Raider Meet FLWHost by huangyuarong


									                                             DEPARTMENT OF THE ARMY
                                            WAYNESVILLE CAREER CENTER
                                                    400 GW LANE
                                            WAYNESVILLE, MISSOURI 65583
                                               (573) 774-6106 Ext 5054

                                                                                                       15 October 2012

MEMORANDUM FOR: Faculty,Advisers and JROTC Commanders

SUBJECT: Memorandum of Instruction (MOI) for the 1st Annual Fort Leonard Wood Survival of the Fittest Raider Meet

1. Waynesville Career Center Army JROTC and the 3 Chemical Brigade will host the 1 Annual
                                                                                                       “Fort Leonard
      Wood Survival of the Fittest Raider Meet” on 20 April 2013. This event will consist of 6 team events and 1
      Ultimate Raider Buddy Team event and will take place on Fort Leonard Wood, Missouri.

 a. Army Physical Fitness Test (Annex A)

 b. 10K Road March                 (Annex B)

 c.    One-Rope Bridge             (Annex C)

 d. PECS Course                    (Annex D)

 e. Monkey Fist                    (Annex E)

 f.    Gauntlet                    (Annex F)

 g. Ultimate Raider Buddy Run (Annex G)


      a. To host a safe, fair, and challenging competition that will test the physical and mental limits of all competitors.
         Our ethos for this competition is “Fairness is second only to Safety!”

      b. To allow Raider Teams to compete against each other in a Raider Challenge competition.

      c.   To instill pride, teamwork, esprit de corps and self-confidence among JROTC cadets.

      d. To test a Raider Team both physically and mentally. The Raider Challenge is designed to be a thorough
         evaluation of a Raider Team’s physical fitness level and technical competency in field tasks and teamwork. The
         competition is designed to be physically and mentally strenuous.
      e. Have Fun.


 a. REGISTRATION: All schools wishing to participate are required to complete and submit the pre-registration form for
    each team. This form is attached as Annex Iand is also available from 1SG(Ret) Scott Hildenbrandt
    ( or (573) 774-6106 ext 5054. Email is the preferred method of form
    submission. The suspense for pre-registration is NLT 31 January 2013. Final registration forms must be
    submitted NLT 20 March 2013.

 b. We are limiting the total number of team submissions to 12. Additional teams may be added at the discretion of FLW
    and WCC Cadre if it is determined that the addition will not hinder the overall execution and quality of the event.

 c.   Arrival / In processing will be at Fort Leonard Wood, beginning at 1530 hours on 19 April 2013.

 d. On Saturday morning, the competition day will begin at 0500 with registration for those teams that did not register on
    Friday. The commanders meeting will take place at 0530.

 e. The competition will begin at 0545with the Army Physical Fitness Test (APFT). The APFT uniform is ACU bottoms,
    t-shirt and running shoes. See Annex A for Task, Conditions and Standards. APFT Standards WILL NOT be read
    before each event. It is the team coach/advisor’s responsibility to ensure that team members know the rules and
    requirements of the APFT. Grading will be to standard and evaluated by Active Duty Drill Sergeants from Fort
    Leonard Wood.

 f.   APFTpush-ups and sit-ups will be conducted on a field and the run will be conducted on a 1 mile out and back
      course. Teams will not proceed to the run until they are linked up with their evaluator after the sit-up event. Teams
      will ensure their 9 Raider or coach is with the evaluator for the 2-mile run to identify cadets as they finish.

 g. Teams will execute breakfast immediately after the Army Physical Fitness Test. It is imperative that team
    commanders and team coaches stress that breakfast is not a social gathering. Get it, eat it, and move out!

 h. The 10K road march is executed immediately following breakfast. Teams will draw numbers for the order of start at
    the Commander’s meeting.

 i.   All other events will be conducted on the vicinity of Fort Leonard Wood. Maps will be issued to coaches and Team
      Commanders with locations of each event.

 j.   When teams cross the 10K finish line they will be instructed where to go for their next event.

 k.   In the event of a tie for any event or an overall award, the tiebreaker event will be the 10K RoadMarch time.If an
      additional tie breaker is necessary, the team APFT average will be used.

 l.   FRIDAY 19 April 2013

        Timeline for teams that arrive on 19 Apr2013.
        These times are all tentative. Timeline is dependent upon the supporting unit.

