LHS%2C%20HOSA%2C%20March%2011-13%2C%202025.pdf

Parent document: School Board Regular Business Meeting-01-28-2025.pdf

Text

Docusign Envelope ID: 89C7FC93-A749-4B7C-9A7E-86991 C6046E5

AD P-101
~ =v Edmonds Request for Field Trip, Excursion,
== School District oF Outeieor Education

This form is being submitted pursuant to Policies 2320 Field Trips, Excursions and Outdoor Education and related
procedures; 6622 Student Transportation and related procedures.

Instructions
Originator:
¢* Completes form, via DocuSign
¢ Submits to principal for review

Initial
Principal: | IGS
¢ Reviews form for compliance to policies and procedures 2320 and 6622
« Signs at bottom

When complete, principal sends to administrative assistant for elementary (mcgiek280@edmonds.wednet.edu) or secondary
(anderson|i@edmonds.wednet.edu) education three weeks prior (No Exceptions) to the next scheduled board meeting.

Name of school/program: Lynnwood High School HOSA
Group: HOSA State Leadership Conference Destination; Spokane
Date(s) of trip: March 11-13, 2025 Number of students: 20

Number of chaperones:
(min. of 2 chaperones, but must meet 1 per 10 ratio beyond that)

Grade level(s): 9-12 What is the cost per student: 500.00
List all funding sources for trip, including available scholarships: Is this event CTE funded:
CTE funds & student fees kyYes [JNo

Objective, curriculum and learning activities:
Career Technical Student Organization state competition and leadership conference (HOSA). Student will
compete in health career related events and develop career and leadership skills.

Transportation (select all that apply):

[% District bus k] Van

_] Private vehicle, # of drivers - all drivers must be certified through procedures as outlined in 6622)

_j Watercraft transportation: Other than Washington State Ferry watercraft, compliance with Washington Schools Risk
Management Pool (WSRMP) requirements exist. Please contact Risk Management at riskmanagement@edmonds.wednet.edu
[_] Other (describe):

Name of staff member or adult chaperone who has current first aid and CPR card:

Debbie Meservy and Susan Russell

Overnight accommodations:
Hotel (Davenport Spokane)

Are there any other organizations, sponsors, or co-sponsors involved with this field trip (e.g. travel agencies, sports
organizations, etc.) contractually or otherwise? KJNO LJYES
If YES, please provide the name(s) of the organization(s) and details of involvement:

n/a

Signatures below indicate Originator and Principal or Designee have reviewed all related policies and procedures while
pl ingsthis field trip, and that principal or their designee approves this trip:

sisney: Russell nate 2/6/2025
= 1/7/2025

Signature of Originator

Signature of Principal
or Designee

DS
| UA Rev 9/23

Date