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CAMBRIDGE ELEMENTARY SCHOOL

VOLUNTEER/CHAPERONE AGREEMENT

The staff at Cambridge Elementary School would like to thank you in advance for volunteering to chaperone our school field trips or volunteer in our school building.  These trips are an extension of our curriculum and an important part of a quality school experience.  It would be very difficult to take field trips without parent support, since we try to have at least one adult supervising no more than six students at one time.  All Cambridge Elementary School rules and policies apply to both students and adults on all field trips.  We ask that you give careful consideration to the requirements below before signing the agreement.  In order to provide a safe trip experience, and to fully adhere to all School Board Policies, as well as State and Federal regulations, we require the following:

• No tobacco products or alcohol are allowed.
• Younger siblings or other children are only allowed to accompany parent chaperones on field trips with permission from the school
• Issues regarding student discipline, other than redirecting students, should be reported to a staff member as soon as possible.  Chaperones should not issue consequences or get heavily involved in mediating disagreements
• Chaperones need to be legal guardians, parents, grandparents, or others at the discretion of the Principal
• Confidentiality is a must.  Information about individual students, discipline problems, etc. cannot be shared with non-school personnel.
• Chaperones need to be familiar with all the school rules addressed in the Parent Handbook, and should enforce them on all trips.
• Professional language should be used at all times.  Students should never be exposed to adult conversations, swearing, etc.
• Never leave the group you are chaperoning without arranging for another adult to take over your responsibilities.

Have you ever been convicted of a felony or misdemeanor?  Yes or No
If yes, please explain:

_________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________

I authorize CES to conduct a criminal background check at their expense and at their discretion.

I have read and do understand the above.  I agree to fulfill my obligations as a Cambridge Elementary School Volunteer/Chaperone.

__________________________                   ____________________________
Signature                                                                               Date

___________________________                 _____________________________
Print Name                                                                             Relationship to Child(ren)

___________________________                 ___________________________
Child’s Name                                                                        Child’s Name

For school use only

__________ Approved                                     ________ Not Approved

Board Approved 6/20/07