Redland Middle School Goes to Smith Center for Outdoor Education Who: What: 6 th Grade Redland Middle School Students Outdoor Education When: September 28-30: Selig s periods 1, 2 and 7 September 30-October 2: Selig s period 6 and Lugo s periods 3 and 7 Where: Lathrop E. Smith Environmental Education Center 5110 Meadowside Lane, Rockville MD 20855 Parent Meeting: More information will be provided Thursday September 10, 2015 at 6:00pm in the RMS Media Center. Outdoor Ed Coordinator: Mrs. Bryna D. Selig (Bryna_D_Selig@mcpsmd.org) Sixth Grade Counselor: Mrs. Ehlers The following forms need to be completed, signed and returned to Mrs. Selig by Tuesday, September 15, 2015 Completed and Signed Parent Permission Form Completed Financial Information Form with payment Completed and Signed Medication Authorization Form (if needed) Completed and Signed Emergency Care/Anaphylaxis Form (if needed) Parent Volunteer Form (if interested in volunteering) (WE NEED YOU!)
REDLAND MIDDLE SCHOOL www.montgomeryschoolsmd.org/schools/redlandms 6505 Muncaster Mill Rd, Rockville, MD 20855 (301) 840-4680 FAX: 301-840-4688 August 2015 Dear Parents and Guardians of 6 th Grade Students, Redland's 6 th grade staff is preparing the students for one of the most exciting and important experiences of their school year: Outdoor Education at the Lathrop E. Smith Outdoor Education Center in Rockville. A great deal of planning is required for a successful trip and your assistance is very much appreciated. This year Selig s periods 1, 2 AND 7 students attend September 28-30. Selig s period 6 and Lugo s period 3 and 7 students attend September 30- October 2, 2015. In order to attend the Outdoor Education Program, we need to receive a Parent Permission form and payment by September 14, 2015. The fee for the program is $76. Checks should be made payable to Redland Middle School and should have the student s name in the memo line. Payment can also be made by credit card at Redland s Online School Payment site (see link at the Redland website). A financial information form is provided for any family that finds it a hardship to pay the full amount for the program. Parents of students who require medication of any type must give the medication in the original container to the school nurse. All medication (prescription and over-the-counter) must be delivered to the school nurse by Monday September 14, 2015 and must be accompanied by the MCPS Authorization to Administer Prescribed Medication form. This form must be completed in its entirety by both parent/guardian and physician. Pharmacy labels must correspond to physician's orders. Over-the-counter medication must have the safety seal intact. Medications stored and administered from our school health room will not be sent to camp. The only exception will be Epi-Pens and inhalers which will be sent from school to the Smith Center. A separate Anaphylaxis form is required for students with Epi-Pens. Students are expected to follow the rules and regulations of Redland and the Smith Center while participating in the program. Any student who does not meet the expected standards of behavior will be sent home. The parent(s) of that student will provide transportation home, and there will be no refund of trip costs under these circumstances. Students will be held responsible for any damage to propery. Please discuss appropriate behavior with your child to prevent the possibility of such occurrences. After reading the above conditions and signing the attached permission slip, you are acknowledging and agreeing to come for your child immediately if he/she does not abide by them. If you have any questions or concerns about the Outdoor Education program, please do not hesitate to contact either Ms. Geddes( 6 th grade team leader) or Mrs. Selig ( Outdoor Ed. Coordinator). Our goal is to have 100% participation in this part of the 6 th grade science curriculum. Provisions are made for students who are unable to spend the night as well as for families who might have financial concerns. Again, please contact us if you have any concerns about your child s participation in this program. Please return the $76.00 fee, the permission slip and payment, and medication and emergency care forms (if needed) to Mrs. Selig by Monday, September 14th. The 6 th grade teachers are looking forward to an exciting and rewarding program at Outdoor Ed with your child. Approved: Everett Davis, Principal Sincerely, Mrs. Selig, Outdoor Ed Coordinator
