Planning Workbook NatureBridge|Prince William Forest Park
[email protected] tel 703.634.9041
www.naturebridge.org
Prince William Forest Park Field Science Planning Workbook Contents (revise d August 2 013 )
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Prince William Forest Park Field Science Planning Workbook Contents (revise d August 2 013 )
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Planning Workbook Overview Thank you for organizing organizing your group's group's trip to NatureBridge! !"#$ &'()*'') &'()*'') +#,, *- "-,./0, #1 2"- .,311#14 .('5-$$ 316 .('7#6-$ #1/'(832#'1 2' $"3(+#2" $206-12$9 .3(-12$9 5"3.-('1-$9 316 /-,,'+ 2-35"-($: Pre-Program Planning LP(.'-P.'& &P) 01%$$+$- 0(./)44^ &P) >(.-(%2 K%$%-)( "+11 4)(W) %4 S.'( 0.+$& .3 /.$&%/& "+&P A%&'()H(+,-)# B3 S.' )W)( P%W) %$S Z')4&+.$4^ /.22)$&4 .( /.$/)($4^ don’t P)4+&%&) &. /.$&%/& '4# DP)$ 01%$$+$-^ +& "+11 *) P)103'1 &. ()3)( &. &P) OP)/Q1+4& &. U)10 _.' >1%$ %$, E(-%$+`) % A%&'()H(+,-) L(+0# D) %14. )$/.'(%-) %$ !n-s"#$ &"'"# 0(+.( &. S.'( 0(.-(%2 +3 S.' %() % 3+(4&-&+2) A%&'()H(+,-) &(+0 .(-%$+`)(# M))+$- &P) 3%/+1+&S &P) 3%/+1+&S %,,4 % 1)W)1 .3 /.23.(& %$, 3%2+1+%(+&S &. S.'( 01%$$+$-# >1)%4) /%11 &. %((%$-) %((%$-) % 2'&'%11S %-())%*1) ,%&) %$, &+2)# @$.&P)( .0&+.$ +4 +4 &. %&&)$, % A%&'()H(+,-)L)%/P)( >(.3)44+.$%1 T)W)1.02)$& .00.(&'$+&S .$ 4+&)# V.( 01%$$+$- 0'(0.4)4^ +& +4 P)103'1 &. /.$/)0&'%1+`) &P) 0(./)44 %4 /.$4+4&+$- .3 &P()) +$&)-(%&), %40)/&4a (!)"'#"*'+ *,--"*,(,.+ /01 2"0/0*$' # B$ &P) >1%$$+$- K%&)(+%14 0.(&+.$ .3 &P+4 ".(Q*..Q^ S.' "+11 3+$, 4)/&+.$4 "P)() )%/P .3 &P)4) &.0+/4 +4 ,+4/'44), +$ ,)0&P#
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Regarding Chaperones ?1,(# *6/7$-!0$' 7(/4 / *$0#-/( -!($ "0 #6$ ',**$'' !2 / ;/#,-$<-"1)$ 7-!)-/.@ O1%44(..2 &)%/P)(4 %$, %,2+$+4&(%&.(4 &)$, &. *) &P) 2.4& )33)/&+W) /P%0)(.$)4^ %$, 0%()$&4 '4'%11S ,. %$ )b/)11)$& c.*# D) 4&(.$-1S ()/.22)$,a L". /P%0)(.$)4 0)( 1)%($+$- -(.'0 0)( ,%S 2%b+2'2^ %4 2 .() %,'1&4 /%$ ,+4&(%/& 4&',)$&4# @,,+&+.$%1 /P%0)(.$)4 %() /P%0)(.$)4 %() ")1/.2)^ ")1/.2) ^ *'& 4P.'1, *) '&+1+`), *S (.&%&+$- &P)+( &+2) "+&P 1)%($+$-(.'04 %$, *S 4'0)(W+4+$- ()/()%&+.$%1 %/&+W+&+)4^ ,+$$)( %$, )W)$+$- 0(.-(%2# >%()$&4 2%S *) 01%/), %4 /P%0)(.$)4 +$ 1)%( $+$- -(.'04 .&P)( &P%$ &P)+( ."$ child’s. LP+4 01%/)2)$& %11."4 *.&P /P+1, %$, 0%()$& & . 0%(&+/+0%&) 3())1S "+&P &P) -(.'0 % 4 % "P.1)# 3# "' $''$0#"/( #6/# /(( *6/7$-!0$' *!.$ #! ;/#,-$<-"1)$ :"#6 / *($/- ,01$-'#/01"0) !2 #6$"-$'7!0'"9"("#"$'@ U.1,+$- a pre-tr+0 /P%0)(.