2014-2015 MS Week Without Walls Program Guide

1 | Week Without Walls

Week Without WallsAMERICAN SCHOOL

O F D U B A I

Program Objectives & Learning

DESTINATIONSTRIP

Health & Safety

Tips

Parent & Student

Roles and Responsibility

An ASD Middle School tradition since 1997

AMERICAN SCHOOLO F D U B A I

MissionWe challenge and inspire each student to achieve their dreams and to become a passionate learner prepared to adapt and contribute in a rapidly changing world.

Core ValuesCompassion | Excellence | Integrity Respect | Responsibility


4 Introduction to Week Without Walls

4 History of Week Without Walls

5 Student Eligibility & Trip Selection

6 Program Objectives

8 Journal Standards

9 Grade 6 Trip Descriptions



16 Parent Roles & Responsibility

17 Student Expectations & Responsibility

18 Risk and Safety

18 Health Information

19 Insurance

20 Sample Forms

Contents


Dear Middle School parents and students,

In 1996 I was working at a school in New South Wales, Australia when I was selected, along with one of my students to participate in the Wilderness Enhanced Program--a 10 day hiking and canoeing adventure in the Australian outback. This first foray into experiential education transformed me as an educator and led to a firm belief that programs like Week Without Walls are an essential part of a young person’s development. Watching students trying to scramble together up a rock chimney, the program leader, Ray Handley reflected, “Nature teaches.”

Since that time with the Wilderness Enhanced Program, these words have echoed back to me each time I watch a student in that challenge zone:

– about to jump off a pier into icy water in Aberdovey, Wales

– on a windy, early morning run around a lake in the Pennines

– about to take the microphone in front of 300 MUN delegates

– assisting a friend on those last steps to the summit of a hill

– negotiating a price for a locket in a Greek market

– having the courage to start the conversation with a new seatmate you hardly know

In each of these cases, what was most remarkable was how the students “experienced the power of an idea for themselves”. At ASD we strive to create an environment that facilitates this learning principle. Week Without Walls is the extension of this principle into the real world. To follow on Ray Handley’s observation: Experience teaches.

Someone said to the teacher: ‘You relate stories, but you do not tell us how to understand them.’ He said: ‘How would you like it if the man from whom you bought fruit consumed it before your eyes, leaving only the skin?’ Indries Shah (1971)

Sincerely,

Ronald Lalonde Ed. D

Middle School Princpal

Based on a solid curricular foundation, Week Without Walls (WWW) extends students’ academic skills to authentic, real-life situations through a series of academic, social and interpersonal learning experiences occurring outside a traditional classroom setting. The WWW experience assists students with a greater understanding and appreciation of cultural diversity, different environments and international awareness.

History of Week Without WallsA tradition for over 15 years, WWW began as a middle school trip to explore the United Arab Emirates. In 1997, students and teachers traveled to Musandam, braved desert tours and studied the marine life in Fujairah. Teachers quickly realized the great benefit of student learning outside of the classroom walls. Students experienced new cultures and learned about local traditions. ASD was encouraged to create an international trip to enhance student understanding of the world and engage in meaningful community service projects.

The following year, sixty-three Middle School students departed for Thailand for week of culture, adventure, and community service at a local orphanage, Pakkret Babies Home. Students participated in team building activities and were introduced to the Grand Palace, some for the very first time! As ASD grew, so did the WWW program. By 2001, the WWW program expanded to include trips to Nepal,Thailand and Oman.

ASD Middle School students have visited more than 25 different countries since the first international trip in 1997. Today, we are proud to continue the WWW tradition by sending Grade 6, 7 and 8 students to Greece, Nepal, Tanzania, Thailand, Cambodia, South Africa and Sri Lanka.

An annual service learning program for the American School of Dubai Middle School.

What is Week Without Walls?

Week Without Walls | 5

The trip selection process is an exciting tradition, and just the beginning of the Week Without Walls experience.

Student EligibilityAll Grade 6, 7, and 8 students at American School of Dubai participate in WWW as part of the MS curriculum. Each student is required to have a current UAE residency visa and a passport that is valid 6 months from the date of travel. Students with repeated disciplinary or academic concerns will not attend WWW. Should a situation occur, cases are reviewed by the Middle School administration.

The Trip Selection ProcessStudents in Grades 7 and 8 choose between three different WWW destinations through a lottery system. Each trip is unique and offers students a rewarding experience. To ensure the trip selection process is fair, students pull a lottery number to represent their turn in selecting their first, second or third choice of destinations. The trip selection process is an exciting tradition, and just the beginning of the WWW experience.

