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ie Colchester Public Schools
nein, Application for Approval of Field Trip
ERS
Overview : This Form must be completed by all staff to request approval of a Field Trip
Directions
1. Complete the form with all applicable documeniation and submit to your Department Head (BA only} and your Administrator. The
Form must be submitted at least 2 weeks prior to the Field Trip for In-State Trips and 10 weeks prior to the Field Trip for Out-of-State Trips.
2. If approved by your Administrator, the form must be sent to the Assistant Superintendent for approval.
3. If approved by the Assistant Superintendent, the form will be sent to the Superintendent for approval.
4. If the Trip is Out-of-State, it will be brought to the Board of Education at their next scheduled Meeting for approval and final decision.
Instructional Focus
Is this Trip directly related to curriculum? ("Yes No Curriculum Unit : please see attached
Field Trip Information : :
Applicant Name Samantha Chuck Method of Transportation ; bus
School: Bacon Academy Bus Service Number :
Grade(s) & Group(s)current French 1, 2, 3 & Advanced| Number of Students : 20-40
Date(s) of Trip : 10/23/26 - 10/26/26 Number of Day(s) of Trip : 4
Event: Montreal 2026 Trip
Destination: Montreal, QC, Canada Phone Number :
Destination Address : State :
Time of Departure from School : 6am Clothing / Equipment Required :
colder weather clothing, clean running shoes
Time of Arrival to School: 9PM
ie ce
a a
Student Cost Information aT
*Cost to Student $ Suggested Student Pocket Money $
p1069-1629 depending on number of students $179 for insurance $100 for lunch and spending
Supervision Information
1. Name: Samantha Chuck Cell Phone : 401-533-4437
2. Name: Richard Incorvati Cell Phone : 860-819-4803
List all Adult Chaperones: Ratio of adult chaperones to students must be at least : 1:5 for Grades K-2, 1:8 for Grades 3-5, 1:10
for Grades 6-8 and 1:15 for Grades 9-12 (1 day trips) or 1:10 (overnight trips)
Samantha Chuck Samantha Burroughs 4 | Omi n
Richard Incorvati more if needed
Administrator Signatures
Applicant Se—Le Date | i, (iS72S
Depariment Chair (BA Only) \Yo Blue, —. Date hiss ppro' = Denied
Principal/Administrator OK Wty fd pre Date lofza 5 Denied
(Ks / prove
Assistant Superintendent in t~Z- Date re Denied
Superintendent 7a Date / 0 Jeep? aahreves > Denied
Board of Eddcation (if applicable)
Board of Education Meeting Date N OV E M BE R 18 i 46 95 Approved Denied
Page 1 Updated October 2024
Field Trip Instructional Plan
Field Trip Location : Montreal, QC, Canada
Reference Check: Visited Site On: OR Spoke with: Alex Ffrench at Jumpstreet To
urs
Name of Staff Completing Form : Samantha Chuck SURES AGIO XOS 159
Grade / Group Attending : 10th, 11th, 12th grades _j, 2696-202}
Instructional Focus of Field Trip
Specific Curriculum Standards Addressed by Field Trip:
ACTFL Standards:
Interpersonal Communication: Learners interact and negotiate meaning in spoken, signed or written
conversations to share information, reactions, feelings and opinions.
Interpretive Communication: Learners understand, interpret and analyze what is heard, read, or viewed
on a variety of topics.
Relating Cultural Practices to Perspectives: Learners use the language to investigate, explain, and reflect
on the relationship between the practices and perspectives of the cultures
Relating Cultural Products to Perspectives: Learners use the language to investigate, explain and reflect
on the relationship between the products and perspectives of the cultures studied.
Assessment of Student Learning:
please see attached
Trip Agenda/Activities
List/Attach entire break out of times for each day. Include travel time and all activities
Date/Time Location Activity
please see attached for the proposed itinerary
Bus Information
Bus Reservation Date Price of Bus(es) $
Page 2 Updated October 2024
Curriculum Units:
French 2:
Unit 2: En ville et chez moi
Unit 3: A Table
Unit 5: En Vacances
French 3:
Unit 1: Les Retrouvailles Aprés les Vacances
Unit 3: Notre Environnement, Soyons Responsables
Unit 6: Les Sports
Frangais 3250:
Unit 2: Le voyage
Unit 5: La Musique
Assessment of Student Learning
French 2: Choose one of the questions and write a response as if you are taking the
Interculturality section of the IPA. Include at least two products and two practices for your culture
and the culture of Montreal. Try to include one or two perspectives as well! Use specific
examples of things you saw, heard, read, did, etc while on the trip.
