORMERLY: EEAE (PART 1) (PART 2) 14

22 FORMS REQUIRED FOR FIELD TRIPS 15

23 LAKE COUNTY SCHOOLS FIELD TRIP/SCHOOL ACTIVITY PARENT CONSENT/LIABILITY WAIVER/MEDICAL RELEASE OVERNIGHT OUT-OF-STATE OFF CAMPUS Student School Club/Group/Class Supervising Faculty Member Activity Location Date & Time of Departure Date & Time of Return Method of Transportation : School Bus Charter Bus Private Car Leased Vehicle Walking Other MEDICAL INFORMATION Does your child have any of the following conditions? Epilepsy/Seizures Yes No Motion Sickness Yes No Diabetes Yes No Any Medication Yes No Asthma/Wheezing Yes No Heart Disease Yes No Muscular/Skeletal Problems Yes No Hemophilia/Bleeding Disorders Yes No Allergies: Is there any other condition which might possibly require treatment and/or medication during the trip? Yes No If yes, you must complete and attach the Administration of Non-Prescription Medication Consent Form and/or the Administration of Prescription Medication Consent Form. PARENT CONSENT / LIABILITY WAIVER / MEDICAL RELEASE I/We hereby give permission for my child to accompany employees of the LCSB, acting as chaperones, to for the days indicated above. I/We will not hold the LCSB nor their agents or employees accompanying the group responsible for any accident or injury to my child/ward. In the event my child/ward causes any property damage or personal injury, whether individually or in concert with other persons or entities, I/we agree to indemnify and hold harmless the LCSB, its agents and employees. I/We have read all the information in regards to this trip. I/we are aware of guidelines of said trip and the number of chaperones which will accompany my/our child/ward. I/We hereby grant permission to the attending physician or his consulting physicians, to render to my/our child/ward any emergency treatment, medical or surgical care that might be deemed necessary to the health and well-being of said child/ward. Also, when necessary for the administering of such care, I/we grant permission for hospitalization at an accredited hospital. I/We assume full responsibility and liability for any and all expenses, damage, accident, illness, injury or medical expense of and to my/our child/ward or my/our property resulting from such participation. I/We attest and affirm that the participant has no limitation that should prevent participation in the activity and I/we have not been advised or informed by anyone to the contrary. I/We further agree to inform the appropriate school official(s) should my/our child/ward s physical condition change in any way and any time so as to affect his/her participation in the activity herein named. I/We further relieve and release said LCSB from any liability in its failure to carry insurance upon my/our said child/ward. Our/My child/ward has medical insurance Yes No If yes, you must complete and attach a copy of proof of insurance to this form. Insurance Co Policy # Home Phone Work Phone Cell Phone Emergency Phone Parent/Guardian Name (Please Print) Parent/Guardian Name (Signature) Date Home Address / City / Zip THIS SECTION MUST BE COMPLETED BY PARENT/GUARDIAN ONLY IF CHILD/WARD IS GOING OUT-OF-STATE OR OVERNIGHT! (SIGN IN PRESENCE OF A NOTARY) Parent/Guardian Signature NOTARY STATEMENT STATE OF FLORIDA, COUNTY OF LAKE On before me personally appeared, personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the instrument and acknowledged to me that he/she executed the same in his/her authorized capacity and that by his/her signature on the instrument, the person or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal One copy must be retained by the administration and a duplicate copy must accompany the sponsor when leaving school property with student 75 F004 03/13/14 NEW Submitted by Risk Management 16

