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Allendale Robotics

2025 Trip Permission Forms


Allendale Robotics provides trips to several Events and other team related occurrences during the Robotics Season.

This form shall be used to approve and acknowledge the events and policies for Allendale Robotics in accordance with the Allendale Robotics requirements (AR Handbook) and the Allendale Public School requirements (per APS Policy po8660).

Approvals are required for all students to travel with the team, regardless of age.  All approvals shall be done by a Parent or Legal Guardian of the student.

First Member's Name

First Name*

Last Name*

Phone*
First Member's Age Acknowledgment*
First Member's Date of Birth*
I certify that I am 20 years of age or older
First Member's Signature*
Second Member's Name

First Name*

Last Name*

Phone*
Second Member's Date of Birth*
Third Member's Name

First Name*

Last Name*

Phone*
Third Member's Date of Birth*
Fourth Member's Name

First Name*

Last Name*

Phone*
Fourth Member's Date of Birth*
Fifth Member's Name

First Name*

Last Name*

Phone*
Fifth Member's Date of Birth*
Sixth Member's Name

First Name*

Last Name*

Phone*
Sixth Member's Date of Birth*
Seventh Member's Name

First Name*

Last Name*

Phone*
Seventh Member's Date of Birth*
Eighth Member's Name

First Name*

Last Name*

Phone*
Eighth Member's Date of Birth*
Ninth Member's Name

First Name*

Last Name*

Phone*
Ninth Member's Date of Birth*
Tenth Member's Name

First Name*

Last Name*

Phone*
Tenth Member's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Event 1 Approval

Destination: Mt. Pleasant District Event - Mt. Pleasant, MI - Mt. Pleasant High School

Depart Date / Time: March 7 - 2:00pm

Return Date / Time: March 9 - 10:00pm

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: School Bus & Private Vehicle*

Fees: Included with Team Participation Fee (Needs to be paid prior to event)

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I understand that the approval of this trip is in accordance with the Allendale Public Schools form fm2340F2 (Parent Consent for Trip)

I understand that these trips are part of the District's educational program and provides a learning experience of educational value to my child. I further understand that the activities associated with this trip are such that my child cannot be supervised by school staff during certain segments of the trip (in accordance with form fm2340F2a - Parental Consent for Partially Unsupervised Event). In light of the above, I hereby give consent to my child's participation in the trip and in the unsupervised activities.

*If the field trip is by private vehicle, please be assured that the adult driver has completed "Transportation by Private Vehicle Form" and will adhere to all district policies and procedures, including safety issues.






Deny
Approve
Event 2 Approval

Destination: West Michigan District Event - Allendale, MI - GVSU

Depart Date / Time: March 20 - 5:00pm, March 21 & 22 - 7:00am

Return Date / Time: March 20 - 10:00pm, March 21 & 22 - 7:00pm (Exception on March 24 for Scouting at HS until 10pm)

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: Personal Arrangement - Daily Drop off and Pickup required**

Fees: Included with Team Participation Fee (Needs to be paid prior to event)

------------

I understand that the approval of this trip is in accordance with the Allendale Public Schools form fm2340F2 (Parent Consent for Trip)

I understand that these trips are part of the District's educational program and provides a learning experience of educational value to my child. I further understand that the activities associated with this trip are such that my child cannot be supervised by school staff during certain segments of the trip (in accordance with form fm2340F2a - Parental Consent for Partially Unsupervised Event). In light of the above, I hereby give consent to my child's participation in the trip and in the unsupervised activities.


*If the field trip is by private vehicle, please be assured that the adult driver has completed "Transportation by Private Vehicle Form" and will adhere to all district policies and procedures, including safety issues.

**For students that wish to drive themselves, prior approval must be made using the "AR - Student Permission to Drive Personal Vehicle" form. This requirement is in adherence to APS School Policy 8640.