$) 2))&+$- +4 %$ )b/)11)$& +,)%# >1)%4) 0P.&./.0S %$, ,+4&(+*'&) ,./'2)$&4 +$ &P) OP%0)(.$) B$3.(2%&+.$ 4)/&+.$ %$, /.0+)4 .3 &P) M&',)$& O.$&(%/&^ O%20'4 C'+,)1+$)4 %$, Jb0)/&%&+.$4^ O1.&P+$- %$, JZ'+02)$& ?+4&^ %$, F)-+4&(%&+.$ V.(2# LP+4 +$3.(2%&+.$^ 0()0%(), "+&P +$0'& 3(.2 &)%/P)(4 %$, /P%0)(.$)4^ +4 +$&)$,), &. %/ /'(%&)1S ()31)/& "P%& &. )b0)/& ,'(+$- % A%&'()H(+,-) V+)1, M/+)$/) 0(.-(%2# """#$%&'()*(+,-)#.(- - /.$&%/& 0(+$/)"+11+%23.()4&5$%&'()*(+,-)#.(- - tel 678#98:#;7:<
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Communication A($/'$ !-"$0# 4!,- '#,1$0#' /9!,# :6/# "' $B7$*#$1 !2 #6$. :6"($ /# ;/#,-$<-"1)$ /01 *!..,0"*/#$ *!..,0"*/#$ :"#6 #6$. #! )$0$-/#$ $B*"#$.$0# /01 */(. 2$/-' /9!,# #6$ 7-!)-/.@ @ 1+4& .3 O%20'4 C'+,)1+$)4 %$, Jb0)/&%&+.$4 &. 4P%() "+&P 4&',)$&4^ 0%()$&4^ %$, /P%0)(.$)4 /P%0)(.$)4 +4 0(.W+,), +$ &P+4 0%/Q) @14. +$/1',), +4 % M&',)$& O.$&(%/& &P%& .'&1+$)4 &P) 4&%$,%(,4 .3 *)P%W+.( %$, 0%(&+/+0%&+.$ )b0)/&), .3 A%&'()H(+,-) 4&',)$&4# LP+4 /.$&(%/& +4 .3 W%1') +$ 0(.W+,+$- S.' %$ .00.(&'$+&S &. ,+4/'44 "+&P S.'( 4&',)$&4 &P)+( ()40.$4+*+1+&+)4 "P+1) 0%(&+/+0%&+$- +$ &P) 0(.-(%2# >1)%4) ,+4&(+*'&)^ ,+4/'44^ %$, P%W) P%W) S.'( 4&',)$&4 4+-$ &P) /.$&(%/ A-!)-/.' /# ;/#,-$<-"1)$ /-$ 1$'")0$1 #! 9$ /*/1$."*/((4 '#".,(/#"0)+ 2,0+ /01 #/C$ 2,(( /1&/0#/)$ !2 #6$ "0*!.7/-/9($ '$##"0) !2 0/#,-$ ’s *(/''-!!.@ >1)%4) ()3)( &. A%&'()H(+,-) %4 “Field M/+)$ce” (%&P)( &P%$ %4 d/%20d 4. &P%& &P) 4&',)$&4 %$&+/+0%&) %$ )b0)(+)$/) ,+33)()$& 3(.2 % 4'22)( /%20# A($/'$ C$$7 "0 *!0#/*# :"#6 #6$ A-!)-/. D/0/)$- /01 ',9."# 7(/00"0) ./#$-"/(' "0 / # ".$(4 ./00$-@ D) "+11 *'+1, % ")11-paced, grade-appropriate 0(.-(%2 3.( S.'( 4&',)$&4 *%4), .$ &P) @()% .3 M&',S S.' /P..4) %$, &P) 1)$-&P .3 S.'( 0(.-(%2# 0(.-(%2# B3 S.' %() +$&)()4&), +$ 4/P),'1+$- % 0(e-trip /1%44(..2 W+4+&^ /.$&%/& &P) J,'/%&+.$ T+()/&.(#
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Planning Materials Checklist to Help You Plan and Organize Your NatureBridge Program ; $055-$$/0, <#-,6 =5#-15- >('4(38 *-4#1$ +-,, #1 367315- '/ ?'0( 3((#73, 32 @320(-A(#64-: !"#$ 5"-5),#$2 316 '2"-( #1/'(832#'1 .('7#6-6 #1 2"- &'()*'') +#,, "-,. ?'0 .(-.3(- ?'0( $206-12$ 316 5"3.-('1-$: !"('04"'02 2"- .,311#14 .('5-$$9 .,-3$- don’t "-$#232- 2' 5'12352 2"- >('4(38 B3134-( #/ ?'0 "37- C0-$2#'1$ '( #/ 2"-(- 3(- 5"314-$ 2' ?'0( $5"-60,- '( 108*-( '/ .3(2#5#.312$:
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Need help? Call Cassie Hughes, Program Manager, at 240-644-9701!