@ How do my town and my home define who | am?
e How are my town and my home similar to and different from those in various
francophone regions of the world?
How does food help to define a culture?
How does travel define us and broaden our horizons?
French 3: Choose one of the questions and write a response as if you are taking the
Interculturality section of the IPA. Include at least two products, two practices, and one
perspective for your culture and the culture of Montreal. Try to include an additional perspective
as well! Use specific examples of things you saw, heard, read, did, etc while on the trip.
How do travel experiences shape our worldview?
What do you need to know to travel successfully?
How do natural events define our world?
What are our responsibilities to caring for our planet?
How do sports define a culture?
Frangais 3250: Choose one of the questions and write a response as if you are taking the
Interculturality section of the IPA. Include at least two products, two practices, and two
perspectives for your culture and the culture of Montreal. Use specific examples of things you
saw, heard, read, did, etc while on the trip.
e How does travel open horizons and change the perspective of people?
e What value does music have in one’s life?
4 Days
October 23 to 26, 2026
Included:
A detailed itinerary tailored to your needs;
A price sheet with details about what's included;
Information about options, insurance, and health & safety;
A link to our full Terms & Conditions.
Peace of mind must be at the core of what we offer. Jumpstreet by WorldStrides uses the
services of Exlog Global to understand the world around us when it comes to travel risk
management and making safe decisions for our groups. Meanwhile our Doctors on Call
program offers real time medical consultation while on tour.
You can also help ease the decision-making process with our Insurance Plans and Cancel For
Any Reason Waiver Benefit (CFAR), which your participants can purchase to cancel their trip
for whatever reason up until 2 days from departure and get a 75% refund.
Now that you know you'll be well taken care of, let's turn our focus to the fantastic world of
educational travel.
Alexandre Ffrench
"Lonly.wish-| would have known about Jumpstreet sooner.
BG alee [eae iN (cM (1 o COLMAN MAN CLE MICA MAO Muah acide (eal eaa ar 1a
past tours (not-led by Jumpstreet), but the guides were
intuitive to-the students' needs -and willing to switch up
something or.add in an‘extra activity for fun."
- Alexa, middle school teacher
Bacon Academy 4 Days Montreal
611 NORWICH AVE (27-96330/1)
COLCHESTER www jumpstreet.com / yourteam@jumpstreet.com
Connecticut Oct 8, 2025
O6415 Page 1 of 1
Bacon Academy
4 Days Montreal R
October 23 to 26,2026 =
Aye
2025
06:00 AM The day has arrived! The trip you've been waiting for is finally here!! Hop aboard your locally chartered luxury
motorcoach, get comfortable and get ready for your adventure!
Stops and lunch en route (at individual expense).
01:30 PM Hooray! You've arrived in Montreail Your tour leader will greet you at Esplanade Tranquille (1442 Rue Clark, Montréal, QC
H2X 2R3) and get the show underway. The fun starts now :)
Explore the Quartier des Spectacles with your tour leader, where, within a square kilometer of the heart of Montreal, one
can find over 80 cultural venues, including 30 performance hails and more!
03:00 PM Retrace the steps that De Maisonneuve took to the top of the city's iconic Mont-Royal. You'll make your way up to Beaver
Lake and the Chalet de la Montagne for a stunning view of the greater Montreal area.
04:30 PM Check in to your hotel to relax and unwind before you...
06:00 PM Experience the Notre-Dame Basilica in a different way during today's presentation of AURA, an incredible multimedia
show created by Montreal's very own: Moment Factory!
> After the driver drops you off for your evening activities, they will be off duty for the rest of the night.
07:15 PM Tonight you will have dinner at Le Cartet, a local secret in Old Montreal. This French bistro presents a very convivial
atmosphere and a menu that is sure to please all palates!
