HALTON CATHOLIC DISTRICT SCHOOL BOARD ALPINE SKI TRIP FORM INFORMATION - CONSENT TO PARTICIPATE

Transcription

1 ALPINE SKI TRIP FORM INFORMATION - CONSENT TO PARTICIPATE TRIP INFORMATION: 1. Alpine Ski Site: 2. Date(s) of Trip: Time leaving: Return time: 3. Method of Transportation: 4. Supervisors: 5. Cost: Ski Pass/Lesson: or Tow Ticket/Lesson: Tow Ticket/Equipment Rental/Lesson: STUDENT ACCIDENT INSURANCE NOTICE The Halton Catholic District School Board does not provide any accidental death, disability, dismemberment, and medical/dental expenses insurance on behalf of the students participating in the activity. For coverage of injuries, you may wish to consider the STUDENT ACCIDENT INSURANCE PLAN made available by the school to parents at the beginning and throughout the school year. ELEMENTS OF RISK Alpine skiing is an activity with physical demands and inherent risks are beyond the control of the board and ski resort. Without limiting the generality of the foregoing, a few examples of the type of situations which one is at risk of having occur while Alpine Skiing are: Falls, collisions, exposure to environmental elements and other incidents. Some injuries could lead to paralysis or prove to be life threatening. The Halton Catholic District School Board requires your child to know and obey the attached SKIER S/ SNOWBOARDER S RESPONSIBILITY CODE. The Ski Resort may revoke a ski ticket in violation of the code or other unacceptable conduct. Please review this Responsibility Code with your child. The chance of an accident occurring can be reduced by carefully following instructions at all times while engaged in the activity. EQUIPMENT: The Ski Resort provides rental equipment. Bindings on equipment reduce the risk of injury when falling. They will not release under all circumstances and they do not guarantee safety in all cases. SUPERVISION: Parents/guardians should note that on site/in the area supervision will be shared by designated school personnel and ski resort personnel during the alpine skiing activity. It is understood that direct and constant supervision of students is not possible due to the number of skiers and the extensive ski area to supervise. SKI INSTRUCTION: A ski lesson, from a certified ski instructor, is mandatory for all students. Please complete the following information: Ski Classification Level: Using the attached ski classification chart, the participant is identified as having the following level of skiing ability: NON-SKIER BEGINNER INTERMEDIATE ADVANCED (Skiing ability will be checked by a certified ski instructor at the ski resort.) REQUIRED SIGNATURES FOR PARTICIPATION ACKNOWLEDGEMENT I/we have read the above and understand that participating in the above activity we are assuming the risks associated with doing so. Signature of Student Date Signature of Parent/Guardian Date PERMISSION AND BEHAVIOUR AGREEMENT I/we give permission for my son/daughter/ward to participate in the above activity. I/We agree to pay any damages that may be occasioned through the misconduct or carelessness of my son/daughter/ward to the person or property of any other party or parties. Signature of Parent/Guardian Date SEPTEMBER 2000 Turn Over

2 EMERGENCY CONTACT- MEDICAL INFORMATION This form must accompany the teacher during the trip STUDENT NAME TEACHER GRADE CURRENT EMERGENCY INFORMATION: Home Telephone Number Health Card number Mother s Name Mother s Contact Number Father s Name Father s Contact Number Emergency Contact Name Contact s Number CURRENT MEDICAL INFORMATION: 1. If your son/daughter/ward wears or carries a medic alert bracelet, neck chain or card: Please specify what is written on it: First aid procedures in case of incident: 2. Date of last tetanus immunization (for overnight trips only): 3. If your son/daughter/ward is allergic to any drugs, foods, and/or medication, please specify: First aid procedures in case of incident: 4. If your son/daughter/ward takes any prescription drugs, please specify: Provide details: 5. What medication(s) should the participant have on hand during the field trip? Who should administer the Medication? 6. Specify any other physical limitations your son/daughter/ward has that may affect their full participation with activities. Provide pertinent details or contact supervising teacher: MEDICAL SERVICES AUTHORIZATION - (OPTIONAL SIGNATURE TO PARTICIPATE) Every reasonable effort will be made by the school/hospital to contact parents/guardians before any medical services are provided. In cases where contact is tried but not made I/we give consent for medical personnel to administer medical and/or surgical services including anaesthesia and drugs. Signature of Parent/Guardian Date FREEDOM OF INFORMATION NOTICE The information provided on this form is protected under the Freedom of Information and Protection of Privacy Act and will be utilized only for the purposes related to the Board s policy on Out-of-Classroom Programs.

3 SEPTEMBER 2000 HALTON CATHOLIC DISTRICT SCHOOL BOARD

4 SKIER/SNOWBOARDER CLASSIFICATION All students must be classified according to the following plan. These stages are consistent with the operations of member ski resorts of the Ontario Ski Resorts Association. The classifications must appear on the Parent Consent Form and be checked off by the parents. NON-SKIER/ SNOWBOARDER The student has never skied/snowboarded before. BEGINNER The student has skied/snowboarded once or twice or a few times per year and has experienced and maintained control on a number of novice hills of varying difficulty. He/she is able to stop and turn with some success. INTERMEDIATE The student has skied/snowboarded on many occasions and has experienced a variety of hills and different ski areas. He/she can turn and stop under control using recognized formal techniques. ADVANCED The student is an experienced and competent skier/snowboarder. He/she has received formal instruction, knows and understands the Skier's Responsibility Code and can demonstrate ability at an advanced level. Such students can be called upon to assist in the program. SKI HELMETS MAY PREVENT HEAD INJURIES! Wear a ski helmet for safety! Be cool! Be safe! Use a helmet!

5 ALPINE SKIER'S/SNOWBOARDER'S RESPONSIBILITY CODE Officially endorsed by: ONTARIO SKI RESORTS ASSOCIATION THERE ARE ELEMENTS OF RISK IN SKIING AND SNOWBOARDING THAT COMMON SENSE AND PERSONAL AWARENESS CAN HELP REDUCE. REGARDLESS OF HOW YOU DECIDE TO USE THE TRAILS, ALWAYS SHOW COURTESY TO OTHERS. PLEASE ADHERE TO THE CODE LISTED BELOW AND SHARE WITH OTHERS THE RESPONSIBILITY FOR A SAFE OUTDOOR EXPERIENCE. 1. Always stay in control. You must be able to stop or avoid other people or objects. 2. People ahead of you have the right-of-way. It is your responsibility to avoid them. 3. Do not stop where you obstruct a trail or are not visible from above. 4. Before starting downhill or merging onto a trail, look uphill and yield to others. 5. If you are involved in or witness a collision you must remain at the scene and identify yourself to the Ski Patrol. 6. Always use proper devices to help prevent runaway equipment. 7. Observe and obey all posted signs and warnings. 8. Keep off closed trails and closed areas. 9. You must not use lifts or terrain if your ability is impaired through use of alcohol or drugs. 10. You must have sufficient physical dexterity, ability and knowledge to safely load, ride and unload lifts. If in doubt, ask the lift attendant. KNOW THE CODE BE SAFETY CONSCIOUS IT IS YOUR RESPONSIBILITY BE AWARE SKI OR RIDE WITH CARE!