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The following pages contain informative documents you may print and distribute to chaperones, students, and parents.
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A Typical Day At NatureBridge
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Adult Responsibilities - Chaperones and Teachers Your primary responsibilities with students are in the areas of MX>JFIBMBEA^ >@FLBOB>@LBEA^ %$, M@VJL_# In a nutshell, chaperones are expected to keep the students punctual for meetings; supervise at meals, during recreation, and in the cabins; and participate as a part of the group in an active, positive manner.
Supervision You are responsible for supervising students during their stay at NatureBridge. Students must be under teacher and/or chaperone supervision at all times! The lead teacher will provide you with the names of students for whom you will be directly responsible. It is probable that you will have two lists: one of students who will share your cabin loop, and another of students in your learning group. Adult chaperones play a central role in the success of a NatureBridge program. We strongly recommend no more than two chaperones per learning group per day, as more adu lts can distract students. Additional chaperones are welcome, but should be utilized by rotating their time with instructional groups and by supervising recreational activities, dinner and evening program. 9:00a.m. – 4:00p.m. Instructional Day - You will join a NatureBridge Field Science Educator led trail group each day. During an orientation meeting just after your school arrives, you will meet your Educator and discuss group management and discipline policy, safety protocols, and expectations. Your primary responsibilities while on the trail are to support the Educator by appropriate participation in group activities, positive interactions with and supervision of the students, and assisting in emergency situations.
4:00p.m. – 5:30p.m. Recreation Time – Teachers and chaperones have primary supervisory responsibility for students during recreation times. Please work with the lead teacher to plan and schedule Chaperone supervision. Your group may wish to bring recreational equipment, art supplies, and games for these periods. Meal Times - Breakfasts and dinners are served in the dining hall. Lunch will be eaten out on the trail. Meals in the dining hall are supervised by chaperones. The NatureBridge Site Coordinator will make announcements, provide an educational component, and organize clean-up. 7:00p.m. Evening Program - will take place after the evening meal, typically lasting an hour.
8:00p.m. – 7:00a.m. Cabin Time - You will supervise a cabin unit in the evenings and through the night. It is your responsibility to establish a calm and respectful atmosphere in the cabin areas. Students can use cabin time to read, write in their journals, or do quiet activities. At NatureBridge, we work to keep the cabin area a quieter place on campus and try to keep more boisterous activity to the recreation fields.
7:00a.m. – 8:00 a.m. Mornings - Before the instructional days start is usually spent getting students ready for the day: tidying cabins, organizing packs, and visiting the restroom. On the last morning, students must sweep out their cabins and move luggage to a designated location. Please note: We suggest that the afternoon slots be used for organized recreation. The after-dinner per iod can be a time for you to focus students on journal writing, s haring the day's highlights, or quiet games and reflective activities. A Recreation Time Planner is included in this Workbook to help with this scheduling. """#$%&'()*(+,-)#.(- - /.$&%/& 0(+$/)"+11+%23.()4&5$%&'()*(+,-)#.(- - tel 678#98:#;7:<
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Participation Upon arrival, NatureBridge staff will meet with your entire group to share expectations and information about your program. In a brief teacher and chaperone orientation, we will review field responsibilities, safety procedures, and our discipline policy. This meeting is one of the few times all adults will meet together and presents a necessary forum for sharing information about medical alerts, behavioral considerations, special needs, etc. You and your Educator will also meet individually to discuss group management while out on the trail.
