Chaperones must comply with all local school district requirements pertaining to the supervision of students. The Monroe Science Educational Services (MSES) requires that ALL adult chaperones must be fingerprinted with a current tuberculosis test on file 30 days prior to departure. These can be obtained and verified with your child’s school district. This Agreement Form is also required before attending and chaperoning any event. Due to the fixed seat costs on the buses, some chaperones may be asked to ride together (car pool) in their own vehicle(s). Fuel reimbursements will be available with submission of original receipts.
A. Chaperones must be familiar with local school district (MDUSD) procedures regarding supervision before actual supervision commences.
B. Chaperones must be responsible adults, twenty-one years of age or older, with no record of criminal conduct.
C. For Camp Monroe: the chaperone understands that MSES will be using the existing facilities of the Mount Lassen National Park areas.
D. The chaperone agrees to abide by all rules and regulations set by MSES for the health, safety, and welfare of the children and staff. Such rules and regulations may be provided verbally and in printed publications to campers and chaperones. MSES: Day Trip Rules & Emergency Contact↗.
E. It is understood that MSES reserves the right to dismiss any chaperone whose condition, conduct, influence, or behavior is deemed by camp staff to threaten or be detrimental to, the campers, park property and/or staff members.
F. Chaperones will be responsible for Departure Readiness including Head Counts.
G. Chaperones understand that they are not covered by the MSES liability insurance policy during this activity.
H. MSES is not responsible for Chaperone personal belongings while in transit or on site.
K. Field trips are to begin and end at the site of origin unless other arrangements are made in advance with MSES.
L. Chaperones must be fingerprinted.
M. Chaperones must have a current tuberculosis test on file. Please contact the Mt. Diablo Unified School District Personnel Office at (925)682-8000 to schedule an appointment ASAP.
Contact your personal physician or you may contact your local Muir/Diablo Occupational Medicine clinic: Concord (925) 685-7744 or Walnut Creek (925) 932-7715. Specify MDUSD to receive a reduced rate of $20.00.
Any questions? Please Contact Us ↗ before completing this form.