Deny
Approve
State Championship Approval

Destination: Michigan State Championship - Saginaw, MI - SVSU

Depart Date / Time: April 3 - 7:00am

 Return Date / Time: April 5 - 12:00am

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: School Bus & Private Vehicle*

Additional Fees for States: TBD (Anticipated NTE $300 due prior to trip)

------------

I understand that the approval of this trip is in accordance with the Allendale Public Schools form fm2340F2 (Parent Consent for Trip)

I understand that these trips are part of the District's educational program and provides a learning experience of educational value to my child. I further understand that the activities associated with this trip are such that my child cannot be supervised by school staff during certain segments of the trip (in accordance with form fm2340F2a - Parental Consent for Partially Unsupervised Event). In light of the above, I hereby give consent to my child's participation in the trip and in the unsupervised activities.

*If the field trip is by private vehicle, please be assured that the adult driver has completed "Transportation by Private Vehicle Form" and will adhere to all district policies and procedures, including safety issues.




Deny
Approve
World Championship Approval

Destination: FIRST Championship - Houston, TX

Depart Date / Time: April 13 (Evening) or April 15 (Early Morning)

Return Date / Time: April 20 (TBD, Est. 10pm)

School: Allendale High School

Teacher / Coach: Chad Potinsky

Transportation: Charter Bus, Plane, or Vans - TBD still, working on plans

Additional Fees for Worlds: TBD (Anticipated NTE $500 due prior to trip)

------------

I understand that the approval of this trip is in accordance with the Allendale Public Schools form fm2340F2 (Parent Consent for Trip)

I understand that these trips are part of the District's educational program and provides a learning experience of educational value to my child. I further understand that the activities associated with this trip are such that my child cannot be supervised by school staff during certain segments of the trip (in accordance with form fm2340F2a - Parental Consent for Partially Unsupervised Event). In light of the above, I hereby give consent to my child's participation in the trip and in the unsupervised activities.



Deny
Approve
Parental Consent for Travel by Private Vehicle

In accordance with the Allendale Public Schools Policy po8640 and Form fm8660F2 for the Parental Consent for Transportation by a Private Vehicle.

All vehicles and drivers shall comply with the Allendale Public School requirements of Policy po8640 and shall submit and have approval for use of vehicles with Allendale Public Schools form fm8660F1 (Request for Transportation by Private Vehicle). Copies of the drivers vehicle information, drivers license, and insurance shall be submitted with the form to APS for approval.

For Allendale Robotics, we request the approval for transporting students, as needed, during the robotics season for reasons such as transportation to/from events, practices at other facilities, sponsors, etc.

--------------------

I have reviewed the following information and consent to my child being transported by private vehicle for this purpose.

Purpose of the Trip(s): Transportation as needed by the Allendale Robotics Team

Date(s) of the Trip(s): During the Official Season (January 6, 2024 through April 22, 2024)

Time of Departure: As needed

Time of Return to School: As needed

Owner of the Vehicle: Approved Vehicles with APS / Allendale Robotics Coaches and/or Chaperones

Driver of the Vehicle: Approved Vehicles with APS / Allendale Robotics Coaches and/or Chaperones

Description of the Vehicle: Approved Vehicles with APS / Allendale Robotics Coaches and/or Chaperones

Amount of Liability Insurance on the Vehicle $: As Approved per APS Policy

The school verifies that the driver has a valid operator's license, the vehicle is in proper operating condition, and a safety belt will be available for your child.


Consent to Travel by Personal Vehicle*
Deny
Approve
Other Travel Acknowledgements

In accordance with the APS School Policy po8640 (Transportation For Field And Other District-Sponsored Trips), the following items shall be acknowledged.

  • All students are expected to ride the approved vehicle to and from each activity. A special request must be made to the staff member or sponsor by the parent, in writing or in person, to allow an exception.
  • Allendale Robotics has a diverse student membership. With this diversity, students from Allendale Public Schools and Non-Allendale Students will be traveling together.
  • Students traveling with the team shall follow APS School policies and AR Student Handbook the entire time with the team (traveling, at the venue, at the hotel, etc.).
  • All students are expected to ride the approved vehicle to and from each activity. A special request must be made to the staff member or sponsor by the parent, in writing or in person, to allow an exception.
  • No student is allowed to drive on any trip. An exception may be made by the principal on an individual basis provided the student has written parental permission and does not transport any other student (using form AR-8660F1).


I acknowledge these other travel items
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above. Due to our event trips being excused form school, we need parents to complete the form regardless of the students age.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 20 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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