Category 1 Excursion

PARENTAL ACKNOWLEDGEMENT OF RISK AND INFORMED CONSENT FOR PARTICIPATION IN BSS EXCURSION
Student Name Activity Name Group Leader Destination address Dates & Times Activity Description Student # Annual Hockey Day Bishop Strachan vs. Havergal College Hockey Game BSS Faculty Jane King North Toronto Arena - 174 Orchard View Blvd., Toronto Tuesday February 4, 2014 (Depart BSS @ 12:30pm and departure from arena 2:45pm) Students will travel by school bus with their teachers and watch the Bishop Strachan hockey team plays Havergal College. This is a school wide spirit week event. Students will watch the game from the stands at North Toronto Arena.
Grade 7/8 students must return their forms to Ms. Foster Students in grades 9 12 must hand in forms to Ms. King by February 3 or their attending teacher on the bus

Return consent form by

Below is a list of activities and risks involved in this excursion:

ACTIVITIES OTHER ITEMS Transportation

&

RISKS These include but are not limited to losses caused by: Risks involved in bus travel to and from North Toronto Arena Risks associated from walking and movement in and out of the arena. Being hit by a hockey puck that goes over the boards. Students will be in a cold arena. Students must be dressed appropriately for the weather conditions

PARENT INITIALS

Watching a Hockey Game

Inclement Weather

Medical Information: Are there any medical conditions, new or not disclosed at the time of submitting the Student Information Form? No Yes Signature Signature ___________________________________ __________________________________ Give details: _______________________________________________________

STUDENT SAFETY Off-site excursions can provide students with opportunities for direct reflection valuable educational experiences and practical applications for community building. The Bishop Strachan School strives to ensure the safety of its students while participating in School sponsored student activities. However, despite taking all reasonable precautions to minimize the risks involved, there remain inherent risks of injury. The injuries suffered may be minor, such as sprains, or may, in rare cases, be more serious.

Parents or guardians who consent to a student participating in a School activity should understand that such injuries can occur during School activities because of the inherent nature of the activity, and without neglect on the part of either the student or The Bishop Strachan School. The purpose of this document is to inform you about the excursion and to seek your permission for your daughter to participate in the excursion. IMPORTANT MEDICAL INFORMATION Students are responsible for bringing allergy medication such as Epipens or inhalers and any other prescribed medication required on all field trips. (Add important medical information relevant to the particular excursion.) MEDICAL SERVICES AUTHORIZATION Should the student suffer injury or illness while participating in this activity, the undersigned hereby authorizes any teacher or third party contractor accompanying the student to authorize such medical attention for the student as may be deemed appropriate in the circumstances. The undersigned authorizes medical personnel to administer medical and/or surgical services, including an aesthesia and other drugs. In the event of the students illness or accident, the parents or guardians will be notified as soon as possible. STUDENT ACCIDENT INSURANCE The Bishop Strachan School does not provide accidental death, disability, medical or dental insurance on behalf of students participating in the described activity. The undersigned agrees to maintain appropriate medical insurance coverage for the student. Should the student suffer injury or illness while participating in this event, the undersigned agrees to bear the medical and dental costs required. IMPROPER BEHAVIOUR The chances of injury occurring during School activities will be reduced when the student carefully follows instructions at all times, and wears appropriate clothing and equipment. Should the student fail to obey the rules and regulations prescribed by the School and by the BSS Code of Conduct while participating in the activity, the School may, at its sole and absolute discretion, terminate the students participation without refund. Any additional costs incurred as a result of the student being sent home will be the responsibility of the undersigned. PERMISSION TO PARTICIPATE The undersigned understands the risks inherent in the activity and gives permission for the student to participate in the described activity.

Signature of Parent or Guardian

Date

Print Name of Parent or Guardian

AT 03-04 ParentalAcknowRisk&InformedConsentJan10RevAugust2013.fo

HOCKEY DAY TRANSPORTATION INFO FORM Students Name: ___________________________________________

Circle grade

7 B

8 C

10 D

11

12

Form

Parents Name: _____________________________________________

Please complete ONE of the following three options:

I will pick my daughter up from North Toronto Hockey Arena after the game

My daughter will be walking home from North Toronto Hockey Arena after the game

My daughter will take the bus back to BSS after the game

Parents Signature: ________________________________________