09:30 PM Get into the groove of things and travel back to the hotel like a true Montrealer...by metro (aka: the subway)! Who needs
a car anyway? (1 ticket is included per participant.)
10:00 PM Arrive at the hotel and unload the motorcoach. Hang in there a few more minutes as your tour leader gives you
instructions for proper hotel conduct and for the next day full of exciting activities!
Spend the night at the Best Western Ville-Marie.
3407 Peel St, Montreal, QC H3A 1W7
PH: (514) 288-4141
(Or equivalent pending availability upon receipt of deposit.)
Asecurity guard will monitor your hallway during each night of the trip.
ay, October 24, 2026
Begin your day with a lovely breakfast and orientation session at the hote! with your tour leader.
09:30 AM Everybody ready? Time to head out for your activities! Your tour leader will fill you in on all the fun that’s in store.
10:00 AM Head out on a sightseeing tour of the multicultural communities of Montreal with a local guide to see Little Italy,
Chinatown, the Portuguese neighborhood and more!
11:30 AM’ Take in the sights and sounds of Le Marché Jean-Talon, Montreal's busiest outdoor market, as you partake in our Grocery
Scavenger Hunt. Don't forget to grab lunch along the way (at individual expense).
01:00 PM 3, 2, 1, say cheese! Discover photography's history and learn how to capture those pictures perfect moments like a true
professional during your photography workshop at Entrequatreyeux!
03:30 PM Let's explore the hip Plateau Mont-Royal, with all its vintage clothing stores, record shops and quaint cafés. You might
come away with a one-of-a-kind souvenir.
05:00 PM Re-energize for the evening as you enjoy a lovely meal at La Petite Marche, a quaint French restaurant in the Plateau
Mont-Royal.
Bacon Academy 4 Days Montreal
611 NORWICH AVE (27-96330/1)
COLCHESTER 1-800-663-4956
Connecticut Oct 8, 2025
06415 www.jumpstreet.com / yourteam@jumpstreet.com Page 1 of 2
fee 4 Days Montreal
jumpstreet October 23 to 26, 2026
07:00 PM During your curling session at Ville Mont-Royal, your experience will be identical to Olympic curling: same ice, same
stones, same rules. By the end of your session, you will have learned enough to enjoy participating in a league!
{Remember to bring a pair of clean running shoes to curl and warmer clothing/layers)
09:30 PM Departure for the hotel.
08:00 AM Everybody ready? Time to head out for your activities! Your tour leader will fill you in on all the fun that's in store.
08:30 AM Let's start the day off with a delicious breakfast at Eggspectation's in Downtown Montreal. Hope you're hungry!
10:00 AM Travel through the ecosystems of the Americas during your visit of Montreal's Biodome, a living museum!
11:30 AM Let's explore charming Old Montreal with your tour feader. There’s so much to see! The Place Jacques Cartier, City Hall,
Marché Bonsecours, the Old Port and more!
Time for lunch and to explore in Old Montreal! Hang out with your friends, grab some food (at individual expense) and
practice your conversational French, Your tour leader will give you a meeting place and time.
02:30 PM Embark on a guided tour of Pointe-a-calliére Museum: Tales of Montréal. This must-see activity features the five periods
of occupation of pointe a Calliére, the point of land where the city was founded and built over time by generations of
Montrealers.
04:00 PM All aboard! Next stop; the SUGAR SHACK!
Discover how the people of Quebec managed to brave the difficult winters through the tradition of maple syrup
production as your tour leader shares their Sugar Shack story.
05:30 PM Get ready to party like it's 1699! At La Sucrerie de la Montagne, an authentic French Canadian cabane a sucre outside of
the city, you're going to learn about maple syrup production methods, feast on a 17th Century meal and get down to
traditional songs and dances. Don't forget to add some syrup to your pea soup (we're not kidding).
08:30 PM Departure for the hotel.
clay, October 26, 2026
Begin your day with a lovely breakfast and orientation session at the hotel with your tour leader.
09:30 AM You won't believe it, but the time has come...for your last day of this fantastic journey! Time to leave the hotel with your
luggage and take advantage of today to say goodbye to these foreign lands.