Throughout the instructional portion of a typical day, you and the students will engage in hands-on study on the local environment. Part of your responsibility is taking an appropriate, engaged role in field activities, group challenges, and discussions during the daily hikes. Your positive attitude and active participation will strongly affect the students’ experience. Students are required to go on hikes unless ill, injured, or being disciplined. If a student must stay on campus a chaperone is required to supervise the individual. Please alert the Site Coordinator to any participants remaining on campus during the instructional day.
Safety NatureBridge staff will convey emergency procedures and safety precautions to all adults and students during the Orientation meeting. As a Chaperone you are tasked with helping maintain a safe environment. Please be familiar with and uphold National Park Service and NatureBridge rules and regulations as outlined in the Campus Guidelines and Expectations. While acting in your role as Chaperone, always err on the side of safety.
Although group safety is the primary responsibility of NatureBridge staff, you will be a crucial source of support should an accident or emergency occur. Our Educators hold Wilderness First Responder certification. If you have advanced first aid or medical training, please inform the staff during the Orientation meeting. In the unlikely event that professional medical assistance is necessary, NatureBridge staff is in radio contact with each other and with the National Park Service to access emergency medical service. If you are near a telephone, dial 911 to reach an emergency dispatcher. Students taken ill or injured are under the care and supervision of the group’s leader and adult chaperones. One of these adults will call to confer with the parent/guardian if the need arises. The Participant Registration Form contains important medical information and a copy can be found with the lead teacher or the NatureBridge Program Manager. NatureBridge staff may administer certain over-the-counter medications that are in approved NatureBridge FirstAid Kits (Aspirin, Tylenol, Advil, Benadryl, Imodium, antibiotic ointment).
Thank you for taking time to read this information thoroughly! We appreciate your effort to make your NatureBridge program rewarding and memorable for both students and adults.
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Campus Guidelines and Expectations At NatureBridge, students will live and study closely together in an unfamiliar setting away from their homes and families. The following guidelines have been established to help students and adults prepare for and enjoy the experience safely. Respect each other Respect personal space and property. It is important to take good care of your own belongings and leave others’ alone. Proper clothing and equipment are essential for a safe and comfortable experience. Treat others as you want to be treated. It is important that there be respectful dialogues among students, chaperones, teachers, and NatureBridge staff. Attentive listening and participation in events and activities are key signs of respect. Respect each person’s privacy. Students may only enter their own assigned cabin. Consider the needs of others. Quiet hours are observed between 9:30pm and 7:00am, except under special circumstances. Students are expected to be in their bunks and quiet by 9:30pm so that everyone can get enough sleep for the next day's adventures.
Care for yourself Stay with your group when you are hiking or exploring during the program. Your chaperone must know where you are at all times. Behave in a safe and responsible manner while you are here. An accident or injury can ruin your trip or someone else’s. If you or someone you are with becomes sick or injured, contact your teacher, chaperone, or a NatureBridge staff member immediately.
While on Campus… Help us be stewards of the env ironment by conserving energy: turn off lights and when not in use. Also, REDUCE, REUSE, & RECYCLE whenever possible.
Food is not allowed in cabins at any time. To avoid attracting rodents and other critters to the cabins, any food brought to NatureBridge must be given to a NatureBridge staff member for secure storage, and will be returned to you upon your departure. Please treat the facility with care. Our dining and program facility, sleeping cabins and restrooms, are historic buildings. Wooded areas around the campus are off limits to students. The exception to this is during the day when you are with your learning group and a NatureBridge Educator.
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Leave No Tr ace Trail Guidelines – for Teachers, Students, and Chaperones Take Only Pictures, Leave Only Footpr ints.
