Queen Elizabeth District High School
PO Box 548 – 15 Fair Street
Sioux Lookout, Ontario
P8T 1A9
Steve Poling – Principal
W. Mercer – Vice Principal
Telephone (807)737-3500
Fax (807) 737-1979
Field Trip Permission Form
Name of Pupil: ____________________________________________
Telephone: __________________________ Grade: PAD3O
Outline of Activities: On March 1st the Traditional Technology Students will be taking
part in a field trip to Rugby Lake Cedar Works, near Oxdrift, ON as part of our resource
management unit. Rugby Lake Cedar Works is an operational saw mill and timber
processing business. Students will be allowed to operate some machinery with strict
supervision and appropriate safety demonstrations. There will be 2 QEDHS staff along
with 2 staff from the business supervising at all times. We will be travelling by school
vehicle to and from the operation and will be back at QEDHS for the busses at 3:30pm.
Appropriate clothing will be necessary, we will be outside all day and students have been
instructed to bring steel toe boots if they own a pair. Students have been reminded to
bring a lunch, since we will not be travelling to town for lunch. This activity is weather
permitting (the snow date is set for Mar 8).
I hereby give consent for my son / daughter to participate in the trip outlined above.
I recognize:
1.
2.
3.
4.
That the Keewatin-Patricia District School Board has policies in place to govern the
conducts of students, staff, and volunteers to ensure the safety of all participants;
That the parent understands the pupil may be involved in activities which may entail risk
beyond the normal classroom;
That the Board does not provide any accidental, death, disability, dismemberment or
medical expenses insurance for students participating in field trips and that it is the
parents’ responsibility to ensure that the student has appropriate insurance coverage;
That recreational swimming will not be approved unless supervisors are on duty.
I authorize the supervisor to provide the above named pupil with First Aid should the need arise.
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Date
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Parent’s Signature