_Field Trip Policies and Forms

For all field trips, please read policies:

For field trips which include a Special Needs student:

Field Trip Required Forms:

 

Form

Routine
In-District

Extended
In-State

Out-of-
State

E 6153(a) Preliminary Field Trip Preparation  word 2007 icon 
(10 months in advance for Out-of-State; 18 months in advance for international)

No

No

Yes

E 6153(c) Field Trip Information Form  word 2007 icon

Yes

Yes

Yes

E 6153(d) Verification of Field Trip Information PDF Icon

Yes

Yes

Yes

E 6153(e) Field Trip Questionnaire     

No

Yes

Yes

E 6153(f) Student Indemnification Statement   Word Icon   

Yes

Yes

Yes

E 6153(g) Student Behavior Contract  word 2007 icon

No

No

Yes

E 6153(h) Chaperone/Volunteer Indemnification Statement  word 2007 icon

Yes

Yes

Yes

        Volunteer Screening Process for chaperone background check

Yes

Yes

Yes

E 6153(g) Student Behavior Contract    

Yes

E 6153(i) Permission to Travel Outside the United States (only if trip is international)  word 2007 icon 
Also refer to www.Travel.State.Gov for specific information on international travel.

No

No

Yes

E 3541.1(a) Driver Registration Form (if students are being driven)

Yes

Yes

Yes

E 3541.1(b) Private Vehicle Transportation Safety Check (if being driven in private vehicle)

Yes

Yes

Yes

E 3541.1(c) Booster Seat Safety Check (depending on size of student)

Yes 

Yes

Yes

E 6153.1(a) Field Trip Participation Consent Form for Medically Fragile/Intensive Needs (if needed)

Yes*

Yes*

Yes*

E 6153.1(b) Field Trip Accommodation Plan; Students with Medical Needs (if needed)

Yes*

Yes*

Yes*

Flight Itinerary

No

Yes*

Yes

Daily Itinerary

Yes

Yes

Yes

List of contacts including cell phone of teacher chaperone(s)

Yes

Yes

Yes

List of certified teachers that will be chaperoning

Yes

Yes

Yes

List of chaperones that will be the same gender as students they supervise

Yes**

Yes**

Yes

All chaperones will need a background check

Yes    

Yes

Yes

Insurance summary

Yes

Yes

Yes

Due to safety concerns, no 9-15 passenger vans may be used.  8-passenger (or less) mini vans are allowed.

Yes

Yes

Yes

* Special needs/medically fragile student(s) only
** If overnight, only
     

Note: All forms for out-of-state or international field trips should be submitted to the Assistant Superintendent of Instructional Services for approval after they are approved by the site administrator.