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Butler 7th Grade Trip to Gettysburg: Signup Form PlaceholderJennifer Cummings2020-01-04T12:44:40-05:00

Butler Gettysburg Trip: SIGN UP

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  • What You'll Need

  • You will be providing student information, parent information, medical history & insurance information, and signing several waivers.

    You will also need to provide 3 signatures:

    • Parent or guardian
    • Student
    • Witness (a person other than yourself who will attest that you did sign these forms).

    Gather the information you need before proceeding. Have everyone available to sign.

    If this form is not working or you need assistance, contact Rebecca Green at 724 355 4997

  • STUDENT INFORMATION

  • In event of emergency if neither parent can be reached.
  • Butler Area School District Release of Liability and Hold Harmless Agreement

    TO: Butler Area School District, Its Board of School Directors, Superintendent, and Employees
  • Please check the box next to each paragraph to mark as read.
  • **Have someone over the age of 18 (other than the parent/guardian signed below) witness the signing of this agreement.
  • Date Format: MM slash DD slash YYYY
  • Medical Information

  • This student has permission to take the following medicine if needed during the field trip. He or she must ask a sponsoring teacher and will be given the medication under a chaperone's supervision. Students should not bring any of these OTC medications - we will provide them.
  • Has the student had any of the following? (check all that apply).
  • If you checked any of the above conditions, or if there is another condition we should know about, please provide additional information.
  • Is this student's tetanus immunization current?
  • List all allergies and any medication in case of exposure and/or steps of action
  • Will this student need any medicine, prescription or otherwise, during the field trip?
  • Please list the exact medicine including strength, reason for taking, and directions for dosing. On the morning of the trip, put enough medicine for 2 days in the origiinal RX (if applicable) with a note includeing what the medicine is, and when it is to be taken. THIS APPLIES TO ALL PILLS FROM TYLENOL TO ANTIBIOTICS TO VITAMINS. If they need it over the weekend, it must be given to the chaperones with clear instructions. Thank you in advance for your cooperation in this matter.
  • Students are not permitted to have any medications (pills) in their possession during the field trip -(ONLY EXCEPTION are rescue meds). If your student needs medication of any kind:
    • Parents or guardians must give medication to the bus chaperone on the morning of the trip.
    • Medications should be in the original container (in particular if it is a prescription) with the student's name, medicine name, dosing information, and any additional information on the label.
    • Send only the amount that the student will need during the trip
  • If there are any additional circumstances of which the tour coordinator or bus chaperones should be aware, medical or otherwise, please contact Rebecca Green from Logan Tours, at 724. 355. 4997 or logantoursinc@gmail.com All medical and other information is treated with strict confidentiality and only the chaperones who are with your child will be made aware of information needed to keep your child safe.
  • Please check the box next to each paragraph to mark as read.
  • Permission to Photograph, Discipline, and Tobacco Policies

  • If you agree to the following policies, please check the box next to each section to mark as read and sign at the end of this section.
  • BY SIGNING BELOW, I HAVE READ AND AGREE TO ALL THE POLICIES ON THIS PAGE (Permission to Photograph, Discipline Policy and Tobacco, Controlled Substance and Firearm Policy)
  • Date Format: MM slash DD slash YYYY

 

Logan Tours, Inc Where on Earth or YOU going?

Rebecca Green, Owner

142 Bryson Road

Phone: (724) 355- 4997

Email: logantoursinc@gmail.com

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