Positive Active Living for Students (PALS)
Positive Active Living for Students (PALS) On Wednesday, May 9, 2018, Mr. Hayter’s and Mr. Brecevich’s classes will be attending the PALS program at Brock University. Activities will include Archery, Tchoukball, Fencing, Tennis and Swimming On Thursday, May 24, 2018, Mr. Roy’s, Mrs. Pink’s, Mr. Zanatta’s and Mrs. Bartley’s classes will be attending the PALS program at Brock University. Activities will include Archery, Lacrosse, Tchoukball, Kinball and Swimming Typical Daily Schedule 9:00 Leaving on the bus. If you are late, you will be left behind. 9:45
Welcome and class organization
10:00 First Activity 10:45 Second Activity 11:30 Recreational Swim 12:15 Lunch 1:00
Third Activity
1:45
Fourth Activity (This activity will continue until departure time)
Dress: Please dress for the weather. Active wear including running shoes (sandals are not appropriate), sweatshirt and t-shirt layered, and bathing suits (shorts and t-shirts are not allowed in the pool). What should students bring?
bathing suit if your group is swimming
towel
sun hat
sunscreen
bag lunch (peanut free)
water, beverages
Students should avoid bringing large amounts of money, valuables, and electronics such as iPods and expensive cameras. This program has been running for over 20 years and has consistently proven to be a great experience. A parent information session will be held on Wednesday, May 2, 2018 at 3:30 in room 113 to address any concerns. Teacher in Charge: Mr. Hayter
IN FORMATIONLET T ER PARENT/GUARDIAN
HAMILTON. WENTWORTH DISTRICT SCHOOL BOARD
.
View Mountain schoolPhone: (905)662-6939
z':'=::*: Please keep this form at home for your information
Date DearParenVGuardian:
Division program, the Intermediate of the curricular As an extension
an excursion. is/areplanning
Activity:PALSProqram
Location:BrockUniversity Leavingthe School:9:00 Date(s)/Time(s) Returningto School:3:00 Date(s)/Time(s) Method: Transportation Non-StaffVolunteers/Driverswill
in this activity. be participating
The cost per pupilfor the excursionis $ 40.00 alsoaccepted. youto payonline, cash/cheque Weencourage hat baqlunch,sunscreen, Studentsare requiredto bring:swimsuit,towel,water/drinks, learn: will students program. intended the is lt is partof the regularschool The excursion To participateactivelyand regularlyin a wide varietyof physicalactivities,and demonstratean
lifelongparticipation of factorsthatencourage understanding
regardingstudentbehaviourare the sameas thosefor the regularschoolday. While Expectations any problems,any seriousbreachof the SchoolCodeof Conducton the part we do not anticipate and of the studentmay resultin the studentbeingsenthomeatthe expenseof the parenUguardian actionmay be imposed. furtherdisciplinary containedin yourchild'sschoolrecordswill be takenalongon the excursion Studentinformation in the caseof an emergency.Pleaseensurethe followingelementsin your only and will be used recordis upto-date. Notify the school office immediatelyof any child'sstudentinformation changes: . . o
and HomeAddress/PhoneNumbers Parents/Guardians EmergencyContactNames/PhoneNumbers Medical/HealthConcerns
enrichingexcursion.Pleaseindicateyour We are lookingforwardto an excitingand educationally and returningto the schooltheattached completing by above otthe_rgldlons oullined acceptance 8 consentform by
Pleasecontactyourchild'steacherif interested. @ Volunteers flVotunteerDrivers areneeded. Pleasecontactyourchild'steacheror the SchoolPrincipalif you haveany concernsor if yourchild for this activity. requiresany specialaccommodations Sincerely, Mr.Hayter
(Teacher in Charge)
Mr.Griffiths
(Principal)
CONSEN TF OR M PARENT/GUARDIAN
HAT,IILTON' WENTWORTH DISTRICT SCHOOL BOARD
P/easereturn this form to the school
ffi. IN THE OF ANY STUDENTPARTICIPATING THISFORMMUSTBE READAND SIGNEDBY A PARENT/GUARDIAN THIS STUDENTOVER18 YEARSOF AGE. PLEASECOMPLETE EXCURSION AND/ORBY ANY PARTICIPATING FORM,ARRANGEFORPAYMENT, AND RETURNTO THESCHOOLBY School:MountainView
May9 & 24,2018 Dateof Excursion:
BrockUniversity Location:
Activity:PALSProqram
The followinglist includes,but is not limitedto, examplesof the Injuriesmayoccurwhileparticipating in theseactivities. in thisactivity: typesof injurywhichmay resultfrom participating 1. trips,falls,andsprains 3. sun burn,heatstoke
2. drowning 4. impalement, cuts,banqsand bruises
'
lANeacknowledge receiptof the letterdated 16-Apr-2018 by FirstStudent excursion.We authorize transportation
'
lAly'e thatexcursions containan elementor riskand accidentsmayoccurthat may resultin injuryand/orloss understand fault the without of either student,or the schoolboard,its'employeesor the facilitywherethe activityis takingplace.
