INCURSION/EXCURSION

PROPOSAL
APPLICATION

Application Date: 22nd June 2022 Date Inc/Exc Monday 8th August 2022

Teacher/s in Charge of Excursion: Elena Roberts

Classes involved: Year 5/6 Dance Troupe (LA8, LA9, LA10, LA14, LA15, LA16)
Number of Children 35

Incursion/Excursion Venue/Description: Perth Concert Hall PERFORMANCE

Curriculum Related: Yes/No

Rationale: On stage PERFORMANCE for Wakakirri performance

COSTING:

• A field trip or excursion NOT related to the curriculum (ie. predominantly recreational)
attracts GST.
• Additional accompanying parents and/or staff paying a separate charge, are subject to
GST.
• Any ‘treat’ (eg. an ice-cream) included in the outing, will attract GST and must be shown
below.
• Food supplied with the excursion is subject to GST.
Remember – we are just a collection agency for the GST and must not look for ways to
save the parents money. There is a tax break to cover such contingencies.

Transport: Students to arrange own transport to and from the venue.

Transport Cost $ N/A
GST Component $ N/A
Venue Cost $ N/A
GST Component $ N/A
Other Costs? ____________________________ $____________________
Total Cost $ ____________________
Total GST $____________________
Cost/Child $ ____________________

Names of accompanying adults: Elise O’Connor (EDUCATION ASSISTANT)

Principal’s approval ____________________________ SEE OVER FOR FURTHER DETAILS

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 PROCEDURE
❑ Obtain costing for various elements of incursion/excursion
(see Registrar for GST implications if unsure)
❑ Complete Application for Incursion/Excursion Form for approval from Team Leader.
❑ If using private transport, complete the Private Vehicle Drivers’ Report.
❑ Confirm Bus and Venue
❑ Business Manager to complete order purchase order forms for bus, venue entry etc.
❑ Copy of incursion/excursion information for parents to Registrar.

Transport: Arrive at 5:00PM SHARP – Parents to drop students off and pick them up at 9:30PM
(approx.. finishing time)

Has a parent note been prepared? A copy is to accompany the application)

Do you have emergency medication for children who may need it?

Arrangements for non attending students N?A __________________________________________

___________________________________________________________________________

Other teachers informed of the excursion eg. DOTT, support.

Inc/Exc noted on whiteboard Canteen informed

Duty exchanges arranged First Aid box collected
Snake Bite Kit (if applicable) Mobile Phone

Emergency
• Be calm. Attend to child/ren first. Decide who will attend to other students.
• Ring ambulance or school.
• The school will provide coordination support by phone (and in person if possible).
• Use the mobile to advantage, (school, parent, ambulance officer, police). Refer media to Principal.
• Assemble, calm and debrief other students.
• Isolate back at school for counselling if required.
Important Telephone Numbers School Mobile: 0409 449 622 - Principal
School Phone: 9456 8300

PERMISSION SLIP – Sample

Campbell Primary School

I have read and understood the attached information regarding the excursion to

_____________________________on _________________ and give my consent for my

son/daughter _______________________ to travel by ___________ to attend.

Where it is not practical to communicate with me, I authorise the teacher in charge of the excursion to consent to my
child receiving such medical treatment as may be considered necessary. I am aware the Department of Education
insurance does not cover personal accidents through misadventure nor loss or damage of personal belongings.

Signed………………………………………… Date…………………………
(Parent/Guardian) Enclosed: $

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 CHECKLIST FOR INCURSIONS/EXCURSIONS

PURPOSE OF THE INCURSION/EXCURSION

The educational purpose of the excursion is described □
1. ASSESS THE RISKS
1.1 Assess the environment
The site has been assessed and is considered to be appropriate for the excursion. □
1.2 Assess transport arrangements
Arrangements have been made for the safe transport of excursion participants.
(Coaches with Seat Belts) □
The consent form indicates the mode of transport to be used. □
1.3 Assess of the students' skills
Excursion activities are suitable for the students' level of skill. □
Provision has been made for any student with special needs. N/A □
Child’s Name _____________________ LA: _____
Arrangement
_____________________________________________________________________________

Child’s Name _____________________ LA: _____

Arrangement
_____________________________________________________________________________

Child’s Name _____________________ LA: _____

Arrangement
_____________________________________________________________________________

Child’s Name _____________________ LA: _____

Arrangement
_____________________________________________________________________________

Child’s Name _____________________ LA: _____

Arrangement
_____________________________________________________________________________

Child’s Name _____________________ LA: _____

Arrangement
_____________________________________________________________________________

_____________________________________________________________________________

Up to date information regarding student medical conditions has been obtained □

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1.4 Assess the capabilities of the supervisory team
Collectively the supervisory team has the skills to:

□
-identify and establish a safe activity environment (Public Liability and Evacuation

□
Procedures)
-effect a rescue and/or render emergency care

□
-monitor weather and environmental conditions before and during activities

□
____________________________________________________________________________

□
-monitor the physical performance of the students
-relocate or cancel the excursion if conditions become adverse

Volunteer supervisors have completed a Confidential Declaration. □

Names of Volunteers: ____________________________________________________________

