A Off-Site Single Activity

A_Single_Proposal.
doc Updated June 2012

Off-site Administrative Assistant Page 1 of 10

A Off-Site Activity Proposal
Single Activity

PLEASE READ AND REVIEW THE CBE OFF-SITE ACTIVITIES PROCEDURES MANUAL PRIOR TO COMPLETING THE PROPOSAL
Once the Principal has approved this off-site activity:
The Principal should e-mail a copy of the proposal (do not send support documents) to A Online @cbe.ab.ca at least
one (1) week prior to the trip.
SCHOOL: GEORGES P. VANIER JUNIOR HIGH
PRINCIPAL: ROSS BUSHELL
PHONE:
403-777-7460
FAX:
403-777-
7469
AREA:
II
DESTINATION (VENUE):
NOSE HILL PARK

DEPARTURE DATE (dd-mth-yr):
14-Sep-21
RETURN DATE (dd-mth-yr):
21-Sep-14
DEPARTURE TIME: 9:00AM RETURN TIME: 2:30PM
AREA OF STUDY (AS DEFINED IN THE PROGRAM OF STUDIES):
Science, Social Studies, English curriculums
TYPE OF TRIP:
GRADE 7 Educational Field Trip
GRADE LEVEL (Please check all that apply):
ECS 1 2 3 4 5 6
7 8 9 10 11 12 SP
# OF STUDENTS :
32
MALE: 17
FEMALE: 15

Contact phone number of the teacher-in-charge during the field trip: 403-777- 7469
Facility: Nose Hill Park Cell No. 403-803-9035
SUPERVISION

STAFF/
VOLUNTEERS GENDER

WHAT
CURRICULUM
AREAS ARE
TAUGHT?
DATE
OF LAST
VISIT TO SITE:
WILL YOU BE
PRESENT FOR THE
ENTIRE TRIP? IF NOT,
SPECIFY SCHEDULE.
LIST RELEVANT
CERTIFICATIONS
(E.G. LEVEL OF FIRST AID,
ETC.
AND EXPIRY DATE)
(APPENDIX 2 AND CHAPTER 7)
Teacher-in-
Charge

(1 TIC only)
Karah Chilton

Female

Grade 7
Teacher

21/07/2014

Yes

First Aid 2012
Staff:
# 4

(list) of Staff
Amber Gajdos
Sandra
Manyfeathers
Therese
Schultz
Emily
Larocque

Female

Grade 7
Teacher

N/A

Yes

Volunteers:
# 2
(list)of
Volunteers
TBA

Female
Male

N/A

N/A

Yes
Yes

Teacher in Charge has confirmed volunteers have completed the Volunteer Clearance process. Yes No
A_Single_Proposal.doc Updated June 2012
Supervision
Students must be supervised at all times by CBE Staff and/or Volunteers.

1. List the training, skills, knowledge and experience related to the activities and supervision in general, that support the
choice of each supervisor. List each individual separately, including the Teacher in Charge. If specific volunteers are
not known, please provide the general criteria. E.g. knowledge of students, first aid, etc.
- all teachers have knowledge of the Grade 7 Science, Social Studies and English curriculums
- Karah Chilton, Teacher in Charge, is a Grade 7 Teacher, coordinator of the fieldtrip and has Standard First Aid & CPR
training
- all volunteers have their police clearance and are available to volunteer on the fieldtrip date
- the larger group will be split into smaller groups while participating in the fieldtrip
- at least 8 volunteers and the Teacher-in-Charge will be present as supervisors
- the Teacher-in-Charge will be supervising over all activities and checking in with the volunteers throughout the day
- the parent volunteers will be assigned a group of students to supervise

2. List the specific responsibilities for each supervisor?
- supervise a small group of 4 students to ensure the safety and security of all students through the Duty of Care
- facilite the completion of activities as set out by Teacher-in-Charge
- communicate with Teacher-in-Charge throughout the day

3. How has such information and responsibilities been communicated? (e.g. meetings, manual, written communication)
- expectations will be communicated with parent volunteers via letter
- volunteer meeting prior to the fieldtrip
- electronic communications updating volunteers prior to fieldtrip
4. Will the larger group be split into smaller groups at any time during the off-site activity? Yes No

5. How will you manage/split the group?
Each group of students will be accompanied by a CBE staff/ Volunteer at all times. At lunch, groups will
meet at a designated location to ensure groups are working cooperatively and staying on task. Any
issues arising will be assessed by the Teacher-in-Charge and dealt with immediately.

