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1 of 8 . EXHIBIT F.1.K-EX3-C3 . OUTDOOR WILDERNESS/CULTURAL ACTIVITIES APPROVAL FORM . Please note the following when completing the attached approval form:


1 of 8 EXHIBIT F1KEX3C3 OUTDOOR WILDERNESS/CULTURAL ACTIVITIES APPROVAL FORM Please note the following when completing the attached approval form: • The attached form is to be used for requesting approval for outdoor wilderness/cultural activities Due to the complexity of these activities and potential for risk, this form must be completed by the teacher/staff person in charge, reviewed and approved by the Principal and school committee, submitted to the Area Superintendent and forwarded to the Board of Trustees at least six weeks in advance of the date of the planned activities If an activity is planned for September and October, and the approval request cannot be submitted to the Board prior to the activity taking place, the request may be submitted to the Chief Superin\ tendent for approval The Board of Trustees has authorized the Chief Superintendent to approve activities in these circumstances provided all planning procedures are followed and all other approvals are in order • Please review the policy, regulations and the Outdoor Wilderness/Cultura\ l Activities Planning Guide prior to completing this form • Please ensure that all information requested of the form is provided Insufficient information will result in approvals being withheld and possible delays or cancellations • Information on the form, including the itinerary, must be shared with students, parents/guardians and staff members prior to the activity being undertaken SUMMARY School Destination Dates Approvals: Principal Date (Signature) School Committee Date (Signature) Area Superintendent Date (Signature) Board of Trustees (if required) (Board Motion/Date) Instruction/Programs and Curricula /Educational Trips, Educational Excursions and Outdoo r Wilderness and Cultural Activities Outdoor Wilderness/Cultural Activities Approval Form Page 28 of 38 FRONTIER SCHOOL DIVISION EXHIBIT F1KEX3C3 GENERAL INFORMATION Please provide the following general information: School Brief description of trip Destination Dates 1 Who is applying for approval? Name Signature Position 2 What are the educational benefits of this activity? Trips must have an educational value and be related in an identifiable way to student outcomes, curricula, approved school programs, or culturallybased activities What is the overall rationale for the trip? What are the outcomes for students? What is the relevance to the curricula or school program or culture of the students? What educational activities will take place prior to and after the activity? Instruction/Programs and Curricula /Educational Trips, Educational Excursions and Outdoo r Wilderness and Cultural Activities Outd oor Wild erne ss/Cultura lActivities Appro valForm Page 29 of 38 POLICY A1A FRONTIER SCHOOL DIVISION EXHIBIT F1KEX3C3 3 What students will be participating? Details regarding participating students must be provided to ensure activities are appropriate to the ages, grades and gender of students What criteria was used for the selection of students? How many students will be participating? Number of male students Number of female students

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