Field Trip Request

It is great to see so many of you taking students off campus as an extension of your classroom!

All field trips occurring off campus must utilize this form.
Adequate planning time is required. Please complete this Field Trip Request at least three weeks in advance.
If you have questions, contact the appropriate Division Head.

As you plan your trip, please use the following as a checklist. These are things you must do in order to host a field trip with students.

Check the boxes below to confirm that you understand and will complete the following tasks prior to the trip requested:

Approval(Required)

You must seek approval from your Department Chair or Division Head for the trip requested prior to completing this form.

Chaperones(Required)

Two chaperones are required for any field trip, and a ratio of 10:1 students to chaperones must always be maintained.

Transportation(Required)

You must have an adequate transportation plan, you cannot transport students in your own vehicle and cannot ask students to drive themselves.

If requesting MPH-owned transportation, please follow up with the Director of Community Programs to make sure your request can be accommodated.

Food(Required)

If any food will be eaten during your trip, please first make yourself aware of any food allergies of your students. This information can be found by hovering over any red “Medical Alert” tags on a student’s contact card in Blackbaud.

Health Office(Required)

Confirm any allergies/conditions of your students with the Nurse and collect a first-aid kit and field trip medication bag for any students who might need medications on the trip.

Parent Permission(Required)

Check the “Field Trip Opt-Out List” on the Blackbaud Resource Board to verify if all of the students on your trip have permission to go on trips.

Any student who does not have a Field Trip Agreement form completed can have their parents email you separately for permission prior to departure, otherwise they will not be able to participate on the field trip and must stay at MPH and either attend a study hall or their regularly scheduled courses.

Parent Communication(Required)

You must notify parents via email about the trip at least 24 hours in advance.
Please include:

Destination
Day and time
Means of transportation
Names of chaperones
Cost, if any are incurred by students
Meals, if applicable

Coverage(Required)

If you will be missing class(es) due to the field trip, please fill out a Coverage Request Form and turn into the Division Office.

BEFORE YOU LEAVE(Required)

Email attendance@mphschool.org on the day and time of departure with the names of student(s) who you are bringing off campus.

*You MUST notify attendance any time you take students off campus.

Trip Sponsor

Name (First Last)(Required)

Contact Email(Required)

Contact Phone(Required)

Department that your trip falls under(Required)

Trip Information

Destination(Required)

Destination Phone(Required)

Destination Address(Required)

Departure Date(Required)

Departure Time(Required)

Return Date(Required)

Return Time(Required)

Grade/Class/Club(Required)

Students Participating(Required)

Learning Objectives(Required)

Chaperones

Two chaperones are required for any field trip, and a ratio of 10:1 students to chaperones must be maintained.

Chaperone #1(Required)

(First & Last Name)

Chaperone #1 Contact(Required)

(Cell Phone Number)

Chaperone #2(Required)

(First & Last Name)

Chaperone #2 Contact(Required)

(Cell Phone Number)

Additional Chaperone(s)

(First & Last Names and Cell Phone Number)

Additional Chaperone(s)

(First & Last Names and Cell Phone Number)

Transportation

You must have an adequate transportation plan. Note: you cannot transport students in your own vehicle and cannot ask students to drive themselves.

Type of Transportation:(Required)

Walking

MPH-owned van or bus

Full-sized bus (Note: additional costs will incur)

MPH has vehicles available for request for student field trips/sport events.

2 Chevy Express Vans (9 passenger)
2 MPH Buses (18 and 20 passenger)

The vans will be driven by the teacher requesting the vehicle, another MPH employee, or you may request a driver (dependent on bus driver availability). MPH buses must be driven by an MPH bus driver with a CDL B license. All drivers must have their New York State driver's license on file with the Community Programs office. All drivers of the vans must complete the online training "Multi Passenger Van Safety" through Safety Skills, a training course presented through our insurance company. (Once you request a vehicle, information will be emailed to you from the Community Programs office.)

Vehicle and Quantity Requested(Required)

Van (1)

Van (2)

Bus (1)

Bus (2)

Number of Passengers(Required)

Please enter a number from 1 to 40.

Providing a Driver? (Vans only)(Required)

Yes

No - I am requesting a driver

If Providing Driver Enter Name(s)(Required)

Note: If requesting MPH-owned transportation, please follow up with the Director of Community Programs to make sure your request can be accommodated.

If you will require a full-sized bus, please reach out to the Division Head Office to make arrangements and to determine availability of this request.

Food

If any food will be eaten during your trip, please first make yourself aware of any food allergies of your students. This information can be found by hovering over the red “Medical Alert” tag on a student’s contact card in Blackbaud.

Will students be eating while on the trip?(Required)

No food on this trip

Students will be bringing their own food

We will be purchasing food while on the trip

We need MPH-provided bagged lunches (Note: additional costs will incur)

How will you be paying for food on your trip?(Required)

Students will incur cost of any food

MPH will incur the cost of any food

Note: Please make sure to inform parents of any costs incurred by students for this trip.

Approximate cost per student:(Required)

Note: If you will be needing MPH-provided bagged lunches, you must complete this request at least 3 weeks in advance and coordinate with the Head Chef to ensure your request can be accommodated.

Will students be missing their regularly scheduled lunch and/or snack at MPH?(Required)

Select all that apply

Students will not miss any MPH-provided meals

Students will miss MPH snack

Students will miss MPH lunch

Budget

Total approximate cost(s) for trip:(Required)

Include any transportation and food, as well as any other costs anticipated for this trip:

Budget line (if applicable)(Required)

Include the budget line to be used for any transportation costs incurred on this trip. Please make sure you have the approval of the appropriate Budget Manager first.