General Information Finances Each child is charged $76.00 for the three-day outdoor education program. This fee includes transportation, meals, lodging, snacks, on-site nurse, medical insurance and other expenses. Final payment is due to Mrs. Selig as soon as possible, but no later than Monday, September 14, 2015. Make checks or money orders payable to Redland Middle School, writing your child s name in the memo. For your convenience, use the link at the Redland website to pay online with a credit card. If this fee imposes a financial hardship, please indicate that on the attached Financial Information Form. Medications All medications, including aspirin, vitamins, and cough medicine to be administered at Outdoor Ed must be accompanied by the MCPS Form 525-13 Authorization to Administer Prescribed Medication. One copy of this form is attached but a copy per medication is needed. If you need extra copies of this form, you may make copies of the form attached to this packet. The medicine should be in the original container. Parents must bring their child s medication and Form 523-13 to the Redland Middle School nurse by Monday September 14, 2015. The medications will be stored and administered in the health room at the Smith Center. Medication must be picked up by the parent in the Redland health room at the conclusion of the Outdoor Ed. Please note on the permission slip if your child has health problems including allergies, a need for medication or any condition of which the nurse and the staff should be aware. Please feel free to contact Mrs. Selig or Ms. Ruffner, the school nurse, to discuss any problems your child may have. Information will be kept confidential. Dietary Restrictions If your child requires a special diet of any kind, please send dietary instructions to Mrs. Selig as soon as possible. They will be forwarded to the Smith Center. The Center s kitchen is prepared to provide alternative menus which will accommodate most dietary restrictions. In certain cases, parents will be asked to send prepared meals for their child s individual needs. Weather The weather can be challenging. Our outdoor activities will be carried on even in wet and cold weather. Students must be prepared with appropriate clothing. Please do not buy new things for Outdoor Ed. Comfortable shoes appropriate for walking all day are necessary. Broken-in sneakers are a perfect choice. In case of inclement weather, we will follow MCPS procedures. An extra newspaper is extremely helpful for drying out sneakers in case they get wet.
Day of Departure Luggage and Transportation Please make arrangements for your child s transportation with his/her labeled luggage to get to the school cafeteria at 9:30 AM on his/her day of departure. MCPS will not allow students to bring their luggage on the regular school bus. The Outdoor Ed buses will arrive at 9:30 to pick up the students and their luggage. The students will not have their regularly scheduled classes that morning. Your child s belongings should be contained in only two pieces of luggage. One should be a suitcase or duffel bag and the second should be a sleeping bag with a pillow wrapped in a waterproof cover (a large plastic garbage bag works great) and tied securely. You may also choose to pack a sheet and blanket instead of a sleeping bag. BOTH pieces of luggage should be clearly labeled with the student s first and last name. Day 1 Lunch Each student will need a bag lunch and drink for the first day of Outdoor Ed. All lunch items must be packed in recyclable bags or containers (no glass). Be sure to clearly write your child s first and last name on the lunch bag. If your child needs a bag lunch prepared by our cafeteria for that day, please indicate that on the bottom of the Financial Information form. Mail Students love to get mail! You can give letters for your student to his/her team leader on the morning we leave for camp. You can also mail letters directly to the Smith Center ahead of time at the following address: [Student s name], RMS Lathrop E. Smith Environmental Education Center 5110 Meadowside Lane Rockville MD 20855 Day of Return Students will return to Redland at approximately 12:30 PM on their return day. Sixth grade staff and students will be dismissed to go home immediately after the buses arrive at Redland. It is essential to make transportation arrangements for your child to be picked up at this time. For safety reasons, students are not allowed to take luggage on their regular school bus. If you are unable to meet your child, please make sure that Mrs. Selig receives a note authorizing alternate transportation prior to departing for Outdoor Ed. Parents must have a picture ID when picking up their child at Redland Middle.