Grade 6 students do not participate in the lottery; all students travel to Greece as part of the Grade 6 curriculum focus on ancient civilizations.


The Week Without Walls program enhances middle school curriculum by exposing students to new cultures and academic and personal growth opportunities that cannot be achieved in a regular classroom setting. It is a unique opportunity for ASD Middle School students to experience a new country and culture in a small group setting of their peers and ASD faculty. Each grade level may travel to different destinations, but the program objectives and learning goals are consistent for each trip in the areas of cultural understanding, personal growth, life skills, service learning and curriculum enrichment.

Cultural UnderstandingTo promote an appreciation of cultural understanding, students participate in a number of local activities and interact with residents to understand how life in other countries differs from their own experiences. Students may have the opportunity to learn a traditional dance or song or visit historical sites that help to develop an appreciation for cultural diversity and traditions.

Personal GrowthThe WWW experience offers the opportunity for students to grow and mature in their interpersonal relationships and to develop a sense of independence through adventure. Traveling to a new country challenges students to be responsible and teaches students to step outside of their

The WWW Program Objectives and Learning

Life SkillsThe skills students learn during WWW become life lessons and building blocks for student growth and maturity. Students learn important traveling skills such as reading a map, photography, time management, communicating in a foreign country, safety awareness and compassion for other cultures.

Service LearningEach student participates in an activity of service to the community they visit. Students grow in cultural awareness and global perspective by working hands-on with the local community. Service learning activities include planting trees, building houses, visiting orphanages and more depending on the WWW location. Middle School students become global citizens and begin to understand the impact they can make on the world around them.

The program objectives and learning goals are consistent for each trip in the areas of cultural understanding, personal growth, life skills, service learning and curriculum enrichment.

comfort zones. Trip activities are designed to encourage students to build camaraderie and experience WWW as a team to further develop students’ social skills.

Trip leaders also encourage self-reflection. Students are coached to take seriously each service learning activity or cultural adventure. As part of the WWW curriculum, each student records their experiences of the trip in a journal along the way.


Curriculum Enrichment and Learning ObjectivesThe WWW experience extends the MS curriculum and learning objectives outside the walls of ASD. Each destination is truly a classroom without walls, and learning objectives are tied to every activity and service learning project. Trip leaders work with students in small groups and evaluate student growth and development in three key areas:

Positive Learning AttitudeSeeks/accepts challenge and copes well with changeDemonstrates independence

Organization and Time ManagementRespects timelinesFollows guidelines

Collaboration and ParticipationParticipates enthusiasticallyListens actively Respects group goals Works to resolve conflictCore Values in actionAssumes responsibility for decisions and behaviorTreats others with compassion and understandingRespects ASD’s Expectations and Code of Conduct

Students demonstrate growth in these areas in a student journal. Trip leaders provide prompts throughout the week to challenge students to make connections between the country they are visiting and their own life experience. Students are encouraged to be creative with their words to express their growth and understanding. Journals are evaluated as part of the student grade for WWW.

Sample Journal PromptsHow are your pastimes different from people you’ve met on this trip?

How did you challenge yourself out of your comfort zone today/during this trip?

What are you finding the most surprising? What is different than expected?

How would your life be different if you had been born in _____? How would it be the same?

CCLS Learning Target

Language Arts I can produce clear and coherent writing where my development, organization, and style are appropriate to task, purpose and audience

Social Studies I can present an argument/claim about an issue and support it with evidence

Trip-specific standard and learning targets

Teacher Score

Student Score

What does an exemplary journal look like?

I have 5 journal entries to submit for evaluation. These are clearly labeled so my chaperone knows which ones to assess

Overall, my journal entries present an argument/claim about an issue. I support this argument with evidence

Trip-specific checklist item goes here (if applicable)

My journal entries meaningfully address the writing prompts. I’m making a clear connection be-tween the prompt and my experience. My writing shows reflection and not just a list or itinerary of what I did that day

My journal entries are neat, organized and legible

Obvious effort was put into my journal. I didn’t just craft it overnight or after the trip

My journal contains artifacts and pictures to support my journal entries

Week Without Walls Journal Standards and Checklist

• Journal entries can take on a variety of formats: sketches, drawings, bullet points, paragraph form, cast of characters, charts, graphic organizers, quotes, memorabilia etc.

• Journal entries can be written outside of times required by chaperones. • Students may bring a glue stick, tape and envelope to paste and store artifacts and

pictures.• Some journal entries can remain private; students may fold over and/or staple the page.• Journal entries should include the prompt question (if applicable) and the date.

