Details:  

• Depart: Wednesday 18 March at 8:30 am – SGHS Gymnasium 
• Return: Friday 20 March at 3:00 pm – SGHS Gymnasium 
• Accommodation: Cascade Creek Campsite
• Staff Attending: Mr Dave Beadle, Mr Nathan Muir, Miss Courtney Hansen will be leading this trip supported by parents.
• Food and Gear Lists: As part of  the students planning gear lists, tenting and food arrangements will be formulated in class prior to leaving.
• Cost: Included in the NCEA Level 3 course fees.

Itinerary  (weather dependent)

Drive to Cascade creek set up tents at campsite and familiarise with the area. Depending on the weather walk either Lake Marion track or Key Summit with a possible visit to Humboldt Falls.Up bright and easily to travel to Milford Sound to Sea kayak with Roscos Milford Sound Kayaks. The afternoon will see another walk as per the previous day. Pack up and travel home via Te Anau for a stop at Ivon Wilson Park where the inaugural SGHS Frisbee Gold World Championships will take place.

This event contains risks, including driving, camping in tents, cooking, off road and on road cycling. This event is supervised by school staff who will manage risk and hazards according to the school’s safety management plan, each staff member also holds a valid First Aid Certificate.  While risks can be maintained to acceptable levels they cannot be totally eliminated.  Some risk is retained for its learning and experiential value.  If you wish to come in to school to see our safety management systems or have any questions, feel free to contact our Teacher in Charge, Mr Dave Beadle at [email protected] or 027 600 6424.

It is important for safety reasons that students follow instructions given to them by all staff and follow all appropriate school rules. Behaviour by students that is deemed dangerous and puts themselves and/or others at undue risk will result in removal from activities and parents/caregivers contacted to collect their child from Alexandra at their own cost.

Please pay and complete the permission form below.

"*" indicates required fields

Student Information:

The information on this form will remain confidential to the teachers/instructors in charge of/assisting with the camp/trip. However, in the interests of the safety of all involved, any life-threatening conditions may be made known to other students. Please be assured that your child’s physical and emotional well-being always remains of paramount importance to us.

Student's Full Name*

First Last

Home Phone

Students Medical Information:*

I give permission for this information to be shared with the teacher in charge as required.

Yes (Medical)

Medical Conditions

Migraine

Diabetes

Chronic Nose Bleeds

Colour Blindness

Sleep Talking

Epilepsy

Travel Sickness

Heart Condition

Anaphylaxis

Bedwetting

Asthma

Seizures of any type

Dizzy Spells

Sleepwalking

Home Sickness

Medication

If you child is taking any prescribed medication please list below

Medication NOT to be taken

Is there any medication your child is NOT able to be given?

Major Breaks/llnesses

Has your child had any major injuries (breaks or strains) or illness (Glandular fever etc) that may limit full participation in any activities? (If Yes, please complete in the box provided below).

Allergies

If your child has any allergies please list below

Water Competence for activities on, in or around water. (please tick those that apply)

Providing this information does not remove the need for group leaders to ascertain for themselves the level of the student's swimming/water competence ability.

My child is a non-swimmer (unable to float or move themselves through water)

My child can confidently and competently swim 25 metres

My child can confidently and competently swim 50 metres

My child can confidently and competently swim 200+ metres

My child is confident in deep water

My child is able to survival float on their back for 2-3 minutes

My child is safety conscious in and around water

Special Access Arrangements

Visual Concerns

Mobility Issues

Hearing Issues

Other

Dietary Requirements

Outline any special dietary requirements. Please be specific, eg: vegetarian, lactose intolerant, etc

Transport*

Please indicate below if you give permission for your child to be driven by the named staff member. (If you have any queries in relation to this please contact the Teacher in Charge of the trip).

Yes, I give permission (Transport)

Other Information

Is there any other information that your child's teacher or staff should know to ensure the physical and emotional safety of your child. eg: cultural practices, anxiety, phobia about heights or small spaces, etc

Parent/Caregiver Consent:

Please tick the boxes below to complete the Parent/Caregiver consent.

Parent Consent*

I give my child permission to participate in PED3 Fiordland Spectacular Trip.

My child has read and understands the Student Code of Conduct.

My child's medical information is up to date with Student Services

I acknowledge the school policy that states you must 'pay before play/attend' an event/trip or sport.

I acknowledge that full payment is required by the due date specified for my child to be eligible to participate in this event.

I acknowledge that any payments made to my child's account will be allocated to the oldest unpaid fees/charges if any and that my child is not able to participate until all these charges are paid in full.

I acknowledge and accept the Risks Disclosure.

I agree that my child is responsible for managing the taking of her prescribed medication. They are willing and able to manage the medication without direct supervision. A designated adult will hold/carry the medication for safekeeping. The prescribed medication must be clearly labelled and securely fastened. A set of detailed and clearly written instructions must be included.

I am willing and able to pick up my child if they develop any signs of sickness during the event/activity. eg: Covid

I will inform the school as soon as possible of any changes in the medical or other circumstances between now and the commencement of the event

I agree to my child receiving any emergency medical treatment as considered necessary by the medical authorities present.

Any medical costs not covered by ACC or a community service card will be paid by me.

First Name

Last Name

Parent/Caregivers Email*

Parent/Caregivers Mobile*

Parent/Caregiver Signature*