MONTGOMERY COUNTY PUBLIC SCHOOLS MONTGOMERY COUNTY DEPARTMENT of Health and Human Services Rockville, Maryland 20850 AUTHORIZATION TO ADMINISTER PRESCRIBED MEDICATION Release and Indemnification Agreement PART I TO BE COMPLETED BY THE PARENT/GUARDIAN I hereby request and authorize Montgomery County Public Schools (MCPS) and Montgomery County Department of Health and Human Services (MCDHHS) personnel to administer prescribed medication as directed by the physician (Part II below). I agree to release, indemnify, and hold harmless MCPS and MCDHHS and any of their officers, staff members, or agents from lawsuit, claim, demand, or action against them for administering prescribed medication to this student, provided MCPS and MCDHHS staff are following the physician s order as written in Part II below. I have read the procedures outlined on the back of this form and assume the responsibilities as required. Student: Birthdate: / / School: Prescription: Renewal New If new, the first full day's dosage was given at home on: / / List all medication(s) student is taking, including over-the-counter medication(s): PART II TO BE COMPLETED BY THE PHYSICIAN - - / / Parent/Guardian Signature Phone Number Date The Montgomery County Department of Health and Human Services and the Montgomery County Public Schools discourage the administration of medication to students in school during the school day. Any necessary medication that possibly can be administered before and after school should be so prescribed. Only non-parenteral medications are administered except in specific emergency situations. School personnel will, when it is absolutely necessary, administer medication to students during the school day and while participating in outdoor education programs and overnight field trips, according to the procedures outlined on the back of this form. PLEASE USE A SEPARATE FORM FOR EACH MEDICATION Name of Medication: Trade name and/or generic Diagnosis: Dosage: Time(s) To Be Given At School: Route of Administration: Effective Dates: From / / To / / Side Effects: If PRN, specify: When indicated (signs/symptoms) Frequency of administration - - / / Physician s Name (print/type) Physician Signature Phone Number Date SELF-CARRY/SELF-ADMINISTRATION OF EMERGENCY MEDICATION AUTHORIZATION/APPROVAL Self-carry/self-administration of emergency medication such as inhalers and EpiPens must be authorized by the prescriber and be approved by the school nurse according to the State medication policy: Prescriber s authorization for self-carry/self-administration of emergency medication / / Signature Date School Registered Nurse (RN) approval for self-carry/self-administration of emergency medication / / Signature Date PART III TO BE COMPLETED BY THE PRINCIPAL OR SCHOOL NURSE Check as appropriate: Parts I and II above are completed, including signatures. (It is acceptable if all items of information in Part II are written on the physician s stationery/prescription blank.) Prescription medication is properly labeled by a pharmacist. Medication label and physician order are consistent. Over-the-counter medication is in an original container with the manufacturer s dosage label and safety seal intact. / / Date any unused medication is to be collected by the parent or guardian (within one week after expiration of the physician s order). MCPS Form 525-13, Rev. 11/11 / / Principal/School Nurse Signature Date DISTRIBUTION: COPY 1/Student Health Record; COPY 2/Parent/Guardian
INFORMATION AND PROCEDURES 1. No medication will be administered in school or during school-sponsored activities without the parent s/ guardian s written authorization and a written physician order. This includes both prescription and overthe-counter (OTC) medications. 2. The parent/guardian is responsible for completing Part I and obtaining the physician s statement on Part II. This is required every school year for each new or continuing order or if there is a change in dosage or time of administration during the school year. (A physician may use office stationery or prescription pad in lieu of completing Part II.) Information necessary includes: child s name, diagnosis, medication name, dosage, time of administration, duration of medication, side effects, physician signature, and date. 3. The medication must be delivered to the school by the parent/guardian or, under special circumstances, an adult designated by the parent/guardian. Under no circumstances will either the school health (MCDHHS) or school (MCPS) personnel administer medication brought to school by the student. 4. All prescription medication must be provided in a container with the pharmacist s label attached. Nonprescription OTC medication must be in the container with the manufacturer s original label. Physician samples must be appropriately labeled by the physician. 5. The first day s dosage of any new medication must have been given at home before it can be administered at school. 6. The parent/guardian is responsible for collecting any unused portion of a medication within one week after expiration of the physician s order or at the end of the school year. Medication not claimed within that time period will be destroyed. 7. Self-administered and/or non-medically prescribed medications are entirely the responsibility of the parent/ guardian and not that of either the Montgomery County Public Schools or Montgomery County Department of Health and Human Services. Medications without accompanying physician s orders and parental consent will not be stored in the health room. 8. Students may not self-administer controlled substances. 9. A physician s order and parental permission are necessary for self-carry/self-administered emergency medications such as inhalers for asthma and EpiPens for anaphylaxis. The school nurse must evaluate and approve the student s ability and capability to self-administer medication. It is imperative the student understands the necessity for reporting to either the health staff or MCPS staff that they have self-administered their inhaler without any improvement or have self-administered an EpiPen, so 911 may be called. 10. The school registered nurse (RN) will call the prescriber, as allowed by Health Insurance Portability and Accountability Act (HIPAA), if a question arises about the child and/or the child s medication.