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Remember, the less we disturb an area, the more we can discover about it. Follow the guidelines below and be prepared to observe and explore the world around you. You’ll be amazed at what you discover! Be prepared for the day. Wear and pack ap propr iate gear in your backpack including hiking boots, a warm jacket, hat, gloves, rain gear, leak-proof water bottle, notebook, pencil, and other items as requested by your NatureBridge Educator or teacher. Please stay on the trails. If we limit our travel to existing trails, we protect the plants and animals alongside the path. This is important to do for the sake of those living things and to allow other people the pleasure of walking in a wild and beautiful place. Please be observant and careful wherever you go. Attention to trail irregularities (roots, rocks, etc.) will help avoid unnecessary mishaps. Natural objects like rocks, twigs, or shells may be picked up, but please put them back where you found them. Do NOT throw objects, as throwing things can harm others and will disturb plants and wildlife. Dispose of waste properly. Pack out what you pack in. You can also help the environment by picking up litter that others have left beh ind. Your Educator will inform you about the availability of restrooms and minimum impact ways to answer nature’s call while on the trail! Respect wildlife: though it can be tempting to approach, feed, or follow wild animals, please do not . Animals can be stressed when people approach or make loud noises near them. Human food is unhealthy for wild creatures and feeding animals can make them si ck o r even die. Al so , animals can injure you and may carry serious diseases.. Respect other visitors to wild places. Follow the directions of your NatureBridge Educator regarding noise level and what to do when your group meets other people on the trail. You are in a National Park! Collecting any natural objects or artifacts within the National Park is prohibited.
And remember to have fun – we are lucky to have these beautiful woods, streams, and trails to explore!
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Clothing and Equipment List When asked what they could have done to make their stay at NatureBridge more enjoyable, many students answer that they would have followed the equipment list more closely! On your arrival day, please show up dressed for hiking and with your day backpack ready!
Day Pack - Be prepared! Upon arrival you will be on the trails and need a day pack filled with the six items below.
Pack your
personal and over-night items in a different bag please. Bag Lunch# Water Bottle - unbreakable one quart plastic bottle with screw-on, leak-proof top (such as soda or sports-drink
bottles). No glass bottles please! Notebook and Pencil Extra layer of warm clothing Handkerchief or bandana – you need this every day for lunch! Rain Gear: jacket, poncho, etc. Foot gear : sturdy, worn in hiking boots, sneakers, or walking shoes. Trails can be wet and muddy in any season, your
shoes will get dirty! Allow an extra pair of shoes in case others get wet. Pants - two rugged pairs (including one pair of warm pants). Shirts - two rugged shirts, plus a few lightweight shirts for warm weather. Sweater or fleece - one lightweight wool or fleece layers are best; avoid cotton. Jacket – an insulated layer, such as a parka with hood is a good choice. Gloves – or mittens,
it gets chilly at night! Warm Knit or Fleece Hat - for cool nights and possibly rainy days. Hats are small, you won’t regret packing this!
Socks - four pairs of socks (at least one wool , dries faster). Underwear Pajamas, bathrobe, shower sandals - remember
bathrooms/showers are in a separate building.
Towel Toiletries - shampoo, soap, toothbrush, toothpaste, personal medication. Sleeping bag or sheets and blankets, pillows – you want to be comfy and warm at night! Flashlight Optional items - sunglasses, binoculars, hat, field guide, recyclable camera. NOTE TO PARENTS
AND STUDENT S: Please do not bring Extra food - food is not allowed in the cabins. Ample food will be provided. Knives - are a safety hazard! Devices / games - including iPods or other mp3 players Anything that you would miss if lost! A note on cell phones: Teachers establish the cell phone policy for their group. Often they choose to keep all cell phones and allow students to call home once a day. If you would like to reach your child, please call the lead teacher first. NatureBridge staff can be reached at the number below. """#$%&'()*(+,-)#.(- - /.$&%/& 0(+$/)"+11+%23.()4&5$%&'()*(+,-)#.(- - tel 678#98:#;7:<
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NatureBridge Student Contract Greetings and welcome in advance to NatureBridge at Prince William Forest Park! We are excited that you will be joining us soon. Our commitment is to provide new experiences, fun learning opportunities, and safe adventures. By choosing to participate, we ask that you come to NatureBridge with a commitment of your own: to live by the following guidelines. If you agree to this contract, please put your initials next to each item and sign at the bottom.
