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Adult/Family Trips
About

Slippery Rock 8th Grade Field Trip to

Washington DC

May 14 - 15, 2022

Trip Info
Payments
Fundraiser Packet
Info Packet
Brochure

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Trip Info
Payments
Fundraiser Packet
Info Packet
Brochure

Slippery Rock DC Trip: SIGN UP

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What You'll Need
This form must be completed by the parent or legal guardian of the student who wishes to attend the field trip.

You will be:
- entering student and parent information
- providing medical & insurance information
- agreeing to several policies and releases
- making a payment by credit card or checking account
Both the parent/guardian AND the student must sign the form before submitting it

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

STUDENT INFORMATION
Student Name*
First Last
Gender*
- Male
- Female
Birthdate
Month
Day
Year
Student Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student Phone
Parent/Guardian 1*
First Last Relationship
Primary Phone*
Secondary Phone
Email*
Enter Email Confirm Email
Parent/Guardian 2
First Last Relationship
Parent/ Guardian 2 Phone
Parent / Guardian 2 Email
Enter Email Confirm Email
Emergency Contact
In the event school personnel cannot contact a parent or guardian, please list two relatives or friends who would have the authority to advise us regarding this student.
Emergency Contact 1*
First Last Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Emergency Contact 1 Phone*
Emergency Contact 2
First Last Relationship
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Emergency Contact 2 Phone

Medical Information
Insurance
Company Group # Policy # or Member ID
Policyholder Name
First Last
Student's Primary Care Physician
First Last
Physician's Phone
Over-the-Counter Medications
My student has permission to take the following if needed during the field trip. If he/she needs any of the following medications, he/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.
- Acetaminophen
- Ibuprofen
- Benadryl
Conditions
Please list any ailments which chaperones or medical personnel should be made aware. (Example: epilepsy, heart condition, diabetes, etc.)
Is the student currently under medical treatment?
- Yes
- No
Describe the Treatment
Provide doctor's name and phone, if not the student's primary care physician.
Tetanus*
Is this student's tetanus immunization current?
- Yes
- No
- Unknown
Known Allergies*
- Yes
- No
List all allergies and any medications. Explain what to do in case of exposure.*
List all allergies and any medications. Explain what to do in case of exposure.
Medications*
Will this student require any medicine during the field trip? (Note: be aware that sustained focus and impulse control is needed at most of our stops, just like it is in class.)
- Yes
- No
Please list the exact medicine including strength, reason for taking, and directions for dosing.*
Please list the exact medicine including strength, reason for taking, and directions for dosing.
Students are not permitted to have any medications in their possession during the field trip. If your student needs medication:
- Parents or guardians should give medication to the bus chaperone on the morning of the trip.
- Medications must be in the original container with the student's 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.