.
in thisactivity,you mustunderstand thatyou bearthe lANeunderstand that by choosingto allowthe studentto participate injury can be reduced by students carefully The of an occurring chance responsibility of for any injurythat mightoccur. followinginstructions at all timeswhileengagedin the activity.
.
death,disability, DistrictSchoolBoarddoesNOTprovideaccidental lA/Veunderstand that Hamilton-Wentworth participating in this activity. lf you do not have or medicalexpenseinsurance on behalfof students dismemberment purchased privateinsurancecoverage,StudentAccidentInsurance may be throughReliable coverageis availableand (5437)or onlineat www.insuremvkids.com Lifeat 1-800-463-KIDS
.
whereattemptsto makecontact lANegrantpermission to obtainmedicaltreatmentin the eventof a medicalemergency providedto the schoolare not successful. usingthe information
.
thatthe SchoolCodeof Conductas well as the Board'sCodeof Conducton SchoolRelatedVehicles lA/t/eunderstand are in effectandwillapplyto all studentsat all timesduringthisactivity.
.
for DistrictSchoolBoardor the Schoolwillacceptresponsibility lAy'y'e thatthat neitherHamilton-Wentworth understand costsincurred, shouldyou subsequently decide any moneynot refundedby the serviceprovider,norfor transportation notto permitthe studentto attend.
'
for financialloss DistrictSchoolBoardnorthe School,willnot be responsible lM/e understand Hamilton-Wentworth Carrieror cancellation by the resulting fromthe cancellation of any schoolexcursionby a Tour Company,Transportation board.
fromthe schoolwithrespectto the upcomingstudent
!
IN THE ACTIVITYDESCRIBEDABOVE,WE ARE I/WEHAVEREADTHE ABOVEAND WE UNDERSTANDIN PARTIGIPATING ASSUMING THE RISKSASSOCIATEDWITH DOINGSO.
n
IfWEGIVEPERMISSIONFORTHE STUDENTTO PARTICIPATEIN THE ACTIVITYNOTEDABOVE.
Namesof Student: Signature of Student(if over18):
Date:
Signature of ParenVGuardian:
Date:
PLEASECHECKBOXFORMETHODOFPAYMENT: tr ONLINE n D
Teacher:
CASH
D
I am interestedin volunteering. Pleasecontact me to initiate the volunteer screening process.
CHEQUE
HAMILTON. WENTWORTH
m
STUDENTEMERGENCYMEDIC AL/C ON T AC T INFORMATION FORM
DISTRICT SCHCOL BOARD
Mountain View
zffi:
Pleasereturn this form to the school
- PALSProgram Excursion Location:BrockUniversity Date(s)of Excursion:May 9 & 24,2018 Grade(s):4-8
ClassiCourse/Group: 4A,4/5A,5A, 6/7H,7lBA& 7/88
At the conclusion of this excursion/seriesof excursions, this form will be shreddedby the school. To be completedby the parenVguardian: Surname:
FirstName:
MiddleName:
Dateof Birth: ln the event of an emergencyduring this excursion,please listin order of priority who should be contacted. Name
Relation(e.9.: parent, uncle.friend\
PreferredContact Teleohone #
AlternateContact Pickup Teleohone # Student Yesn Noo
Yesr Non Yesr Noo
Yesn Non MedicalInformation requiredfor thisexcursion to be usedbv Teacher/Supervisors: Allergies
Life Threatening:Yes c No n Epipen:Yes a No n
OtherMedicalConditions/Restrictions/Lim itations : Are thereany medicalconcerns/specific instructions relatedto thisexcursion(pleaseattachadditional information if
necessary): FOROUT OF PROVTNCE/COUNTRY EXCURSTONS ONry M e d i c a lI n s u r a n c eP r o v i d e r :
PolicN y umber:
Provider Telephone: Contact
Proofof Coverage: Yesn No l
Consentof Parent/Guardian l/We understand that in the eventof a medicalemergency, whileon the excursion, medicalofficials canauthorize emergency medicalcare.Thiswouldapplywhena seriousconditionexistsandthe Hamilton-Wentworth District SchoolBoardandmedicalofficials havebeenunableto contactthe parents/guardians. Parent/Guard ian Signatu re:
Date:
Information on thisform is collectedunderthe legalauthorityof the Education Act and in accordance with the MunicipalFreedomof Information and Protection of PrivacyAct [MFIPPA]. lt will be usedonlyin the eventof an accidentor illnessof the studentattendingthe excursion.Questions or concerns shouldbe directedto the schoolprincipal.