24 LAKE COUNTY SCHOOLS ADMINISTRATION OF PRESCRIPTION MEDICATION CONSENT FORM Medications must be brought to school by the parent; NEVER by the student. The medication must be presented to school personnel in the original container with a current date. Metered inhalers should have the label affixed to the inhaler for easy identification or must be in the original box with prescription label. The parent must give the first dose of prescription medication at home. Under no circumstances will the school accept more than a four-week (30 days) supply of prescription medication. Parents may request that the pharmacist dispense two labeled bottles for medication, one for home and the other for school. Student DOB Parent School Address Home Phone Work Name of medication Dosage to be given Diagnosis Date to start Time to be given Allergies Last date to be given Please circle one: may may not carry and use the inhaler himself/herself. Special instructions on administration of medication (i.e. to be given after lunch, do not chew, to be given with food, etc.) Reaction(s) that may occur I request Lake County Public School personnel to administer medication as directed by this authorization. If there are questions regarding this medication I authorize the School Nurse/District Nurse to contact ordering physician as needed throughout the school year. It is the parent s responsibility to pick up medications that are no longer needed at school. Medications that have expired and/or are discontinued during the school year will be disposed of within a week of the expiration or discontinuation date. At the end of the school year left over or unused medications will be disposed of immediately after the last day of school. Parent Signature Date Doctor Signature Date Doctor s Official Stamp MIS 61D001 05/05/14 RVS Submitted by Student Services

25 ESCUELAS DEL CONDADO DE LAKE FORMULARIO DE CONSENTIMIENTO PARA LA ADMINISTRACION DE RECETA MEDICA Medicamentos deben de ser traídos a la escuela por un padre; NUNCA por el estudiante. El medicamento debe de ser entregado a un personal de la escuela en el envase original con fecha actual. El inhalador debe de tener la etiqueta fijada al inhalador para poder identificarlo fácilmente o debe de ser mantenido en su caja original con la etiqueta del medicamento. Es necesario que el padre de la primera dosis del medicamento al estudiante en la casa. Bajo ninguna circunstancia la escuela podrá aceptar una receta de medicamento con una cantidad de más de cuatro semanas (30 días). Los padres pueden solicitar que el farmacéutico dispense dos envases con etiquetas del medicamento, uno para la casa y el otro para la escuela. Nombre de Estudiante Fecha de Nacimiento Padre Escuela Dirección Teléfono de la Casa Trabajo Nombre del medicamento Dosis que ha de darse Diagnostico Fecha de comenzar Hora para dar Alergias Fecha de última dosis Favor de circular una: si puede no puede llevar y utilizar el inhalador él/ella mismo/a. Instrucción especial de administración de medicamento (por ejemplo, después del almuerzo, no se debe de masticar, debe ser tomado con la comida) Reacción que pueda ocurrir Solicito que el personal de las Escuelas Públicas del Condado de Lake administre el medicamento según las indicaciones en esta autorización. Si hay alguna pregunta acerca de este medicamento yo autorizo a la enfermera de la escuela o del distrito comunicarse con el médico mientras sea necesario durante el año escolar. Es responsabilidad de los padres recoger los medicamentos que ya no son necesarios en la escuela. Los medicamentos que han expirado y / o descontinuado durante el año escolar serán eliminados una semana después de la expiración o fecha de discontinuación. Al final del año escolar los medicamentos no utilizados serán desechados inmediatamente después del último día de clases. Firma de Padre Fecha Firma del médico Fecha Sello Oficial del Medico MIS 61D001 05/05/14 RVS Submitted by Student Services

26 LAKE COUNTY SCHOOLS ADMINISTRATION OF NON-PRESCRIPTION MEDICATION CONSENT FORM Non-prescription medication may be administered at school by school personnel when such medication is necessary for school attendance and cannot otherwise be accomplished. The non-prescription medication may be administered for 72 consecutive hours, once in the school year. Medication must be brought to school by parent/guardian in a sealed, unopened container. A form must be completed for each medication administered. Student Name Parent/Guardian Address DOB Phone Emergency Phone Name of non-prescription medication Dose to be given Diagnosis Time(s) to be given Allergies Purpose/reason for this medication Discontinue date Instruction(s) (i.e. take with water, milk, food) What reaction(s) may occur, if known? I request Lake County Public School personnel administer medication as directed by this authorization. A doctor s signature is required if: A medication is necessary beyond the 72 consecutive hours or When medication needs to be taken on Field Trips If there are questions regarding this medication I authorize the School Nurse/District Nurse to contact ordering physician as needed throughout the school year. It is the parent s responsibility to pick up medications that are no longer needed at school. Medications that have expired and/or are discontinued during the school year will be disposed of within a week of the expiration or discontinuation date. At the end of the school year left over or unused medications will be disposed of immediately after the last day of school. Signature of Parent/Guardian (REQUIRED) Doctor signature (REQUIRED) Date Date Doctor s Official Stamp MIS Form 61D003 05/05/14 RVS Submitted by Student Services

27 ESCUELAS DEL CONDADO DE LAKE FORMULARIO DE CONSENTIMIENTO PARA LA ADMINISTRACION DE MEDICAMENTO SIN RECETA El medicamento sin receta puede ser administrado en la escuela por un personal de la escuela cuando dicho medicamento es necesario durante el horario de la escuela y no pueda ser logrado de otra manera. El medicamento sin receta puede ser administrado por 72 horas consecutivas, una vez durante el año escolar. El medicamento debe de ser llevado a la escuela por el padre o persona encargada en el envase original sellado y sin abrir. Es necesario completar un formulario por cada medicamento administrado. Nombre de Estudiante Padre/Persona Encargada Dirección Fecha de Nacimiento Teléfono Teléfono de Emergencia Nombre de medicamento sin receta Dosis que ha de darse Diagnostico Hora para dar Alergias Propósito o la razón de medicamento Fecha de descontinuar Instrucciones (por ejemplo tomar con agua, leche, comida) Que reacción(es) puede ocurrir que usted esté al tanto? Solicito que el personal de las Escuelas Públicas del Condado de Lake administre el medicamento según las indicaciones en esta autorización. Se requiere una firma del doctor si: El medicamento es necesario por más de 72 horas consecutivas o Cuando es necesario tomar el medicamento durante un día de pasadías Si hay alguna pregunta acerca de este medicamento yo autorizo a la enfermera de la escuela o del distrito comunicarse con el médico mientras sea necesario durante el año escolar. Es responsabilidad de los padres recoger los medicamentos que ya no son necesarios en la escuela. Los medicamentos que han expirado y / o descontinuado durante el año escolar serán eliminados una semana después de la expiración o fecha de discontinuación. Al final del año escolar los medicamentos no utilizados serán desechados inmediatamente después del último día de clases. Firma de Padre o Persona Encargada (REQUERIDO) Fecha Firma de Doctor (REQUERIDO) Fecha Sello Medico Oficial MIS Form 61D003 05/05/14 RVS Submitted by Student Services

28 LAKE COUNTY SCHOOLS Submit at least TWO WEEKS PRIOR to date of trip. FIELD TRIP AND BUS REQUEST FORM Curriculum & Instruction Copy School Type of Trip: Educational Trip Curriculum Area Athletics (Specify) Date of Request Band Chorus Other (Specify) Date of Trip Destination Number of persons to be transported: Adults Pupils Teacher(s) in charge: Method of Transportation: Students and Adults in privately owned cars (Subject to adequate liability insurance on private vehicles.) School Buses Indicate A.M. or P.M. Number of buses required Time of Departure: Time of Return: Driver(s): Parent permission and waiver forms will be required for each student. FUND SOURCE: Budget Int. Accts. Other FUND (to be completed if budget checked) COST FUNCTION OBJECT CENTER PROJECT PROGRAM Signature of Principal Date Approved Not Approved Curriculum Supervisor Date Approved Not Approved Transportation Supervisor Date *TO BE COMPLETED BY TANSPORTATION DEPARTMENT* School Bus Number: Driver(s) Odometer Reading: Beginning Ending Miles Drivers Retirement/Social Security Total Cost.. $ $ $ $ Remarks MIS Form /20/04 REW Submitted by Transportation 19

29 LAKE COUNTY SCHOOLS REQUEST TO TRANSPORT STUDENT(S) IN PRIVATE VEHICLE Name of School Name of Driver Home Phone Other Phone Address Event Date(s) of Event Origin Destination I request permission to transport up to (maximum number of passenger restraints) student(s) in the following described private vehicle for this event: Make Model Year License Tag# State Insurance Company Policy# Policy Exp. Date To my knowledge, my vehicle meets the requirements of the Department of Education & Department of Transportation. I reviewed this information at the LCSB website under Risk Management at I understand that the student(s) will be transported only in designated seating positions and I will require the student(s) to use the vehicle manufacturer s crash protection system (lap/shoulder belts). I also understand that student(s) 12 and under should ride buckled up in the back seat if my vehicle has front passenger air bags. I am aware that children under 40 pounds and/or age four and under must be in appropriate child safety seats. While using or operating a motor vehicle with the approval or authority of the school district on a school function, I understand that I am not covered for third party liability damages in excess of my required coverage. I understand that it is my personal insurance providing coverage for liability and injury. I certify that the vehicle being used for the purpose indicated is covered by liability insurance with limits of at least $100, per person, $300, per occurrence for bodily injury and $50, coverage for property damage. I have completed and passed a Level II Volunteer Clearance for the LCSB, I declare that I have read the above form and that the facts stated therein are true. Date Driver Signature Each student s parent or guardian must be notified in writing of the transportation arrangements and written consent has been obtained from the student s parent or guardian. Date Supervising Faculty Member Signature A photocopy of the driver s valid driver s license and insurance card is attached to this form with a list of students to be transported. APPROVAL TO TRANSPORT STUDENTS Approval is granted for the above-listed driver to transport student(s) in the private vehicle and only for the event shown above. Date Date 75 F002 01/15/10 NEW Submitted by Risk Management Verified by School Volunteer Coordinator Principal/Designee Signature 20

30 FIELD TRIP SPONSOR FORMS 21

31 LAKE COUNTY SCHOOLS SPONSOR CHECK LIST OVERNIGHT - OUT OF COUNTY SCHOOL YEAR School Name Date Submitted Staff Member Name/Title Work Ext. & Cell Number Field Trip Destination City, State Departure Date/Time Return Date/Time FIELD TRIP PLAN MUST HAVE APPROVAL FROM SCHOOL PRINCIPAL/DESIGNEE Name of class/club/group attending Trip roster is attached. Number of students Number of chaperones Mode of Transportation Number of LCS Buses Charter Bus (Approved LCS Vendor) Personal Vehicle (no more than 20 students per trip) Rental Vehicle (Approved LCS Vendor) The following items must be attached for Principal/Designee review prior to approval of field trip. If using a Charter Bus Company a copy of transportation information to include number of buses and name of company is attached. If using private automobiles: A list of driver s is attached. All volunteer drivers have completed the following: application and background clearance on record with LCSB. (77 E001) the Level II application process as required by LCSB policy. are cleared and approved by the LCSB Human Resource Department. Copy of a valid driver s license and car insurance for each driver is attached. Copy of the completed Request to Transport Student(s) in Private Vehicle Form for each driver is attached. (75 F002) The vehicle must meet the requirements of the Departments of Education and Transportation. This information is available on the LCSB website under Risk Management at If using leased vehicles: The leased vehicle is from a LCSB approved vendor and is leased in the name of the school district. A copy of the lease agreement is attached. A list of drivers is attached. All drivers are LCSB employees. Lay coaches may not drive leased vehicles. For each leased vehicle there must be two (2) LCSB employee drivers. No more than eight (8) occupants in any vehicle. All occupants must have their own seat belt. Page 1 of 2 75 F006 04/29/10 REV Submitted by Risk Management 22