The Journal Grading CriteriaEXEMPLARY = 5 journal entries feature the requirements above. PROFICIENT = 4-5 journal entries feature the requirements above.ADEQUATE = 3 journal entries feature the requirements above.LIMITED = 2 journal entries feature the requirements above. DND = 1 or no journal entries feature the requirements above.

Students Should Remember….



Greece

Journal Entry:

The tour Guide Jenny let us go

into the Olympic stadium and

I nearly cried I was so happy.

The whole stadium was made

of marble and it has lasted

around 1000 years. The track

was around the same size as my

school track except they used

black gravel while we used red

gravel. When I stood up on that

podium I really felt like 1st place!

During the Grade 6 trip to Greece, students explore the Parthenon, visit museums, shop and dine in the Plaka, learn traditional Greek dances and watch Greek theater. The trip also includes excursions and activities outside of Athens. Students experience the Ancient Delphi, the original Olympic site, visit the historic Poseiden’s Temple, learn the art of pressing olives and much more.

One day is designated to a service learning project with Plant-a-Tree, an organization that aims to increase urban greenspace in Greece. Students work together to plant trees on a hillside in an area that was destroyed by forest fires.

Experience what life is like today in Greece and learn about the rich, ancient history of the past.

GRADE 6


Experience a safari adventure in the Serengeti and spend time with the local Masai community.

TanzaniaGRADE 7

Students arrive in Arusha, Tanzania and travel with a tour guide to Serengeti for a safari adventure. The safari includes game drives and hikes where students encounter elephants, zebra, wildebeest and lions. Team building is a big part of the safari adventure and students work together to learn to set up a campsite and participate in activities to strengthen friendships. Each day ends with a lesson focused on the day's activity and the WWW objectives.

One day is designated to working with a local school as part of a service learning activity. Students visit a remote school to help ongoing building projects by laying brick, pouring floors and painting. Students also make time for a cultural exchange to play games, talk, eat and learn about one another.

Journal EntryIf I was born in Tanzania, I would have to start working at a young age and I would not be able to gain the education I need. I would not get to live in a nice big house or go to nice big malls everyday. If I was born in

Tanzania, I might have been very poor or in extreme poverty. Local water for people in Tanzania is not always clean which makes it unhealthy and leads to serious health issues.


the people saying “hi”. It’s

funny how a “hello” can go

a long way.

NepalDuring the trip to Nepal, students experience the Nepali culture and also learn about life in Nepal while visiting the local Phutung orphanage supported by Sunrise Kids Nepal.

Note: this is an outdoor, physically active trip. Students will hike 5 to 7 hours for 3 days to allow students to fully immerse into the Nepali culture.

Tour Kathmandu, learn to cook a traditional meal and explore the many outdoor activities such as mountain trekking and whitewater rafting in the Annapurna Range.

GRADE 7

Journal Entry:

One thing about the journey

that really surprised me is how

nice the people are. They always

say “hi” or “namaste”, and I

respect them for that because

it must be hard to see people

more fortunate than you. It

makes me feel really good to see Week Without Walls | 11


Students also enjoy the beautiful outdoor scenery of Thailand while rock climbing, zip lining and trekking through Thai hill villages. This trip includes many opportunities for students to focus on personal confidence, individual responsibility and team building.

Journal Entry:

This experience has allowed me to

really appreciate the world and

fortunate life that I am living in

Dubai. By seeing those children’s

smiles and seeing their living

and school, I now understand

how lucky I am. I loved being

around them, spending time

with them and learning that

to be talented you don’t need

the best art supplies but

a creative mind. This

experience has truly made

me a special person.

More caring and more

appreciative of what I

have.

ThailandGRADE 7

The trip to Chiang Mai includes activities to enhance students’ cultural understanding of Thailand such as a traditional cooking course, a painting lesson and a visit to a Buddhist temple.

13 | Week Without Walls Week Without Walls | 13

GRADE 8

The trip to Cambodia is filled with activities in nature, history, service learning and interactions with the local people of Cambodia. Students travel the Cambodia countryside, Siem Reap, Phnom Penh and cruise the Tonle Sap Lake. Students also participate in service learning projects to support Free the Bears, the Bakong Orphanage Village and help to build a house in Siem Reap.

Activities Include: National Museum - Silver Pagoda Kulen Mountain - ancient temples - River of 1000 Lingas - Reclining Buddha - floating villages - mangroves - crocodile and fish farms - Bokator Martial Art lesson - Horseback riding - Angkor Wat

Cambodia

South AfricaDuring the fabulous trip to the Western Cape of Africa, students explore Cape Town and the surrounding areas and learn about the history of this bustling port.

Students visit many important historical landmarks and natural wonders. One day is designated to a service learning project with a local organization, Hands of Hope. Students spend the day with local children playing games and learning about life in South Africa.

Activities Include:Table Mountain - Robben Island - Seal Island - Cape of Good Hope - safari in Knysna - encounter with elephants - hike in Knysna Nature Reserve - swim in the waterfalls - zipline - traditional Braai - drum lessons - ostrich farm

Journal Entry:The drum session stuck with me out of all the activities that evening. I’m not into drumming The instructor told us to let out all of our feelings on the drum. At first I found it pointless, but after the first minute I started to get into the rhythm and various patterns.

This is the event that gave me the most energy and cultural impact. I could feel the power and energy coming from the drums. The instructor also informed us on the different types of drum and how drums play a huge role in South Africa’s culture and history.

GRADE 8


15 | Week Without Walls Week Without Walls | 15

The Grade 8 trip to Sri Lanka is a balanced itinerary of fun activities, opportunities for challenge and service learning. Students learn about Sri Lanka’s cultural heritage during a visit to the Dutch Fort City of Galle. Students also gain an appreciation of life in Sri Lanka by visiting a tea plantation, a coconut factory, an elephant park and Cinnamon Island. Students are guided along the beautiful beaches of the southwestern coast of Sri Lanka for a surfing lesson, whale watching, fishing and a safari in a mangrove river.

One day is designated to a service learning project with SOS Children’s Villages. SOS Children’s Villages cares for children who are orphaned, abandoned or whose families are unable to care for them. Students spend a day playing with the children and helping with chores around the village homes.

GRADE 8

Sri Lanka

Journal Entry:

Steepness and height have always

been a huge fear of mine and

today I had no choice but to

face them. “Should I back away

from the stairs or should I climb

them?”, I thought carefully. It

was time to suck up the fear,

bring out my inner confidence

and walk up the fearful stairs.

Thank God I had

my friends behind

me to catch me if I

fell. After facing my

fear and pushing

myself to take risks I

learnt that anything

is possible and all

challenges can be

faced.


Stay InformedThe best way parents can support their child is to stay informed and engaged. Parents should attend parent meetings and refer often to the trip specific Haiku pages that are managed by trip leaders. The Haiku pages are a key resource for parents and students as they prepare for WWW. Each Haiku page contains important information such as schedules, packing lists, trip itinerary, important announcements and upcoming parent and student meetings.

Documentation and PermissionsStudent documentation, medical requirements and parent permissions are required for all students. Each family is required to complete WWW Forms A – C that provides emergency contact information, parent permission and a medical release form. Samples of these forms can be found in this guide. Forms are also available through the MS Office and webpage. Every student must have a passport that is valid for six months from the date of travel and a UAE residency visa that is valid during the dates of travel. Parents submit copies of these documents to the MS Office in order for a student to be eligible for WWW.

Financial ResponsibilityParents are responsible for funding their child’s WWW trip. The cost of each trip ranges from AED 5000 - 9000. The cost includes airfare, accommodations, food and trip activities. Also included in the cost is a standard AED 300 student pledge to support the service learning aspect of the WWW program. A non-refundable deposit of AED 1500 is due in the fall, and the remaining balance is due at the beginning of the spring semester.

All fees are paid to the ASD Business Office located on the second floor of the Administration Building. The Business Office hours are Sunday - Thursday, 7:45 a.m. – 3:30 p.m. Payments are made by cash, check or credit card (2.25% service fee for payments made by credit).

Timeline of Key Parent ResponsibilitiesThe general timeline associated with the WWW program are listed below. Trip specific details are communicated by trip leaders through email, parent meetings and the Hakui announcement pages. September Student Passports and Residence Documentation check (Parents review documents to ensure they are up to date) October Grade Level Parent MeetingsStudent Trip Selection and Lottery for Grade 7 and 8 NovemberTrip Deposit due to the Business OfficeForms A - C and Passport Documents due to Trip LeadersWWW Hakui Pages LaunchedJanuary Final Payment Due to Business OfficePersonal Medication Drop-off to Health OfficeFebruaryPre-Trip Parent Meetings and/or Final Parent CommunicationsWeek Without Walls TripsMarchWWW Recovery Day - No school for MS studentsStudent Journals DueStudent Presentations – WWW Exposition

Parent Role and ResponsibilitiesIt is important for parents to be involved as their child prepares for WWW. Parents become a cheerleader and offer encouragement for their child as they embark on this important experience. Preparing for WWW is a wonderful opportunity for parents to talk about the trip and the growth opportunities ahead.


Student Pledge and FundraisingEach WWW trip includes in its fees AED 300 to support aspects of the service learning project. Examples of what this supports are purchasing seedlings, school supplies for local students and materials for the service learning projects. The Middle School recommends that students make this contribution and personally pledge to do service at home, at school or in the community to fulfill the pledge. Families can discuss together what it means to give back, how personal commitment and responsibility are features of making a difference and how to fulfill the pledge.Here are examples of how students have fulfilled pledges:• Ask a parent, neighbor, family friend to take on extra chores or responsibilities.

• Save personal/weekly allowance to fulfill your pledge.• Create a performance for family and friends; they will enjoy contributing to attend. (personal talent show with friends at home, presentation on their trip/country)

• Research the WWW culture/country and host a dinner or bake sale for family and friends.

• Form a group of friends from the WWW trip and coordinate an activity that involves ASD students and teachers.

Note: the AED 300 personal pledge is included in the payments for WWW.

Student Behavior ExpectationsStudents are expected to behave in a manner that represents the ASD Core Values, Compassion, Excellence, Integrity, Respect and Responsibility, and follow the Student Code of Conduct at all times. The Student Code of Conduct is part of the MS Behavior policy which can be found in the Middle School Handbook. If a student violates the Student Code of Conduct, parents and the ASD Administration are immediately contacted. For severe violations, the student is sent home at the parents’ expense if it is feasible. The student is held accountable to the MS Behavior Policy and may lead directly to level 2 consequences.Student behavior expectations specific to WWW are:• Maintain a positive attitude at all times• Arrive to group meetings on time• Respect project and journal timelines and due dates• Act respectfully with peers, trip leaders, chaperones and tour guides

Students Expectations & Responsibilities

Healthy Travel Tips for Students• Wash your hands to avoid getting sick.• Stay hydrated: Drink safe water. Trip leaders will let students know if tap water is safe. If not, students should only drink boiled or bottled water. Brush teeth with bottled water.

• Check your food: Ensure food is cooked properly. Students are not to purchase food from street vendors or food that is not well cooked. It is important that the food is the proper temperature. Food should not be served at lukewarm temperature.

• Protection from the sun: Wear sunscreen, sunglasses and a hat if outdoors.

• Water safety: Only swim with trip leader permission and never alone.

• Watch your feet: Prevent foot infections by keeping feet clean and dry. Always wear shoes.

• Protect from Animal Bites: Protect yourself from rabies and other infections, do not handle or pet any animals. If you are bitten or scratched by any animal, report immediately to your trip leader.

• Mosquito bites: Wear insect repellent, long sleeved shirts and long pants to prevent mosquito and other insect bites.

For further information consult your personal physician and www.cdc.gov/travel.

Health InformationStudent health and safety are of utmost priority to the American School of Dubai. Please note the following important details associated with supporting a safe and healthy WWW experience.

Parents should be aware of the following:1. A review of student health records. Parents are

required to disclose any health issues.2. Some trips may require students to take specific

vaccinations or a physical.3. Student names and passport numbers are

given to the US Consulate in Dubai and/or the US Embassies or Consulates in the respective countries of travel.

4. Students do not travel to destinations with a discouraging travel advisory from the US Embassy.

5. WWW trips that include rigorous physical activity or special skills are communicated to parents.

6. Trip leaders and chaperones have up-to-date and current first aid training (within two years).

7. All students are covered by emergency medical and evacuation insurance. All emergency and travel insurance is included in the cost of each trip.

8. Access to emergency medical care, communication capabilities, proper travel conditions and evacuation procedures are reviewed for each destination. This information is available to parents before their children travel.

A Note About Risk and SafetyThe nature and purpose of Week Without Walls may expose students to a degree of risk not typical of regular on-campus classes. Trips may include activities such as hiking and other physical activities that are not risk free. The Middle School Administration recognizes the need to review each WWW destination and itinerary to minimize potential risks and to determine necessary safety procedures. All trips are subject to a risk and safety assessment.



Personal Medication NeedsTrip leaders carry a first-aid kit with common, over-the-counter medications such as Panadol, Advil, Strepsils, Imodium, Maalox, antihistamines, etc. These medications are available to treat any student on the trip, and parents do not need to supply over-the-counter medication individually for their child. Should a student need to take personal medication on the WWW trip, the ASD Health Office should be notified.

Instructions to drop off personal medications All personal medications are to be given to the ASD Health Office before the trip. Specific drop off times are before and after school at the end of January. When turning in medications, parents ensure:• Medications are in in their original containers.• Medications are clearly labeled with student name and dose.• No liquid medications are allowed.• Medications are not accepted at trip departure unless prescribed the day before travel.• Students are not allowed to carry their own medication with the exception of an asthma inhaler.The ASD Health Office is available to answer any medical questions during school hours. The Health Office is located in the Elementary School hallway nearest Gate 1 and the red stairwell.

Immunizations and Medications for Healthy TravelIt is important for parents to consult their family physician about the proper vaccines and anti-malarial options and to get all necessary vaccinations.

Required ImmunizationsMMR, DPT, Polio and Hepatitis B: These immunizations are required for school and must be up to date before traveling on WWW. Yellow Fever: Only Required for Tanzania. This mandatory vaccination can only be obtained at the Dubai Government Travel Clinics: Al Barsha Health Centre (04-502-3301) or Al Mankool Clinic (04-502-1227). The immunization costs approximately AED 380 in cash. Bring your child’s passport or Emirates ID to the clinic. The Yellow Fever vaccine must be documented in the International Yellow Booklet and carried on the trip. More information about this will be shared with parents and students travelling to Tanzania.

Recommended ImmunizationsTyphoid: A bacterial illness spread by fecally contaminated food and water. The CDC recommends typhoid vaccination for all WWW trip locations with the exception of Greece.Hepatitis A: Recommended by the CDC for all travelers to intermediate and high risk areas including South Africa, Nepal and Tanzania. All other WWW trips travel to areas considered low risk for Hepatitis A transmission.Varicella: For children who have not had the chickenpox disease, the CDC recommends two vaccinations, an initial vaccine and a booster. Be sure you receive both.Malaria Prophylaxis: - Specific to Cambodia, Sri Lanka and TanzaniaMalaria is a serious disease, spread by mosquitoes, with significant potential for morbidity and mortality. Following CDC guidelines, the ASD Health Office strongly recommends that your child take malaria prophylaxis if traveling to Cambodia, Sri Lanka and Tanzania. Please consult with your personal physician to obtain a prescription for the medication that is best for your child. The following table contains two options for anti-malarial medications. The Health Office no longer recommends Mefloquine.

MEDICATION Malarone Doxycycline

START 2 days prior (Begin evening of Feb 18) 2 days prior (Begin evening of Feb 18)

FREQUENCY once daily with dinner once daily with dinner

FINISH take for 7 days after return take for 4 weeks after return

COST $ $ $ $ $

SIDE EFFECTS minimal; well tolerated by most people minimal; well tolerated by most people; increased sun sensitivity; occasional stomach upset


The Underwriter hereby insures all persons whose Application has been accepted by the Administrator, Seven Corners, Inc., on behalf of the Underwriter and whose name is identified on the ID Card, subject to all the exclusions, limitations and provisions as ser for the herein and in the Master Policy of insurance issued by the Underwriter. Coverage is afforded only with respect to the person, coverage, amounts and limits specified herein and as identified on the ID Card for the insurance requested on such Application and for which their specified plan costs has been paid to the Administrator.Note: All coverage and benefit amounts herein are in United States Dollars.

Eligibility: Week Without Walls plan provides coverage for individuals and families provided You are either:Class 1: U.S. or Canadian citizens traveling outside the

United StatesClass 3: Non U.S. citizens traveling outside of their Home

Country (No travel inside of the U.S.)

Eligible individuals may also purchase coverage for their eligible dependents. An eligible spouse shall be defined as the Primary Insured’s legal spouse. An Eligible Dependent Child shall mean the Primary Insured Person’s unmarried children over fourteen (14) days and under nineteen (19) years of age.

It is the insured Person’s responsibility to maintain all records regarding travel history, age and provide any documents to the Administrator, which would verify Eligibility Requirements.

Period of Coverage: The minimum Period of Coverage under Week Without Walls plan is five (5) days, maximum Period of Coverage is twelve (12) months. Coverage can be purchased in a combination of monthly and/or daily periods by paying the appropriate plan cost.

Effective Date of Coverage begins on the latest of the following:1. The date and time the Underwriter receives a completed

application and plan cost for the Period of Coverage; or2. The Effective Date requested on the application; or3. The moment You depart Your Home Country; or4. The date the Underwriter approves the application.

Expiration Date of Coverage terminates on the earlier of the following:1. Your return to Your Home Country (except as provided under

the Home Country Coverage); or2. The expiration of twelve (12) months from the Effective Date of

Coverage; or3. The date shown on the ID card; or4. The end of the period for which plan cost has been paid; or5. The date You fail to be considered an Eligible Person; or6. The maximum benefit amount has been paid.

Schedule of Beneftis:All Coverages and plan costs listed in this Evidence of Benefits are in U.S. Dollar amountsMedical Maximums $500,000 (age 80+, maximum

limited to $15,000). Medical Maximum is per person per period of coverage

Deductible $0. Deductible is per person per period of Coverage

Coinsurance After you pay the Deductible, the plan pays 100% to the selected Medical Maximum

Hospital Indemnity $100 per night, up to a maximum of 30 days

Dental (Accident Coverage) To a maximum of $550Dental (Sudden Relief of Pain) To a maximum of $250Emergency Medical $500,000 (in addition to the Evacuation/Repatriation Medical Maximum)Return of Mortal Remains $50,000Return of Minor Child(ren) $50,000Emergency Reunion $50,000Local Ambulance Benefit $50,000Accidental Death & $25,000 principal sum forDismemberment (AD&D) Insured or Insured Spouse. $5,000

principal sum for Dependent Child. Aggregate limit of $250,000 per family

Loss of Baggage $500Interruption of Trip $5,000Home Country Coverage Incidental Trips to the Home

Country, Up to $50,000. Extension of Benefits: Up to $5,000

Hospital Room & Board Usual, reasonable and customary to the selected Medical Maximum

Intensive Care Usual, reasonable and customary to the selected Medical Maximum

Outpatient Medical Usual, reasonable and customary Expenses to the selected Medical MaximumUnexpected Recurrence Up to $20,000 (Age 65+, up of a

Pre-existing Condition to $2,500). This benefit is payable to U.S. citizens when traveling outside the United States and Canada

Amateur Sailboat $15,000 Maximum per Policy Racing Benefit Period; $60,000 Lifetime Maximum. Subject to $1,500 Additional Deductible per Policy PeriodBenefit Period 180 days

Seven Corners Travel Insurance PolicyWeek without Walls Program SummaryAdministered by: Seven Corners, Inc., 303 Congressional Blvd., Camel, IN 46032 USA


Parent Agreement FormPlease return by November 16, 2014

Name of Student: _______________________________________________________ Grade: _______________

WWW Country: ______________________________________ Trip Leader: ____________________________

I, the undersigned parent and/ or legal guardian of the student listed above do hereby consent to his or her participation in Week Without Walls.

I, as the parent of the student and on behalf of the student, release, hold harmless and agree to indemnify ASD, and its representatives, employees and agents, from and against any present or future claims, losses, liabilities, costs and ex-penses for injury to person or property, or for any other damage, which I or the student may suffer, or for which the student may be liable to any other person, related to the student participation in the trips (including periods in transit to or from the student’s destination), resulting from any cause, including but not limited to negligence on the part of the Student or any of the released parties.

Parent Signature:__________________________________ Date:_____________________

Print Parent Full Name: ________________________________________________________

Emergency Contact Information:

Name: ______________________________________________________ Relationship: ____________________________

Telephone (home): __________________________________ Telephone (cell): ____________________________________

Email Address: _____________________________________________________

Emergency Contact Information:

Name: ______________________________________________________ Relationship: ____________________________

Telephone (home): __________________________________ Telephone (cell): ____________________________________

Email Address: _____________________________________________________

Form A Sample2014-2015 Week Without Walls



Student Rules and ExpectationsPlease return by November 16, 2014

1. All laws of the country must be observed. The possession or use of cigarettes, drugs, or alcohol will not be permitted at any time. If it is not possible to send the student home, the school will deal with this upon return to Dubai. Serious consequences will apply.

2. Independent exploration beyond the designated areas and hotel premises without the knowledge and consent of the supervising adults will not be permitted. Students are not allowed in the building or room of the opposite sex.

3. Housing arrangements may not be altered. Each student must remain in his/her assigned room after curfew time except for emergency situations. If any student violates this rule, he/she may be suspended from the following day’s activities and will be referred to the administration.

4. All families will be provided with an itinerary and the hotels telephone numbers. Parents may contact one of the supervis-ing teachers in case of emergency.

5. Students are discouraged from taking excessive amounts of money, valuables, or jewelry. All students are responsible for their personal belongings.

6. Students should demonstrate courtesy to all individuals providing service to them. Students should display appropriate behavior at all times and represent ASD in a positive way.

7. Dress should be conservative as we are representing ASD. Halter tops, sleeveless tops, bare shoulders, short shorts, midriffs and cut off tops are not allowed. Students will be advised accordingly on what is acceptable for the various activities.

8. The ASD Code of Conduct will be in full effect during the trip. Any problems arising will result in disciplinary action by the supervising teacher. Serious problems will be reported to the ASD administration and parents for possible further discipli-nary measures. Students may be sent home for serious disciplinary reasons.

9. If a student is involved in a serious discipline incident before the departure of the trip, he/she may not be allowed to participate in the trip.

10. ASD liability continues to be in effect for this school-sponsored activity, as it is with all activities.

I, the undersigned, hereby attest that I have read, understand, and agree to abide by the rules for the Week Without Walls trip.

_________________________________________ _________________________________________

Parent Signature Student Signature

_________________________________________ _________________________________________

Date Date


Form B Sample2014-2015 Week Without Walls



Medical Information and Consent FormPlease return by November 16, 2014

Instructions: Please read carefully and complete the form in black ink. Do not leave any blanks on the form; write N/A where not applicable.

Student Name: ______________________________________________________________________ Age:_____________

Date of Birth:________________________________ WWW Country:______________________________________________

Father’s Name:_______________________________________________ Father’s Mobile: __________________________

Mother’s Name:_______________________________________________ Mother’s Mobile __________________________

My child has the following:

Medical condition(s): ____________________________________________________________________________________

Allergies: ______________________________________________________________________________________________

Typical allergic reaction: _________________________________________________________________________________

Treated with: antihistamine epipen other: ____________________________________________

Dietary restriction: vegetarian no pork no beef other: _______________________________

Which personal medication(s) will you provide for your child to take during WWW? (Note: trip leaders will have a first-aid kit with over-the-counter medications)

How OftenAmount Given forMedication

Anti-malarial Medication for Cambodia, Tanzania and Sri Lanka:My child will take the following anti-malarial medication

Malarone (given with evening meal) Start on Wednesday, Feb. 18 evening and daily until departure (then for 1 week following return)

Doxycycline (given with evening meal) Start on Wednesday, Feb. 18 evening and daily until departure (then for 4 weeks following return)

Knowing the risks, and in consultation with my child’s doctor, I have decided that my child will not take anti-malarial medication.

Authorization for Medical First Aid Treatment I, the undersigned, of Dubai, United Arab Emirates, do hereby authorize and empower the ASD designated chaperones and/or Health Care Provider to make any and all decisions concerning the medical care of my child, ________________________________, while in their care for the purpose of this trip.

Parent Signature:______________________________________________ Date Signed: _____________________

Print Parent Name: _____________________________________________

Form C Sample2014-2015 Week Without Walls



Grade 7 Selection FormPlease return by November 2, 2014

Please complete the information below and return this form with a non-refundable deposit of 1500 AED to the ASD Cashier’s Office by 3:45 p.m. on November 2, 2014. The remaining balance is due January 18, 2015.

Name of Student (Please Print)

______________________________________________ ______________________________________________ (First Name) (Last Name)

________________________ _________________________

Parent Signature Date

Please indicate the first, second and third trip choice by marking a 1, 2, or 3 in front of the trip option.

_____ Nepal

_____Tanzania

_____Thailand

Students will be placed on trips according to a lottery. If your son or daughter has a specific medical need that prevents them from attending a certain trip, please contact Grade 7 Team Leader, Mr. Daniel Mendes at [email protected].

Every effort will be made to refund the maximum amount for each trip if there is a cancellation due to political, health or security reasons. Refund amounts will depend on airline cancellation policies.

Thank you, we look forward to a successful Week Without Walls program this year!

Form D Sample 2014-2015 Week Without Walls


Grade 8 Selection FormPlease return by November 2, 2014

Please complete the information below and return this form with a non-refundable deposit of 1500 AED to the ASD Cashier’s Office by 3:45 p.m. on November 2, 2014. The remaining balance is due January 18, 2015.

Name of Student (Please Print)

______________________________________________ ______________________________________________ (First Name) (Last Name)

________________________ _________________________

Parent Signature Date

Please indicate the first, second and third trip choice by marking a 1, 2, or 3 in front of the trip option.

_____ Cambodia

_____ Sri Lanka

_____ South Africa

Students will be placed on trips according to a lottery. If your son or daughter has a specific medical need that prevents them from attending a certain trip, please contact Grade 8 Team Leader, Mr. Stephen Bougor at [email protected].

Every effort will be made to refund the maximum amount for each trip if there is a cancellation due to political, health or security reasons. Refund amounts will depend on airline cancellation policies.

Thank you, we look forward to a successful Week Without Walls program this year!


Form E Sample2014-2015 Week Without Walls


AMERICAN SCHOOL OF DUBAI

P.O. Box 71188, Dubai - UAE Tel: +971 4 395 0005

www.asdubai.org