Method of Transportation (chapter 4)

School-owned Van (name of employee , class of license of driver )
School-owned Bus (name of employee , class of license of driver )
Rental Van (name of company: )
Arranged by Service Provider (name of carrier: Southland Transportation Ltd.)
Charter Bus (name of company: )
No transportation provided by school
Other:

Staff driver (name of employee , class of license of driver )
Has the CBE employee completed the Driver Agreement for School Staff? Yes No
Has a Driver Abstract been provided? Yes No

Volunteer Driver (name of volunteer , class of license of driver )
Has the volunteer completed the Volunteer Driver Agreement Yes No
Has a Driver Abstract been provided? Yes No


Complete If using a Service Provider, Attending Conference or Athletics Tournament
Name:
N/A
Contact Person:
N/A
Phone Number:
N/A
address:
N/A
city/town:
N/A
e-mail:
N/A
1. What role does the service provider have with regards to the preparation of the off-site activity?
N/A
2. What is the role of the service provider during the off-site activity?
N/A

RESTRICTED ACTIVITIES
Please indicate any and all of the following activities that are planned for this Off-Site Activity. By checking the boxes
below, I am verifying that I have read the information on this Restricted activity in the Offsite Manual.
Acitivity/ies

Canoeing-Flat Water Kayaking-Flat Water Skiing & Snowshoeing
Canoe Tripping-Flat Water Kayaking-Moving Water Skiing & Snowboarding-Downhill Facility
Canoeing-Moving Water Kayaking in Sheltered Water Snowshoeing
Cycling Mountain Biking Swimming
Ice Skating Sailing Urban Pathways
Fine and Performing Arts Skiing-Cross Country Wall Climbing
Hiking


CBE Educational Review of Off- Site Activities

General Learner Outcomes: students will use their understandings of environmental stability that they have previously developed in the unit and
apply these understandings in order to creatively consider the future of our environment.

Itinerary:

Specific Learner Outcomes:
(Reflect the Program of Studies, CBE 3 Year Education
Plan and/or CBE Results)

Method of Assessment with Brief Description:
(Self-assessment checklists, performance assessments, written
products etc. with specific student knowledge, skills and attitudes
identified. Identify use of observations and products. Attach
rubrics if used.)

Specific Activity/Brief
Description:

Location:

Synthesizing
Environmental
Sustainability
Perspectives: Interview
with a Tree

Nose Hill Park Junior High English Language Arts General
Outcomes-
develop and follow own plan for accessing and
gathering ideas and information, considering
guidelines for time and length of investigation and
presentation.
compare personal challenges and situations
encountered in daily life with those experienced by
people or characters in other times, places and
cultures as portrayed in oral, print and other media
texts.
assess own contributions to group process, and set
personal goals for working effectively with others.

This off-site activity will focus on applying
previous knowledge to make predictions on the
future of environmental sustainability by
imagining what a tree would say if it could talk.
Students will use their understandings
developed of present and historical
perspectives of environmental stability to
generate questions. They will also apply their
readings from the novel study on Chris
Howard's Rootless to consider the future.
Students will be split into small groups that will
find separate areas where they will find a single
or multiple trees they want to interview.
Students will work in pairs to interview their tree
than will share some key points with their
group. Field Guide Journal prompts will be
utilized to give students a framework for the
interview task. Supplemetary assessment tools
include observation and listening. Students will
do a self reflection in their Field Guide Journals
about what they think Nose Hill will look like in
the future. Students can write or sketch their
responses. Students will complete a self
evaluation that will be given to the teacher once
all activities are completed.

Resources: Alberta Education Program of
Studies, and the Calgary Board of Education
Off-Site Manual.

