PAGE UNIFIED SCHOOL DISTRICT #8 P.O. Box 1927 · Page, AZ 86040

PARENTAL/GUARDIAN CONSENT, MEDICAL AUTHORIZATION & LIABILITY RELEASE Form FT-6-2026-04

FIELD TRIP: Reservoir Ecology Boat Excursion — Lake Powell

Sponsoring Teacher: Mrs. Yazzie, 6th-Grade Earth Science Date of Trip: Thursday, June 5, 2026 Departure: 7:15 AM, Desert View Intermediate School (bus loading, south lot) Estimated Return: 4:30 PM Destination: Wahweap Marina, Lakeshore Drive, Glen Canyon National Recreation Area, Page, AZ Cost: $12.00 per student (NPS group entry + boat fuel surcharge). Fee waiver requests must be submitted to the front office by May 16.

Trip Description & Curriculum Alignment

Students will travel by district bus to Wahweap Marina (approx. 15 min.) for a ranger-guided boat excursion on Lake Powell. Activities include water-quality sampling at two stations in Wahweap Bay using handheld field meters (temperature, pH, turbidity, dissolved oxygen), observation of mineral deposit formations along canyon walls, and instruction on reservoir thermal stratification. The excursion concludes at the Carl Hayden Visitor Center, where students will observe the dam's penstock intake structures and learn how the reservoir regulates water delivery and hydroelectric generation for downstream states. Supports Arizona Science Standard 6.E2U1.7 (Earth's Systems).

Required Items

Please send the following with your student:

• This completed form
• Water bottle, minimum 32 oz., filled before departure
• Sunscreen, SPF 50+, applied before boarding the bus
• Wide-brim hat or cap with neck flap
• Long-sleeved UV-protective shirt or rash guard (recommended)
• Closed-toe shoes with non-slip soles (required aboard vessel and for the walk from the staging area to the current waterline; terrain may include exposed sediment and uneven surfaces; no sandals)
• Sack lunch and two snacks (no glass containers)
• Pencil and field notebook

Water Safety

Per USCG regulations and Arizona state boating law, all students must wear a USCG-approved personal flotation device (PFD) at all times aboard the vessel. PFDs will be provided and fitted on-site. Fit is confirmed by the arm-raise test: with both arms extended overhead, the PFD must not ride above the student's chin or ears. Inflatable PFDs are not approved for passengers under age 16.

Students will not enter the water. Lake Powell surface temperatures in early June average 62–68°F. At these temperatures, hypothermia onset following accidental immersion is possible within 30–40 minutes. Please indicate swimming ability below.

Student Information

Student Name: ________________________________ Grade: ______ Homeroom: ______

Swimming Ability:  ☐ Non-swimmer  ☐ Beginner  ☐ Intermediate  ☐ Strong swimmer

Allergies / Medical Conditions: ___________________________________________________________

Current Medications: ___________________________________________________________

Emergency Contact

Name: ________________________________ Relationship: ____________ Phone: ________________

Alternate Phone: ________________

Assumption of Risk & Liability Waiver

I understand that this field trip involves travel by motorized watercraft on Lake Powell, a Bureau of Reclamation reservoir within Glen Canyon National Recreation Area, and that water-based activities carry inherent risks including but not limited to: drowning, hypothermia, heat illness, sun exposure, slips and falls on wet or uneven surfaces, and contact with submerged objects at or near access points. I understand that conditions on the reservoir are subject to change and that the excursion may be modified or cancelled due to weather, water level, or NPS operational decisions.

I release and hold harmless Page Unified School District #8, its employees, volunteers, and agents, the National Park Service, the Bureau of Reclamation, and the vessel operator from any and all claims arising from my student's participation, except in cases of gross negligence or willful misconduct.

Photo / Media Release

☐ I grant permission for my student to be photographed during this trip for district and NPS educational use.

☐ I do not grant permission.

Invasive Species Compliance

Per NPS policy, all equipment contacting reservoir water is subject to quagga mussel decontamination upon exit from Glen Canyon NRA. Students must not remove water, sediment, or biological material from the site.

Parent / Guardian Authorization

I have read this form in its entirety. The medical information provided is accurate and complete. I give permission for my student to participate in this field trip. In the event of illness or injury, I authorize the supervising teacher or designated chaperone to obtain emergency medical treatment.

Parent/Guardian Name (print): ________________________________

Signature: ________________________________   Date: ______________

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RETURN COMPLETED FORM TO MRS. YAZZIE BY FRIDAY, MAY 23, 2026.