Student Outdoor School Project

STUDENT OUTDOOR SCHOOL PROJECT

Student Information

Date of Birth:    Student ID:    Grade/Program:

Project Overview

Location & Schedule

Location:

Dates: From to    Departure Time: Return Time:

Transportation

Transportation will be provided as indicated below. Students transported by private vehicle require advance written approval.

School bus or chartered bus    School van    Transported by parent/guardian    Walk / local transit

Required Equipment & Clothing

The following items are mandatory unless otherwise noted. Failure to bring required items may result in exclusion from specific activities.

Water bottle    Closed-toe shoes    Rain jacket/poncho    Sun hat/sunscreen

Medical Information & Emergency Contacts

Physician Name:    Physician Phone:

Relationship:    Phone:

Health Authorization & Special Considerations

I certify that the medical information provided above is accurate and complete to the best of my knowledge. In the event of an emergency, project staff are authorized to obtain emergency medical treatment for my child and to administer routine first aid. If emergency treatment is required, reasonable efforts will be made to contact the emergency contact listed above prior to treatment where practicable; however, authorization is given in advance for medical personnel to proceed as necessary.

Conduct, Safety & Supervision

Students are expected to follow all directions of project staff and volunteers and to comply with safety protocols established for on-site activities. Reckless, unsafe, or unlawful conduct may result in removal from activities and, if necessary, return transport at the expense of the parent/guardian. The school will make reasonable efforts to supervise participants consistent with usual school practices.

Assumption of Risk and Release

I acknowledge that participation in outdoor field activities involves inherent risks, including but not limited to uneven terrain, variable weather, wildlife encounters, and physical exertion. On behalf of myself and my child, I freely assume full responsibility for any and all risks of loss, damage, or personal injury, whether caused by the negligence of the school or otherwise. To the fullest extent permitted by law, I hereby release and agree to indemnify and hold harmless the school district, its trustees, employees, volunteers, and agents from any and all claims, liabilities, costs, or damages arising out of or related to my child's participation, except for claims resulting from gross negligence or willful misconduct by the school.

Media Release

I authorize the school to photograph or record my child during project activities and to use such images or recordings for educational or promotional purposes, subject to the limitation below.

I grant permission for photo/video use.    I do NOT grant permission for photo/video use.

Academic Integration & Assessment

Cost, Payment & Refund Policy

Program Fee: $    Payment Plan:

Refunds are governed by school policy. By signing below, I acknowledge responsibility for payment according to the schedule above unless otherwise agreed in writing by the school.

Acknowledgment & Consent

By signing this form I certify that I am the parent or legal guardian of the named student (or that I am the student if 18 years of age or older), that I have read and understand the information contained herein, and that I consent to my child's participation in the Student Outdoor School Project as described. I understand the risks involved and agree to the health authorization, release, and indemnity provisions set forth above.

Optional: Special Instructions or Considerations

Sign Now