REDLAND MIDDLE SCHOOL www.montgomeryschoolsmd.org/schools/redlandms 6505 Muncaster Mill Rd, Rockville, MD 20855 (301) 840-4680 FAX: 301-840-4688 Financial Information Form Due September 14, 2015 Dear Parents and Guardians: The fee for the Outdoor Ed program is $76.00. This cost will cover everything from buses to meals and activities over the three days. There are many options for payment and financial assistance is available. Please check your preference below. Also, if you d like to contribute more than your child s cost to help another student, we would appreciate your generosity. Respectfully, Mrs. Selig, Outdoor Ed Coordinator Student s Name Payment Options (checks payable to Redland Middle School ) The full payment of $76 was made via credit card. Go to Redland s website and use Redland s Online School Payment option. The full payment of $76 is enclosed with my permission slip. Check # or cash I am able to contribute extra to help another student in the amount of $ I will pay the full amount, but I d like to pay $40 now, and $36 later (by Friday, September 25, 2015) I can only pay part of the cost of the trip: $20 $40 $60 Other $ I am not able to pay any amount for the trip. Lunch for the first day Does your child participate in the free and reduced meals program? Yes No Will your child need the cafeteria to provide a bagged lunch? Yes No (If yes, please write your student s cafeteria PIN here: )
Grade 6 Residential Outdoor and Environmental Education Program Equipment List Essential Equipment Boots/sturdy hiking shoes (2) Long pants (2-3) Shirts long/short sleeved (2-3) Socks (4-6) Underwear (2-3) Pajamas Jacket/sweater/coat Raincoat/poncho Gloves, mittens, hat (winter) Sheets and blanket or sleeping bag Pillow Laundry bag Reusable Water Bottle Toilet articles: bath towel, wash cloth, comb, brush, soap, shampoo, toothbrush, toothpaste, deodorant Optional Equipment Camera Flip flops for shower Sunscreen Insect repellent Watch Lip balm Shorts (recreation time only) Pen/pencil Book Journal Binoculars Compass Small games Bandana for a napkin DO NOT Bring Gum, candy, food Bottled drinks Cell phone Aerosol sprays Hair dryer Curling iron Money Electronic games MP3 player, radio As in all schools, weapons, firearms and matches are not permitted. Remember: Check the weather and pack accordingly Label all equipment with the student s name Pants must be worn to all instructional sessions Bagged lunch for first day (no glass)
Parent Volunteer Form (Return ONLY if interested) Please complete if you are interested in volunteering for Outdoor Ed. Check all times you are available. These times are aligned with our schedule. If your available times are different, please make a note of that. Instructions are provided to parent volunteers at the start times noted below. September 28-30----Selig s periods 1, 2, and 7. September 30- October 2---- Selig s period 6 and Lugo s periods 3 and7. Day 1 (September 28) (September 30) 9 AM -1 PM. Will you be staying for lunch from 12-1? Yes or No If yes, pack a lunch. 1 PM 5 PM. Will you be staying for dinner from 5-6? Yes or No 5 PM 9 PM. Will you be arriving in time for dinner from 5-6? Yes or No Overnight 9 PM 8 AM. This is a high priority shift. Please consider at least one night. Day 2 (September 29) (October 1) 8:45 AM -1 PM. Will you be staying for lunch from 12-1? Yes or No 12:45 PM 5 PM. Will you be staying for dinner from 5-6? Yes or No 5 PM 9 PM. Will you be arriving in time for dinner from 5-6? Yes or No Overnight 9 PM 8 AM. This is a high priority shift. Please consider at least one night. Day 3 (September 30) (October 2) 8:30 AM -12 PM. Will you be staying for lunch from 11-12? Yes or No All 3 Days I can do all of the times listed above (i.e., you can be with us for the entire program). Student Name Parent/Guardian Name Email Address (please print) Telephone Numbers: Home: Work: Cell: