This form is due by February 13, 2026, or earlier.

Thank you for completing this form. The information you provide helps us ensure a safe and positive Outdoor School experience for all students.

Please list all students who may require support, even minimal. Students who typically have an aide at school should have the same support at Outdoor School. Please coordinate with your administration regarding aide attendance. The OSU Extension Service will reimburse schools or districts for extra duty pay and/or overnight stipends. I will also make every effort to recruit from a limited pool of adult volunteers to support students as needed.

Include any social-emotional needs, anxiety, mental health concerns, behavioral considerations, physical challenges, developmental delays, learning needs, or use of adaptive equipment. You do not need to include allergies or dietary needs; these will be collected through the Health History form completed by parents.

If applicable, please provide a summary of any required accommodations, by writing them in the notes on this form, or email the documents like 504, behavior contract, feeding protocol or IEPs or "IEPat a glance" to kboryer@mesd.k12.or.us after submitting this form.

If no students require special assistance, you may complete Page 1 only or email me to be removed from the list.

Kitty Boryer
Student Services Specialist

kboryer@mesd.k12.or.us