Complete the chart below to indicate the hazards and the risks of this trip. List all the activities including transportation that will occur during the trip. List all
the risks and hazards (cause of accident) in relation to the identified activities. List the precautions that have been made to minimize the risk.
Note: Common Risks and Hazards have been identified for the specific programs. This is limited based on the possibility of different activities being selected.
Not all risks have been identified. The T-I-C and the Principal must add in additional risks for the specific activities.

ACTIVITY Risk/Hazards (Cause of Injury) Precautions Taken
Terrain The terrain on the paved pathways and off the pathways may be
uneven at times.
Consent and Acknowledgement of Risk Forms collected for
each student.

Allocated additional CBE staff/ Volunteers to accompany the
students on the day trip Consent and Acknowledgement of
Risk Forms collected for all Volunteers.
Inspected pathways and areas students will explore in
August to ensure they were properly maintained and safe.
Transportation The students will ride on a Southland Transportantion Ltd. bus to
and from the camp on city and country roads. Possibility of a
vehicle accident or bus breakdown/ delay during travel.
Booked transportation with a reputable and CBE approved
transportation company.
Weather The weather can be brisk in fall and unpredictable for a full day
trip, it could rain or snow.
Students were encouraged to dress in layer,wear
comfortable walking shoes and bring warm clothing in the
pre-trip meeting and in the Parent Letter.



Requirements Checklist
Complete and attach the following forms to the template when submitting to the Principal for approval
Consent and Acknowledgement of Risk - Student
Consent and Acknowledgement of Risk Volunteer
Parent letter
Swimming Ability Form (if applicable)
Detailed Itinerary: Provide detailed itinerary from sun up to sun down.
Teacher Summary: Use Teacher in Charge Summary form found in the Off-site document library on the website.
Attach the completed Service Request when using a Service Provider.

Trip Preparation
As the Teacher-in-Charge:
What preparation have you undertaken to gain familiarity and check the appropriateness of the site (terrain, equipment,
buses, etc.)?
On August 25 and 26, 2014 the site was visited by the Teacher In Charge . Pathways and areas off pathways were inspected for
potential hazards.
What effects will weather have on this off-site activity?
If the weather effects driving conditions severly such as icy road conditions than the off-site activity will be rescheduled.
How have you prepared the students skills, and knowledge and readiness for the off-site activity?
Yes the students have developed understandings they will be applying for the past two weeks including researching the process of
deforestation and engaging with a variety of historical perspectives on environmental sustainability.
How have you ensured that parents and students have received all pertinent information regarding this trip, including
hazards and emergency procedures?
The Parent Letter and Consent and Acknowledgement of Risk Form was given to each student, electronic communication
regarding the off-site activity answering any questions or inquiries pertaining to the off-site activity occurred, and in-class direct
communication with the students took place.

Emergency Procedures (Chapter 6) OFFSITE Activities Procedures Manual
General: Urban Environment
Identify the:
Emergency Contact phones numbers? Emergency: 403-803-9035 Non- Emergency: 403-803-6679
School Emergency Contact Info: 403-777-7460 OR 403-777-7345
Communication devices used for emergency contact (includes cell phones, 2-Way Radios, etc)? Cell Phone
Are you relying on a service provider to meet the first aid ratio? No
First Aid kit required (type): No. 2 Kit with CBE Incident Report 3 blankets
Steps that will be followed if a student is ill or has a non-life threatening injury?
Communicate directly with the student to make him or her comfortable, administer First Aid if required, Teacher-In-Charge contact
parent or guardian, arrange safe transportation for the student.

In the case of a life threatening injury the item listed below will occur.
Dial 911 and provide the following information:
Location
Call back number
Your name
Emergency problem

Name of Teacher-in-charge
Karah Chilton
Date (year/month/day)
2014/09/05
Signature of teacher-in-charge

I have reviewed, discussed and I APPROVE this trip.
Name of Principal
Ross Bushell
Date (year/month/day)

2014/09/05

Principal: Please note the proposal should be emailed to A Online Activities without support documents
and in doc. format. The system cannot upload a PDF file or support documents. No signatures are
required on the proposal. The proposal must be sent to A Online from the Principals email account, as
proof this trip has been approved.

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