Jr trip release form

Waring School
35 Standley St.
Beverly, MA 01915
2011 Junior Trip Release Form
Trip Leaders: Peter Smick, Trip Director; Allegra Smick, Teacher; Robine Vaneck,
Teacher; John Wigglesworth, Teacher; Gabe DiMauro (Alumnus, 06)
Adult/Student Ratio: 1:4
Participants: Thomas Adam, Celia Balf, Casey Ballin, Quinn Bokor, Megan Clasby,
Ally Colarusso, Molly Colehower, Elspeth Currie, Izzie Davies, Gus Egan, Emily
Glaenzer, Allie Hinrichs, Izzi Hughes, Will MacEwen, Gus Mosse, Rebecca Patey,
Maggie Sheetz, Evan Supple, George Tejada, Caitlin Towers.
Destination: France - Provence/Najac/Paris
Dates: May 29th to June 19th 2010
Statement of Goals: 1) Cultural enrichment, 2) Leadership building, 3) Field experience
of the Waring learning model
Rules/Policies: All school rules and policies are in effect during school-sponsored trips.
Disciplinary responses will be enforced as outlined in the Student Handbook and
Rules/procedures specific to this trip: Note the following policy regarding the use of
alcohol and illegal drugs on Waring-sponsored trips.
Use or purchase of alcohol by students is not permitted on Waring-sponsored travelprograms or field trips. Use of illegal drugs of any kind is not permitted under anycircumstance. The trip leaders acting on the behalf of the Waring School reserve the right to send homeany student who willfully violates the above policy or other school rules, or who acts in areckless way in disregard of his/her own safety or the safety of others. The costs ofreturning a student over and above budgeted trip costs will be borne by the student’sfamily.
The trip leaders reserve the right to conduct random searches of student shoulder bagsand backpacks without cause.
Transportation: Lufthansa Airlines, rental vans, Paris Métro (See trip itinerary), charter
coach (Paris/Giverny & Paris/CDG Airport).
Drivers of vehicles: Peter Smick, Allegra Smick, Robine Vaneck, John Wigglesworth
Accommodations: See trip itinerary.
Time of Departure/Time of Return: See trip itinerary.
Emergency communication arrangements: Waring School mobile phone in France:
011-33-6-98-55-97-68 (when dialing from U.S.) 06-98-55-97-68 (when dialing from
Medical information: Trip leaders will carry copies of each student’s medical
information and release form. Parents are responsible for updating these forms with any
new information that may apply while on this trip.
Parent/Student Agreement:
_____________________________ has my permission to participate in the overnightactivity outlined on this form. I agree to release, hold harmless, and indemnify theWaring School and its agents, representatives, and employees from all claims, damages,or other liabilities for injuries to my son/daughter which are the not the result of grossnegligence, intentional neglect, or willful or wanton conduct by the School, or its agents,representatives, or employees.
By signing below, we acknowledge that we have read and understand the guidelines andagree to follow the rules for this trip.
Signature of Parent/Guardian: Date:
Signature of Student:

Source: http://www.waringschool.org/JUNIOR%20TRIP/JUNIOR%20TRIP%2011/JR_ReleaseForm.pdf


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