General Agreements I agree to participate in the program at NatureBridge. I agree to be on time for scheduled meetings and events. I agree to respect the privacy, property, and feelings of others. I understand that we'll be living together in cabins and sharing the campus. I agree to treat my fellow students, Chaperones, and Educators with respect. I understand that how I talk to people is important. I will also do my best to pay attention when someone is talking to me, whether it's a Chaperone, a NatureBridge Educator or my best friend. I agree to follow my Clothing and Equi pment List and bring the things I will need for my stay (like raingear, a leak-proof water bottle, extra clothes, etc.) I agree to stay out of other students' cabins. I understand that quiet hours start at 9:30 pm. I agree to be quiet and respectful in the evening so that everyone can get enough sleep to participate and stay healthy. I agree to keep food out of my cabin. I will give any food left over from my first day’s lunch to my chaperones.
Bottom-Line Agreements understand that a violation of any one of the below, or a combination of the above, contract agreements may result in a return trip home at my parent/guardian’s expense. I
I agree not to cause physical or emotional harm or threaten any other person. I agree to respect the NatureBridge campus and the National Park, and refrain from any acts of vandalism. I understand how important it is to be safe on the trails. I will participate in a way that will keep the group and myself safe by following all of the trail rules. I agree to refrain from bringing or using non-prescription drugs, cigarettes, weapons, and/or alcohol at NatureBridge. I agree to always let a chaperone know where I am and never wander off alone.
Signature
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School Name
Learning Group List Ma ke 4 copies of this form to create Learning Group Lists – there should be about 12 students in each group. This form is due 3 weeks before your program.
Participant Name
Medical Alert
Dietary Restriction
Medical Alert
Dietary Restriction
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Adult Name
(Indicate Teacher, Parent or O the r)
1 2 I have
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Recreation Time Planner/ Chaperone Schedule We suggest supervised re c r e a t i o n al activities in the afternoon and journal writing or a sharing session after dinner. In the morning before breakfast, chaperones can help make sure that students are prepared for the instructional day.
Suggested equipment options: *Any equipment that you bring for recreation time should be clearly labeled!* Frisbees Football
Day
Arts and crafts materials Journals, pencils, paper
Time
Good books Board games
Cards Soccer Ball
Jump ropes Sit-upons, pads
Assigned Adults
Activity Activity 1
Afternoon
Parachutes Kickball
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Recreation Time Planner/ Chaperone Schedule We suggest supervised re c r e a t i o n al activities in the afternoon and journal writing or a sharing session after dinner. In the morning before breakfast, chaperones can help make sure that students are prepared for the instructional day.
Suggested equipment options: *Any equipment that you bring for recreation time should be clearly labeled!* Frisbees Football
Day
Arts and crafts materials Journals, pencils, paper
Time
Parachutes Kickball
Good books Board games
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Assigned Adults
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For Bus Drivers Hello and thank you for transporting students to and from the NatureBridge program! Below are some helpful tidbits.
Monday drop-off Anytime in the morning (depends on teacher request) Wednesday pick-up Between 11:30-12:00
For Bus Drivers Hello and thank you for transporting students to and from the NatureBridge program! Below are some helpful tidbits.
Monday drop-off Anytime in the morning (depends on teacher request) Wednesday pick-up Between 11:30-12:00
If you are dropping off and picking up on Wednesday, read this schedule upside down (or just flip the times). Wednesday drop-off 12:00-12:30 Friday pick-up Anytime in the afternoon (depends on teacher request)
Directions:
Take I-95 to Exit 152. Take Route 234 (Dumfries Rd) North (towards Manassas). Follow Route 234 for 3 miles. Just after passing the Travel Trailer Village, turn left on Pleasant Roa d to enter the Park. Take the gravel road for 1 mile, please follow signs for Cabin Camp 1 and NatureBridge. Park on the grass field on your left (entrance marked with a small sign).
Please note: If you arrive early for a pick-up and no one is at the field to greet you, please let us know by finding us in the camp (a NatureBridge staff member can be found in the large building on the right side of the paved walkway).