10:00 AM You can't go to Montreal without learning a bit about the Montreal Canadiens hockey team! The best place for this is the
Bell Centre, the Habs’ state-of-the-art arena. You will also get a chance to check out the gift store for some sweet
souvenirs. GO HABS GO!
11:30 AM Free time in Montreal's famous Underground City, a network of malls, museums and restaurants! Here's your chance to
explore with your friends, grab lunch {at individual expense), and practice your conversational French. Your tour leader
will give you a meeting place and time. Enjoy!
02:00 PM Already time to leave! Wave goodbye to your tour leader and head back home.
Stops and dinner en route (at individual expense).
09:30 PM This is when you're expected to arrive back at your school, where your family and friends will be eager to hear all about
your adventure!
Bacon Academy 4 Days Montreal
611 NORWICH AVE (27-96330/1}
COLCHESTER 1-800-663-4956
Connecticut Oct 8, 2025
06415 www jumpstreet.com / yourteam@jumpstreet.com Page 2 of 2
2 is
jumpstreet
=
Cale emer Coed
Double Occupancy
Paying students
Quad Occupancy
aati
US$1069.00
US$1135.00
US$1289,00
USS SI-YERUe)
WHAT 15 INCLUDE!
2 1 Tour Leader{s) with your group 24/7, to bring your itinerary to
life!
» Virtual parent/guardian meeting (by request and pending
availability)
» All programming, reservations and itinerary items
* Bracelets featuring our 24/7 toll-free emergency line
* Round trip transportation via luxury motorcoach(es)
® Hotel(s) and restaurant(s) as per itinerary (or equivalent
depending on availability when trip is confirmed)
2 Tip(s) for your Tour Leader(s)
ee
@ 3:Breakfast(s)
ACTIVITIES
» Plus-Canada - Montreal - Explore Old Montreal with your tour
leader
® Marché Jean-Talon-Grocery Scavenger Hunt + lunch at own
expense
® Guidatour-2 hr Multicultural City Tour with Local Guide
2 Basilique Notre-Dame de Montréal-AURA: Multimedia Spectacle
2 Pointe-a-Calli@re-Guided Visit and Multimedia Show
Bacon Academy
611 NORWICH AVE
COLCHESTER
Connecticut
06415
Bacon Acaderny
4 Days Montreal
October 23 to 26, 2026
included in Tour Price}
Travel Insurance Plan (including CFAR) US$179.00 per student
Standard Travel Protection Plan US$107.00 per student
% 24/7 access to George Washington University Doctors on Call
® Online individual payment and registration platform
2 24/7 tour support, with a direct patch to our senior staff
@ Your money placed in a bonded trust account
® $25M in liability protection for teachers and chaperones
® Early warning service for disruptions or global threats to avoid or
minimize risks to travel security
» All fees related to road, bridge, tunnel and parking tolls
® Private security guard (per coach) to monitor the hallways at night
® Tip(s) for your Motorcoach Operator(s)
® Carbon neutral travel
® 3 Dinner(s)
® Centre Bell (Tours)-Guided Visit
® Espace pour la vie Montréal-Espace pour la vie Montréal -
Biodome
® Curling Ville Mont-Royal-2 hour Curling
* Plus-Quartier des spectacles
® Plus-Canada - Montreal - Mont Royal
» Entrequatreyeux-Photography Workshop
4 Days Montreal
{27-96330/1)
www jumpstreet.com / yourteam@jumpstreet.com
Oct 8, 2025
Page 1 of 2
ae, Bacon feadamy
: * 4 Days Montreal
jumpstreet October 23 to 26, 2026 °:
eeUcATIONAL TOURS
-¢2 TO CONFIRM YOUR TRIP
The contents of the proposed itinerary are subject to availability. As. soon as you sign below and return a copy of this page to me,-|. wil! book your
E-coach and hotel.’| will then activate your online portal which-will give you-access to planning resources, a preliminary itinerary and the payment
Pac Coe tel Ck Ca ried Cee COCR Or Min eC eee em ee Con Rosi)
oat Cee ee) eM els eC LR ele me oe do
i
By law, we are required to inform you of the insurance plans available to your group. | have sent you information about comprehensive coverage.