Welcome and class organization
10:00 First Activity 10:45 Second Activity 11:30 Recreational Swim 12:15 Lunch 1:00
Third Activity
1:45
Fourth Activity (This activity will continue until departure time)
Dress: Please dress for the weather. Active wear including running shoes (sandals are not appropriate), sweatshirt and t-shirt layered, and bathing suits (shorts and t-shirts are not allowed in the pool). What should students bring?
bathing suit if your group is swimming
towel
sun hat
sunscreen
bag lunch (peanut free)
water, beverages
Students should avoid bringing large amounts of money, valuables, and electronics such as iPods and expensive cameras. This program has been running for over 20 years and has consistently proven to be a great experience. A parent information session will be held on Wednesday, May 2, 2018 at 3:30 in room 113 to address any concerns. Teacher in Charge: Mr. Hayter
IN FORMATIONLET T ER PARENT/GUARDIAN
HAMILTON. WENTWORTH DISTRICT SCHOOL BOARD
.
View Mountain schoolPhone: (905)662-6939
z':'=::*: Please keep this form at home for your information
Date DearParenVGuardian:
Division program, the Intermediate of the curricular As an extension
an excursion. is/areplanning
Activity:PALSProqram
Location:BrockUniversity Leavingthe School:9:00 Date(s)/Time(s) Returningto School:3:00 Date(s)/Time(s) Method: Transportation Non-StaffVolunteers/Driverswill
in this activity. be participating
The cost per pupilfor the excursionis $ 40.00 alsoaccepted. youto payonline, cash/cheque Weencourage hat baqlunch,sunscreen, Studentsare requiredto bring:swimsuit,towel,water/drinks, learn: will students program. intended the is lt is partof the regularschool The excursion To participateactivelyand regularlyin a wide varietyof physicalactivities,and demonstratean
lifelongparticipation of factorsthatencourage understanding
regardingstudentbehaviourare the sameas thosefor the regularschoolday. While Expectations any problems,any seriousbreachof the SchoolCodeof Conducton the part we do not anticipate and of the studentmay resultin the studentbeingsenthomeatthe expenseof the parenUguardian actionmay be imposed. furtherdisciplinary containedin yourchild'sschoolrecordswill be takenalongon the excursion Studentinformation in the caseof an emergency.Pleaseensurethe followingelementsin your only and will be used recordis upto-date. Notify the school office immediatelyof any child'sstudentinformation changes: . . o
and HomeAddress/PhoneNumbers Parents/Guardians EmergencyContactNames/PhoneNumbers Medical/HealthConcerns
enrichingexcursion.Pleaseindicateyour We are lookingforwardto an excitingand educationally and returningto the schooltheattached completing by above otthe_rgldlons oullined acceptance 8 consentform by
Pleasecontactyourchild'steacherif interested. @ Volunteers flVotunteerDrivers areneeded. Pleasecontactyourchild'steacheror the SchoolPrincipalif you haveany concernsor if yourchild for this activity. requiresany specialaccommodations Sincerely, Mr.Hayter
(Teacher in Charge)
Mr.Griffiths
(Principal)
CONSEN TF OR M PARENT/GUARDIAN
HAT,IILTON' WENTWORTH DISTRICT SCHOOL BOARD
P/easereturn this form to the school
ffi. IN THE OF ANY STUDENTPARTICIPATING THISFORMMUSTBE READAND SIGNEDBY A PARENT/GUARDIAN THIS STUDENTOVER18 YEARSOF AGE. PLEASECOMPLETE EXCURSION AND/ORBY ANY PARTICIPATING FORM,ARRANGEFORPAYMENT, AND RETURNTO THESCHOOLBY School:MountainView
May9 & 24,2018 Dateof Excursion:
BrockUniversity Location:
Activity:PALSProqram
The followinglist includes,but is not limitedto, examplesof the Injuriesmayoccurwhileparticipating in theseactivities. in thisactivity: typesof injurywhichmay resultfrom participating 1. trips,falls,andsprains 3. sun burn,heatstoke
2. drowning 4. impalement, cuts,banqsand bruises
'
lANeacknowledge receiptof the letterdated 16-Apr-2018 by FirstStudent excursion.We authorize transportation
'
lAly'e thatexcursions containan elementor riskand accidentsmayoccurthat may resultin injuryand/orloss understand fault the without of either student,or the schoolboard,its'employeesor the facilitywherethe activityis takingplace.