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Who’s Who of NatureBridge Prince William Forest Park Washington, DC Director Vanessa Morel Education Director Kim Hanson Program Manager Cassie Hughes Site Coordinator One of the Field Science Educators will serve in this role during your stay with NatureBridge. Field Science Educators Jen Metes Paul Kelly Kristen Emmett Jackie Gallimore Samantha Pepper
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National Park Service U.S. Department of the Interior
Photo Release Form I hereby grant the National Park Service permission to use my likeness in a photograph in any and all publications for Government or nongovernment purposes, including web site entries, without payment or any other consideration in perpetuity. I understand and agree that these materials will become the property of the National Park Service and will not be returned. I hereby irrevocably authorize the National Park Service to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing the National Park Service’s programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge the National Park Service from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I am 18 years of age or older and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release. I agree to indemnify and hold the Government harmless for any and all losses, claims, expenses, suits, costs, demands and damages or liabilities on account of personal injury, death, or property damages of any nature whatsoever and by whomsoever made, arising out of the photographed activities in which I am taking part. Signature/Date
_______________________________________________________________________________________________ Printed Name/Date
_______________________________________________________________________________________________ Address
_______________________________________________________________________________________________ City
State
Zip Code
_______________________________________________________________________________________________ Phone
_______________________________________________________________________________________________ If the person signing is under age 18, there must be consent by a parent or guardian, as follows: I hereby certify that I am the parent or guardian of ______________________________________________ , named above, and do hereby give my consent without reservation to the foregoing on behalf of this person. Parent or Guardian's Signature/Date
_______________________________________________________________________________________________ Parent or Guardian's Printed Name/Date
_______________________________________________________________________________________________ Privacy Act Statement : This information is provided to comply with the Privacy Act (PL 93-579). 5 U.S.C. 301 and 7 CFR 260 authorizing acceptance of the information requested on this form. The data you furnish will be used only to provide the National Park Service with contact information pertaining to this release form. E X P E R I E N C E Y O U R A M E R I C A™
08/2006
NatureBridge Planning Questionnaire – Prince William Forest Park Please he lp our staff prepare the highest quality program for your group by thoughtfully completing this form and returning it at least six weeks prior to your arrival. The information you communicate here is ins tr ument al to the educa tiona l and log istica l aspects of your program, and will he lp us customize our program to best fit the specific needs of your group. Please save
your com puter bef or e you email it to chughes@natur e br idg e.or g. It is due to Natur eBr idge 6 weeks prior to your prog r am!
this f orm to
Section A: General Information about your School/Group Scho ol/Gr oup Nam e:
City/State:
Gr ade(s): Schoo l Distr ict:
Coun ty:
Scho ol Phone :
School Fax:
Tr ip Or gan izer :
Cell Phon e:
e-m ail:
Lead
Cell Phon e:
e-m ail:
Teac h er (if d iffer en t):
Student Demographics at your School Ethnicity
Percentage
School Demographics Please check all that apply
African Amer ican American Ind ian
Asian Amer ican
Elemen tar y School Rur al
Pub lic School Home School
Caucasian Hisp anic/Latino
to
your group:
Middl e School
High Scho ol
Sub ur b an
ban Ur
Pr ivate School Year-Round School
Char ter Scho ol Oth er:
Mu ltir ac ial/Un s pec ified
Trip Funding
Pacific Island er Students at your school who:
Qualify for Fr ee or Reduced Lun ch Receive financial aid/tuition scholar shi p (private schoo ls) Are English Langu ag e Lear ner s (ELL) Are from military f amilies
Source Percentage
Family Fund r aising Gr ants
School Fund s Natur eBr idg e Scho lar ship
Other (s p ecify)
How do these d emog r a ph ics differ (if at all) from the students you are b r ing ing ?
Sources
Percentage
Section B: Logistics
B1: Days and Times
B2: Transportation
B3:
Participants
B4: Student
Groups
Learning Group Lists
Cabin R osters
B5: Chaperones
Chaperone Selection
Section C: Campus
Curriculum
C1: Areas of Study
Areas of Study
C2: Program Outcomes
Please rank these outcomes in order of importance to four, w ith 1 b eing the most im por tant.
Personal
on a
scale of one
Gr ow th
Interperson al Skills Education al Con ten t
NatureBridge Core Educational Framework
Responsible Envir onment al Behavior
With the
above framework
in mind, describe
the two most im por tant
outcomes for your
students:
C3: Program
Elem ents
Will your group bring journals? Yes No If yes, how would you like the journals to be used ( p lease include page numbers for any specific activities )?
Is it im po r tant for each learning group to collect scientific data relating to the same content area? Yes No
Is it im por tant for your students to have scientific data sets w ith them when they return to school? Yes No
Please indicate your even ing program preferences.
Section D: Classroom Connections D1: Pre and Post Trip Curriculum
D2: Group Dynamics