Please distribute this information to your group as insurance must be purchased at the same time as the initial payment.
ONDITIO
Please read our complete terms and conditions. The following sections are particularly helpfut:
> Trip price
> Cancellation policy: group cancellation
» Cancellation policy: individual cancellation
» Exchange rates
By signing below you are confirming:
° That you agree with the itinerary and price
3 That you agree with the payment schedule
That you have distributed our travel insurance options to your group
> That you have read and accepted our terms and conditions
Client signature Date
Portal activation will act as your electronic
signature in case we do not receive this signed
proposal.
Bacon Academy 4 Days Montreal
611 NORWICH AVE (27-96330/1)
COLCHESTER www.jumpstreet.com / yourteam@jumpstreet.com
Connecticut Oct 8, 2025
06415 Page 2 of 2
|
i
| GROUPS FROM THE U.S. ~ DOMESTIC AND INTERNATIONAL TRAVEL
|
8
Tray otection Plan Plus (TPPP)
| We recommend protecting your investment with the Travel Protection Plan Plus. The TPPP includes the
Comprehensive Travel Protection Plan from third-party provider Trip Mate and WorldSirides’
' Cancel For Any Reason waiver benefit which allows you to cancel your trip for reasons not otherwise
covered by the policy, for a reimbursement of 75% of non-refundable cancellation fees.
TRIP PRICE PRICE OF INSURANCE*
a
e
$0 to $1,500 $179
$1,501 to $3,500 $279
$3,501 to $6,000 $379
$6,001 to $8,000 $479
i
|
1
|
i
|
+ The price of the trip will not increase for the remaining
participants due to reduced numbers;
WorldStrides’ Cancel For Any Reason waiver benefit**
+ Cancellation must occur at least 48 hours prior todeparture. |
| | Trip cancellation 100% of the total trip price '
| | (such as illness or injury—doctor’s note must be provided) ° PP {
|
| ' Trip interruption 100% of the total trip price
Travel delay $750 (up to $150 per day)
Itinerary change $150
as
| Accident & sickness medical expense
| Emergency evacuation & repatriation $50,000
| Accidental death $25,000
Baggage & personal effects $3,000
| Baggage delay $300
“Prices are subject to change without notice until time of purchase. Plan must be purchased within 14 days of the initial trip payment and is not
refundable once purchased. See policy (by State of departure) for full details.
“wWorldStrides’ CFAR waiver benefit witl come into effect if the insurance claim is rejected—once rejected, you can send a CFAR refund request to
yourteam@jumpstreet.com, including your reason of cancellation, for a reimbursement within 6 weeks.
jumpstreet
EDUCATIONAL TOURS
by WorldStrides”
YOURTEAM@JUMPSTREET.COM 1.800.663.4956 JUMPSTREET.COM
We recommend covering your investment wit
provider Trip Mate. This insurance plan ensu
individual cancellation penalties a
a Comprehensive 7 ction Plan through i
ur pu urchase is protected and so are you, shieldir
oviding peace of mind throughout your travels
$0 to $1,000 $92
$1,001 to $1,500 $107
$1,501 to $2,000 $121
$2,001 to $2,500 $139
$2,501 to $3,000 $154
$3,001 to $3,500 $170
$3,501 to $4,000 $190
$4,001 to $4,500 $205
$4,501 to $5,000 $226
$5,001 to $6,000 $257
Trip cancellation
(such as illness or injury—doctor’s note must be provided)
i Trip interruption i 100% of the total trip price
$50,000
\ Emergency evacuation & repatriation / $50,000
Accidental death
Baggage & personal effects
Baggage delay
“Prices ara subject to change without notice until time of purchase. Plan cannot be purchased once the trip has been paid in full, and is not refundable.
See policy (by State of departure) for full details.
“*The exclusion af pre-existing conditions is waived if the insurance plan is purchased within 14 days of the initiai trip payment.
jumpstreet
EDUCATIONAL TOURS
by WorldStrides”
YOURTEAM@JUMPSTREET.COM 1.800.663.4956 JUMPSTREET.COM