.
in thisactivity,you mustunderstand thatyou bearthe lANeunderstand that by choosingto allowthe studentto participate injury can be reduced by students carefully The of an occurring chance responsibility of for any injurythat mightoccur. followinginstructions at all timeswhileengagedin the activity.
.
death,disability, DistrictSchoolBoarddoesNOTprovideaccidental lA/Veunderstand that Hamilton-Wentworth participating in this activity. lf you do not have or medicalexpenseinsurance on behalfof students dismemberment purchased privateinsurancecoverage,StudentAccidentInsurance may be throughReliable coverageis availableand (5437)or onlineat www.insuremvkids.com Lifeat 1-800-463-KIDS
.
whereattemptsto makecontact lANegrantpermission to obtainmedicaltreatmentin the eventof a medicalemergency providedto the schoolare not successful. usingthe information
.
thatthe SchoolCodeof Conductas well as the Board'sCodeof Conducton SchoolRelatedVehicles lA/t/eunderstand are in effectandwillapplyto all studentsat all timesduringthisactivity.
.
for DistrictSchoolBoardor the Schoolwillacceptresponsibility lAy'y'e thatthat neitherHamilton-Wentworth understand costsincurred, shouldyou subsequently decide any moneynot refundedby the serviceprovider,norfor transportation notto permitthe studentto attend.
'
for financialloss DistrictSchoolBoardnorthe School,willnot be responsible lM/e understand Hamilton-Wentworth Carrieror cancellation by the resulting fromthe cancellation of any schoolexcursionby a Tour Company,Transportation board.
fromthe schoolwithrespectto the upcomingstudent
!
IN THE ACTIVITYDESCRIBEDABOVE,WE ARE I/WEHAVEREADTHE ABOVEAND WE UNDERSTANDIN PARTIGIPATING ASSUMING THE RISKSASSOCIATEDWITH DOINGSO.
n
IfWEGIVEPERMISSIONFORTHE STUDENTTO PARTICIPATEIN THE ACTIVITYNOTEDABOVE.
Namesof Student: Signature of Student(if over18):
Date:
Signature of ParenVGuardian:
Date:
PLEASECHECKBOXFORMETHODOFPAYMENT: tr ONLINE n D
Teacher:
CASH
D
I am interestedin volunteering. Pleasecontact me to initiate the volunteer screening process.
CHEQUE
HAMILTON. WENTWORTH
m
STUDENTEMERGENCYMEDIC AL/C ON T AC T INFORMATION FORM
DISTRICT SCHCOL BOARD
Mountain View
zffi:
Pleasereturn this form to the school
- PALSProgram Excursion Location:BrockUniversity Date(s)of Excursion:May 9 & 24,2018 Grade(s):4-8
ClassiCourse/Group: 4A,4/5A,5A, 6/7H,7lBA& 7/88
At the conclusion of this excursion/seriesof excursions, this form will be shreddedby the school. To be completedby the parenVguardian: Surname:
FirstName:
MiddleName:
Dateof Birth: ln the event of an emergencyduring this excursion,please listin order of priority who should be contacted. Name
Relation(e.9.: parent, uncle.friend\
PreferredContact Teleohone #
AlternateContact Pickup Teleohone # Student Yesn Noo
Yesr Non Yesr Noo
Yesn Non MedicalInformation requiredfor thisexcursion to be usedbv Teacher/Supervisors: Allergies
Life Threatening:Yes c No n Epipen:Yes a No n
OtherMedicalConditions/Restrictions/Lim itations : Are thereany medicalconcerns/specific instructions relatedto thisexcursion(pleaseattachadditional information if
necessary): FOROUT OF PROVTNCE/COUNTRY EXCURSTONS ONry M e d i c a lI n s u r a n c eP r o v i d e r :
PolicN y umber:
Provider Telephone: Contact
Proofof Coverage: Yesn No l
Consentof Parent/Guardian l/We understand that in the eventof a medicalemergency, whileon the excursion, medicalofficials canauthorize emergency medicalcare.Thiswouldapplywhena seriousconditionexistsandthe Hamilton-Wentworth District SchoolBoardandmedicalofficials havebeenunableto contactthe parents/guardians. Parent/Guard ian Signatu re:
Date:
Information on thisform is collectedunderthe legalauthorityof the Education Act and in accordance with the MunicipalFreedomof Information and Protection of PrivacyAct [MFIPPA]. lt will be usedonlyin the eventof an accidentor illnessof the studentattendingthe excursion.Questions or concerns shouldbe directedto the schoolprincipal.