Permissions and Releases
Parent/Guardian Permission*
I am the rightful guardian of the above-named student and I grant permission for said student to participate on the overnight Slippery Rock 8th Grade field trip to Washington, DC on May 14-15, 2022.
I agree
Slippery Rock School District Release of Liability and Hold Harmless Agreement*
The Undersigned acknowledge that they have been advised that neither the Slippery Rock School District nor the parties responsible for transporting and supervising the students in question can guarantee or assure the security of said students on the trip in question. The District does not provide uniformed or other security officers with respect to said trip nor does it assume such liability. The Undersigned will investigate and satisfy themselves with respect to the provision of security for the students on the trip in question and will hold harmless and release the District and its Directors, Superintendent, and employees, with respect to any liability arising out of the participation by said student on this trip.
I agree
Logan Tours Inc Release of Liability and Hold Harmless Agreement*
As the parent(s)/guardian(s) of the above-named student, I/we on behalf of myself/ourselves, my/our heirs, executors, administrators, and assigns, and on behalf of the above-named student do hereby release and discharge Logan Tours, Inc., their employees, agents, and/or servants from any and all rights, claims, and/or actions which I/we and/or the above named student may hereafter have against Logan Tours, Inc. their employees, agents and/or servants arising out of the aforementioned field trip.
I agree
Medical Release and Hold Harmless Agreement
I, the parent/guardian, do hereby release, discharge, and hold harmless Slippery Rock School District and Logan Tours, Inc. their agents and employees, from any and all liabilities, and claim whatsoever for the administration of the above medication to my child/ward should there develop an allergic or other reaction from the medication.
I agree
Permission for Medication and Emergency Medical Care*
I hereby authorize any Slippery Rock Area School District Approved Trip Chaperone to make emergency medical decisions regarding my son or daughter. It is understood that this authorization is given in advance of any specific medical diagnosis or emergency medical situation, but is given to provide authority and power on the part of our aforesaid representative to give specific consent to any and all necessary emergency medical treatment and hospital care which a physician in the exercise of his/her best judgment may deem necessary. It is understood that the parent / guardian will be responsible for payment of any such medical treatment, including transportation, provided to their child.
I agree
Permission to Photograph*
I give Logan Tours, Inc. permission to photograph and/or video record my son/daughter in a group setting and to use those pictures and videos to promote the trip for future student tours. These pictures and videos could be used in trip brochures, on the tour website, in presentations for student and/or parent meetings, etc.
I agree
Discipline Policy*
All School District policies are in effect during this field trip, including those regarding profanity, disrespect, hazing, and harassment. Students who violate any District policies may be suspended from future overnight field trips, and will face appropriate disciplinary action in accordance with School District policies.
If behavior is an issue with any student, the chaperones will employ the following procedures: 1. Verbal warning, 2. Assigned seat, 3. Deny permission to remain with group at itinerary stops (will remain on bus with a chaperone) 4. Phone call to parent.
If my child’s behavior is disruptive and the first four steps do not resolve the issue, I will make plans to pick him/her up wherever the group may be at that time.
I agree
Tobacco, Controlled Substance and Firearm Policy*
Students may not possess or use any tobacco products, alcohol, suspected controlled substance, or weapons during this field trip. Students who violate this rule will be excluded from participating in any further travel activity. School officials will be immediately notified, and current School District policies governing these offenses will be enforced.
I agree
Bag Check Policy*
I give Slippery Rock School District and Logan Tours Inc permission to search the bag of my son/daughter if either believe it is warranted to ensure the safety of the participant, others participants and/or tour operators.
I agree
Acceptable Use Policy: Cellular and Electronic Devices*
I have read and fully understand the cell phone and electronic usage policy. I also understand that all behaviors will be left up to the discretion of the Slippery Rock School District and Logan Tour Company employees. If, in the event, it is felt that my (or my child’s) cell phone or electronic usage is not in compliance with expected behaviors, I understand that disciplinary action, including removal from the trip, may be taken.
I agree
Show AU Policy
- Show Device Use Policy
Students may possess cell phones and other electronic devices while on the trip to Washington, D.C. All device usage must be kept in accordance with the following policy. Failure to comply with the policy and outlined stipulations will result in disciplinary action which may include removal from the trip. The electronic policy is as follows:
1. All students are responsible for their own devices. Slippery Rock Area School District and Logan Tour Company are not responsible for any lost, stolen, or damaged property.
2. Devices should be used in a manner that does not inhibit the educational value of this trip. With that being stated, phone calls, texting, or disruptive picture/video recording during a presentation, tour, or program are prohibited.
3. Electronic devices, such as MP3 players, IPods, or gaming devices, must be reserved for leisure time. The use of these devices outside of designated time allotment will result in confiscation.
4. Cell phones may be used for limited communication, but should be done so during appropriate times. For example, if a student needs to make a call, they should do so during their leisure time, not in a whole group setting. Continual texting and social media usage is unnecessary, and it will take away from the educational value of the trip.
5. All phones and communication devices will be shut off upon return to the hotel Saturday night. Chaperones will check devices when students are checked in before bedtime. For the safety and security of all students, it is necessary to keep all phones off until morning. In the event of an emergency at home, all students may be reached by contacting a designated chaperone.
6. Any pictures and/or videos taken during the trip must be school appropriate and reflect the school in a positive, respectful manner. Any photographs or videos taken that display vulgar, rude, offensive, suggestive, or inappropriate behaviors will be viewed as a disciplinary concern and addressed immediately.
Parent Signature*
Student Signature*
How do you want to secure your reservation?*
- Pay deposit or full amount
- Commit to sell 40 hoagies to cover the deposit

REBECCA GREEN, Owner

142 Bryson Road
Butler, PA. 16001
(724) 355- 4997
logantoursinc@gmail.com

Copyright Logan Tours Inc | All Rights Reserved