June Trip Days 2021 Informed Consent for All Students

Students who want to participate in the June Trip Days activities must have a parent sign the consent form by Friday, June 11, 2021


Gr 6-9 June Trip 2021 Consent Form

Parent(s)/Guardian(s) AND STUDENTS MUST Initial & Sign this consent form in order for your child to be able to participate in the June Trip activies on June 14, 15 and/or 16, 2021.
  • Non-Exhaustive List of Potential Perils

    Please note that the students will be participating in activities which will expose them to risk on the Island Pacific School June Trip Days from June 14 – 16, 2021. Although the following non-exhaustive list identifies most of the potential perils associated with the June Trip Days, it does not and cannot cover all possible perils.

    • harm, injury, dismemberment, or death in kayaking acitivities taking place around Tunstall Bay or other areas of Bowen Island (e.g. injuries sustained on the water in the kayaks)
    • harm, injury, dismemberment, or death associated with taking up accommodation Camp Bow-Isle
    • harm, injury, dismemberment, or death associated with eating meals at either of the beaches, on the hikes or at Camp Bow-Isle
    • harm, injury, dismemberment, or death associated with receiving instruction in kayaking (e.g. drowning, paddling injuries, strained/broken limbs, hypothermia, sunstroke, sunburn, etc.)
    • harm, injury, dismemberment, or death associated with participating in the group kayak (e.g. drowning, paddling injuries, strained/broken limbs, hypothermia, sunstroke, sunburn, etc.)
    • harm, injury, dismemberment, or death associated with any activity at either of the beaches, on the hike to Mt. Gardner or at Camp Bow-Isle (e.g. cuts, head injuries, drowning, etc.)
    • harm, injury, or death associated with failing to take the prescribed dosage of any required medication.
    • harm, injury, dismemberment, or death associated with moving to, or residing at, any unauthorized location (i.e. going out of bounds)
    • harm, injury, dismemberment, or death associated with participating in any unauthorized activity (e.g. inflicting harm on others)
    1. 1. I have read, understand and agree without reservation to the contents and requirements of the June Trip Days memo.
    2. 2. I have read, understand and agree without reservation to the contents and requirements of the Non-Exhaustive List of Potential Perils for the June Trip Days listed on this Consent form.
    3. 3. I have read, understand and agree with the contents and directions provided in the June Trip Days Equipment List.
    1. 1. I have read, understand and agree without reservation to the contents and requirements of the June Trip Days program memo.
    2. 2. I have read, understand and agree without reservation to the contents and requirements of the Non-Exhaustive List of Potential Perils for the June Trip Days listed on this Consent form.
    3. 3. I have read, understand and agree with the contents and directions provided in the June Trip Days Equipment List.
    4. 4. I give my child permission to participate in swimming activities under the supervision of an adult designated by the Trip Leader.
    5. 5. I hereby certify that I/we understand the nature and possible risks of participation activities associated with the June Trip Days and that I/we accept and acknowledge such risks in light of the benefits of such participation. I/We further certify that I am/we are legally empowered as parent(s)/guardian(s) to consent to the terms of this document on behalf of the child named hereon.
    6. 6. I hereby give full and informed consent for my/our child to attend the June Trip Days on June 15 – 17, 2020.
  • YYYY slash MM slash DD