______________________________________________________________________________

□
1.5 Assess the involvement external providers

□
Competence of external providers is established.
External providers conducting activities with students have a current Federal Police Clearance.
Staff responsibilities of the school and venue/facility have been established. □
External providers hold the appropriate level of public liability insurance (copy to Business
Manager) .
□
2. ESTABLISH SUPERVISION STRATEGIES
On-site supervision strategies have been established. □
The teacher-in-charge will have a list of the names of participating students, contact
telephone
numbers and medical information pertaining to those students with medical conditions. □
______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

____________________________________________________________________________

3. DEVELOP MEANS OF IDENTIFYING INCURSION/EXCURSION PARTICIPANTS

Systems for identifying students, teacher-in-charge, and supervisors have been established. □

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 □
4. PROVIDE INFORMATION AND SEEK CONSENT
Parents/guardians of student participants have been provided with full details of

□
the incursion/excursion.
Signed consent forms have been received.

□
5. DEVELOP COMMUNICATION STRATEGIES
Appropriate methods of communication, including emergency signals, have been developed.

□
6. COMPLETE EMERGENCY RESPONSE PLANNING
An appropriate emergency response plan has been developed.

□
7. BRIEF STUDENTS AND SUPERVISORS
Students and supervisors have been/will be fully briefed on all aspects of the excursion.

8. RETAIN INCURSION/EXCURSION RECORDS

Relevant incursion/excursion details will be retained. □

□
9. GAIN APPROVALS
Appropriate approvals have been gained.

Teacher-in-charge Elena Roberts Date 22.06.22

I am satisfied that appropriate planning has taken place to ensure the duty of care to and
safety of all participants. I approve this excursion.

Assistant Principal Date

I am satisfied that appropriate planning has taken place to ensure the duty of care to and
safety of all participants. I approve this excursion.
Principal Date

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 Incursion/Excursion Procedure Teacher and Administration - Checklist
TEACHER IN CHARGE – STAGE 1

1. Discuss and receive approval with Executive Admin Leader on details of excursion/incursion 
Who will be attending – teaching and non teaching
2. Seek written quotes for venue and transport 
Please note: Be aware if quote is inclusive or exclusive of GST

3. If No Charge or transport – Procedure is identical 

4. Complete Excursion/Incursion Proposal Application 

5. Complete Checklist for Excursions 

6. Draft note – including QKR Information, on separate sheet Attachment 2 

7. Provide all information (Application, Quotes, Insurance from transport and venue, Evacuation Procedures)
and copy of note to Exec Team Leader for approval 

8. Email Note and take application etc once approved by Exec with quotes to the Manager Corp Services
If Manager Corp Services unavailable leave on desk or come back
If Education Assistants are required discuss with Manager Corp Service 

9. Advise Canteen 

10. Write on Staffroom Term Planner 

• Documentation to be provided to Manager Corp Services 5-6 weeks prior to event.

• This time line required for parent communication, school scheduling and team commitments.
• Notes be sent home to parents at least 4 weeks prior.
• SPECIALIST teachers ONLY to the Principal.

MANAGER CORPORATE SERVICES– STAGE 2

1. Complete & approve costing section of Incursion/Excursion Proposal Application 

2. Proof & Approve Note 

TEACHER IN CHARGE– STAGE 3

1. Meet with Executive Team Leader to sign off package who will then provide to Principal for
approval and signed off on behalf of Principal 

2. Confirm Transport and Venue 

3. Return pack to Manager Corp Services 

MANAGER CORP SERVICES –STAGE 4

1. Email note for the web 

2. Order forms to be written 

3. Bill Item, Notes to be collated and emailed to parents distributed to classes 

4. Add to QKR! 

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ADMINISTRATION – STAGE 5

1. Funds Billed to student with unallocated credit, noted on personal note and sent to class.

2. Student Checklist highlighted

3. Three days prior to excursion / incursion – notes and class list sent to teacher with Teacher Excursion
Checklist - Attachment 2

4. Close QKR! 2 days prior and print list and permission slips send to class.

CLASS TEACHER – STAGE 6

1. Class Teacher or Specialist to follow up students who haven’t paid.

Please note – if STAFF OR PARENTS ARE TRANSPORTING STUDENTS the school must have a copy of the
following documents from all drivers on each occasion.
1. Driver’s license
2. Car Registration Papers
3. Car Insurance Policy
4. Car needs to be inspected by the Principal prior to departure.

Teachers Please Note – permission slips, payment details and medical sheets are available at
ANYTIME for you to collect or check at the Administration.

Attachment 2

Teachers Incursion/Excursion Checklist

Enclosed are all forms received by Admin for your excursion in two days time, final Billing for today has been
completed.
Indicated by highlighting are all payments and permission/medical forms received.
All forms received after this date will be placed in your pigeon hole. A Billing report is available on request.

Teacher’s responsibility Completed

1. Follow up – all students who have not paid 

2. Follow up – permission / medical forms not received 

3. Collate and sign out medication (afternoon before) 

4. Count and collate lanyards for excursion 

5. Collect medication and first aid back pack from Admin (morning of exc) 

6. Return all medication to Admin cupboard and sign back in 

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