Excursion planner template



Activity detailsActivity name: FORMTEXT ?????Venue: FORMTEXT ?????Teachers / leaders / supervisors: FORMTEXT ?????Relevant experience or expertise of volunteer supervisors : FORMTEXT ?????Overall activity description including educational aims: FORMTEXT ?????Class groups:Number of students: Male: Female:Supervision ratio:Activity consent form drafted and attachedYes FORMCHECKBOX No FORMCHECKBOX Risk assessment for this excursion completed and attached Yes FORMCHECKBOX No FORMCHECKBOX -352095532816Excursion planner templateThis template contains the minimum requirements. Schools may use the OneSchool Excursion planner or an alternative form that meets or exceeds these minimum requirements.For overseas travel see the International school study tour guidelines (DoE employees only). 00Excursion planner templateThis template contains the minimum requirements. Schools may use the OneSchool Excursion planner or an alternative form that meets or exceeds these minimum requirements.For overseas travel see the International school study tour guidelines (DoE employees only). ItineraryStart date: FORMTEXT ?????Depart school: FORMTEXT ????? Arrival venue: FORMTEXT ????? Finish date: FORMTEXT ?????Depart venue: FORMTEXT ????? Arrival school: FORMTEXT ????? Overnight accommodationDetails: FORMTEXT ?????Venue suitability assessed and risk management processes appliedYes FORMCHECKBOX No FORMCHECKBOX ParticipationAre there any students not participating in this activity?Yes FORMCHECKBOX No FORMCHECKBOX If so please explain why (noting that excursions are curriculum related and should be designed for all students to participate): FORMTEXT ?????What arrangements are being made for them? FORMTEXT ?????Please confirm that an out of hours contact for the principal (or principal's nominee) has been identified.Out of hours contact name:Contact's telephone number:TransportModeProvider/detailsCertification requirementsYesNoBus FORMTEXT ?????Operator accreditation current. Bus with seatbelts. FORMCHECKBOX FORMCHECKBOX Private car FORMTEXT ?????School excursions and international school study tours requirements met. FORMCHECKBOX FORMCHECKBOX Train FORMTEXT ?????(If Qld Rail, no checks required) FORMCHECKBOX FORMCHECKBOX Boat FORMTEXT ?????Certificate of operation and certificate of survey current. FORMCHECKBOX FORMCHECKBOX Aeroplane FORMTEXT ?????If commercial airline, no checks required FORMCHECKBOX FORMCHECKBOX Other FORMTEXT ????? FORMCHECKBOX FORMCHECKBOX Costs (Information on taxation and student costs is available to departmental employees.) Attach a separate table of calculation if appropriate.ItemsCost ex GSTGST of itemDetailsTransport $ FORMTEXT ????? $ FORMTEXT ????? FORMTEXT ?????Venue $ FORMTEXT ?????$ FORMTEXT ????? FORMTEXT ?????Catering $ FORMTEXT ?????$ FORMTEXT ????? FORMTEXT ?????Other costs $ FORMTEXT ????? $ FORMTEXT ????? FORMTEXT ?????$ FORMTEXT ????? $ FORMTEXT ????? FORMTEXT ?????Cost for each student: TOTAL: $ FORMTEXT ????? $ FORMTEXT ????? FORMTEXT ?????GST assessmentBased on the activities and % estimates outlined in activity details, and for the purpose of GST, I, [NAME OF PRINCIPAL or DELEGATED/AUTHORISED OFFICERS], being [TITLE] of [NAME OF SCHOOL], have determined that the purpose of this excursion (tick one box): FORMCHECKBOX ? is curriculum or predominantly curriculum??OR FORMCHECKBOX ? is recreational or predominantly recreationalGST is to be processed per the ‘Excursions’ tax topic available on OnePortal. Charges to the students to include GST where applicable. Approval FORMCHECKBOX Approved as submitted: FORMTEXT ????? FORMCHECKBOX Approved with the following condition(s): FORMTEXT ????? FORMCHECKBOX Not approved for the following reason(s): FORMTEXT ?????By: FORMTEXT ?????Designation: FORMTEXT ?????Information has been entered in the register of approved school excursions.Reference no : Signed:Date: FORMTEXT ?????Attachment 1The following checklist is to assist you to identify the appropriate equipment, hazards/risks and control measures to be considered prior and during an excursion. They are not exhaustive lists and you may choose to add additional considerations.Minimum equipment/facilities For any items not ticked, provide further information.First aid kit suitable for activity FORMCHECKBOX Emergency and first aid requirements and personnel in place for duration of excursion. FORMCHECKBOX Communication system: e.g. mobile phone, phone-line at location, walkie talkies/UHF radio FORMCHECKBOX Clothing suited to weather conditions (e.g. sun protection) FORMCHECKBOX Drinking water (students should not share drinking containers) FORMCHECKBOX Fire restrictions have been checked with local fire authority as appropriate FORMCHECKBOX Permission has been obtained from property owners where property will be traversed FORMCHECKBOX Risk assessmentWhen planning the excursion adhere to the Managing risks in school curriculum activities procedure and consider the following questions:Which students will be involved?What will the students be doing?Where will the students be?Who will be leading the activity?What will the students be using?Hazards/risksExample control measuresConsentObtain parental consent, including relevant medical information. FORMCHECKBOX Student safetyBlue Card requirements met. FORMCHECKBOX Consider whether students will come into contact with people other than school staff (e.g. shared use of venues, use of public toilets) and how this will be managed. FORMCHECKBOX Student considerationsEnsure that venues and facilities are accessible to all students including those with disability. FORMCHECKBOX Refer to relevant student management/behaviour plans or other student records. FORMCHECKBOX Seek advice from relevant staff (e.g. advisory visiting teachers or specialist teachers). FORMCHECKBOX When students with medical conditions are involved, ensure that relevant medical/emergency plans and medications are readily available. FORMCHECKBOX BriefingsEnsure that all supervisors are aware of the emergency contingency plans. FORMCHECKBOX Brief supervisors prior to departure regarding any potential hazards and safety controls. FORMCHECKBOX Brief students prior to departure on any potential hazards and safety controls. FORMCHECKBOX Further information FORMTEXT ????? ................
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