This text was produced by optical character
recognition (OCR) of a scanned document and may contain errors. The linked
document above is the authoritative version.
Machine-extracted text of a publicly
posted document, provided for reference and search. The original document at
the link above is authoritative.
Colchester Public Schools
Application for Approval of Field Trip
Overview: This form must be completed by all staff to request approval of a field trip.
Directions:
1. Complete the form attaching all applicable documentation and submit to your administrator. The application
must be submitted at least two weeks prior for in-state field trips, and two weeks and two months prior for
out-of-state trips.
2. The Administrator will recommend or not recommend. If approved, the form must be sent to the
Superintendent.
3. The Superintendent will either recommend or not recommend and will bring to the Board of Education if the
request is for an out-of-state field trip.
4. If applicable, the Board of Education reviews and makes the final decision.
Today’s Date: 5/9/2022
Field Trip Information
Applicant Name: Keith Morrissette Method of Transportation: Coach Bus
School: WJJMS Bus Service Number(s) (if applicable):
Grade(s) and Group(s): Grade Band&Chorus Number of Students: 76 Bi
Date(s) of Trip: May 26, 2023 Number of Day(s) of Trip: 1
Event: six Flags Trip
Destination: Six Flede New England Phone Number: (413) 786-9300
Add ; State:
(for ae 1623 Main Street, Agagwam, MA oe CT
Time of Departure From School: 1:15PM Special Clothing and/or Equipment Required:
Time of Arrival Back at School: 9:15PM
Student Cost Information
*Cost to Student: $ i Suggested Student Pocket Money: $
$20-$75 $20
RU) YeraV ey ea alcatel) | Meee ieatseyce metas
1. Name: Keith Morissette Cell Phone: (860)303-7777
2. Name: Lynn Goodwin Cell Phone: (860) 334-6211
List all adult chaperones: Ratio of adult chaperones to students must be at least: 1:5 for Grades K-2, 1:8 for Grades 3-5; 1:10 for
Grades 6-8; and 1:15 for Grades 9-12 (one-day trips) or 1:10 {overnight trips)
raperones, and cell phone number for each)
Six chaperones will be recruited a month in advance
PNT ele ee lire ele ce)
Applicant Signature
Veit Wes wisselle /
Ale ; we
Administrator's Signature C Wee Fe reconimens [__] Not Recommended
Superingegdent’s Signature [Recommended Not Recommended
TD ha ed Ey
Board of Education (it appiicabie)
Board of Education Meeting Date: a Recommended [a] Not Recommended
Bus Information
Bus Reservation Date: Price of Bus(es): $
*If a trip to a foreign country, please complete and attached the CIRMA insurance application and notify parents of coverage Last Updated 5/27/21
Field Trip Instructional Plan
Colchester Public Schools
Field Trip Location(s): Sx Flags New England
Reference Check: Visited site on: or Spoke with: Jane Sullivan
Name: Keith Morrissette Grade/Group: Grade 8 Band/Chorus
(Teacher(s) completing this form)
Instructional Focus of Trip
« This field trip is directly related to curriculum L] Yes iv] No
« Curriculum Unit(s):
© Specific Curriculum Standards Addressed by Field Trip (please refer to CT Core and disciplinary standards):
« Assessment of Student Learning (describe or attach the work students will complete ypon their return to
Trip Agenda/Activities: List/attach entire break out of times for each day. Include travel time and all activities.
Attach additional sheet if needed.
DATE/TIME LOCATION ACTIVITY
5/26, 1:15PM WJJMS Board bus
2:15PM Six Flags New England Students arrive
2:30-7:30PM Six Flags New England Time in the park
8PM Six Flags New England Students board bus
9PM WJJMS Students find parents
Approvals: WN, AWotsisveHe siie2 [V] approved | Joenied
Department Chair (High School Only) Date
Le LE St th Trooroed [_ penied
LA fof FTapproved [_ ]oenied
‘or of Teaching and Learning Pate
Updated 5.27.21
Field Trip Cost Form
Date(s) of Trip: May 26, 2023
Event: Six Flags Trip
M&J Bus(es) ONLY
Number of Students: Estimated Hours for trip: g
(Add 1 hour pre/post trip)
20
Number of Buses: 1
Per Student Calculations:
M&J Bus(es) ONLY Coach Bus(es) ONLY
Admission per student: $30
Miscellaneous Fees per student: $20
Total admission and miscellaneous fees: $50
Cost of Bus TBD $1300
Total Field Trip *Cost per Student: TBD $75
Additional Costs:
Number of Substitute Teachers n/a
Rate per Day
Special Education costs nla
Cost Associated if Nursing Required pyaq
Total *Cost to District: 0
Total *Cost of Trip: $20-75
Alternate funding for trip provided by: Music Activity Fund
*Insert these costs on the accompanying Field Trip Application
Form updated 5.27.21