        Arrival/In Process       1530 – UTC
        Dinner                   1730– UTC (on your own)
        Terrain Walk             1800 -- UTC
        Lights Out               2200

 m. SATURDAY20 April 2013

        Late Registration                 0500
        Team Commander Meeting            0530
        APFT Begins                       0545
        Breakfast                         Immediately following APFT (2/10 Infantry Dining Facility)
        10K Road March                    Immediately following Breakfast
        All other events                  After 10K Road March as designated by event agenda
        Awards Ceremony                   1600 (Target time)

4. ELIGIBILITY. To be eligible to enter the competition, cadets must be:

 a. Full time high school students

 b. Enrolled in JROTC, any service, at the time of the competition.

 c.   Permission and liability forms complete and signed.


 a. Safety is our paramount concern. Team commanders and advisers should ensure that safe practices and safe
    physical standards are incorporated throughout the competition. Simple preventive measures such as hydration and
    foot care should continually be emphasized. Coaches are responsible for the training and fitness level of their team.
    This will be a grueling event that requires a great degree of training.

 b. Report any accidents, incidents or unsafe conditions to the Team Guide or an evaluator at any event station.

 c.   A Statement of Physical Condition(Annex L), and a Covenant Not to Sue (Annex K) are mandatory for every
      participating cadet. Team advisers MUST turn in all release forms, properly completed, prior to the start of the
      competition. The Waynesville School District or Fort Leonard Wood will not be responsible for accidents or injuries.


 a. Each team must consist of 8 competing members. One alternate is allowed per team. Teams may consist of a mix
    of genders.

 b. The one alternate can be utilized as a “pinch hitter” prior to the start of any event. An alternate may be utilized for
    any event as many times as the team desires so long as the 8 team members that start an event complete the
    event. No substitutions are allowed after an event begins. Alternate substitution must be declared verbally to the
    Team Guide or evaluator prior to the start of the event in which a substitution occurs.

 c.   In the case where a team does not complete an event with ALL 8 team members that started the event the team will
      forfeit that event. The event time and scores will not be computed for the overall team scores. It is the Team
      Commander’s responsibility to declare forfeiture for his or her team.

 d. Any team found to have substituted an alternate AFTER an event begins or does not declare forfeiture when it
    applies will be disqualified entirely from the competition.


 a. Instructor/Cadre uniform is ACU with patrol cap. For services other than the Army the prescribed duty utility uniform
    shall be worn.

 b. Evaluator uniform is ACU with patrol cap or campaign hat. For services other than Army Services and Foreign
    officers wear appropriate duty utility uniform.

 c.   Cadet uniform:

        1. The uniform for the APFT is ACU Trousers, t-shirt and running shoes.

        2. For all other events the uniform is complete ACU with patrol cap, canteen or a personal hydration system.
        Team T-shirts are authorized in lieu of the Tan ACU T-shirt, as long as the entire team is in the same shirt.

        4. Teams are required to carry one rucksack with all bridge building equipment throughout the entire course
        except if told otherwise by event graders. If the team prefers, each team member may carry their own seat
        building rope and snap links or equipment can be distributed amongst team members so long as all equipment is

         5. Non-competing cadets are required to wear appropriate attire and can watch from a fair distance as long as
        non-competing cadets don’t get mixed up with the competing team. This applies to alternates as well. Alternates
        cannot negotiate a course event with the team, but they can watch.

                                                       st   nd   rd
 a. Overall Team Trophy:                              1 , 2 , 3 Place Trophies
                                                       st   nd   rd
 b. Army Physical Fitness Team Trophy:                1 , 2 , 3 Place Trophies
                                            st   nd   rd
 c.   10K Road March Trophy:               1 , 2 , 3 Place Trophies
                                            st   nd   rd
 d. One-Rope Bridge Trophy:                1 , 2 , 3 Place Trophies
                                                       st   nd   rd
 e. PECS Course:                                      1 , 2 , 3 Place Trophies
                                                       st   nd   rd
 f.   Monkey Fist:                                    1 , 2 , 3 Place Trophies
                                            st   nd   rd
 g. Raider Gauntlet:                       1 , 2 , 3 Place Trophies
                                                       st   nd   rd
 h. Highest 3 male APFT Scores:                       1 , 2 , 3 Place Medals
                                                       st   nd   rd
 i.   Highest 3 female APFT Scores:                   1 , 2 , 3 Place Medals
 j.   Ultimate Raider buddy team event 1 Place Medals

 k.   All competing cadets will receive a participation certificate.


 a. A fee of $100.00 per team is required. Payment may be made with pre-registration submission or during registration
    on arrival. Payment in person on arrival is the preferred method.

 b. Checks must be made payable to Waynesville Career Center JROTC, or Waynesville JROTC.

 c.   This basic entry fee includes the entrance fee, facility usage, meals, and awards.


 a. Cadet’s, chaperones and coaches billeting will be available on Friday night 19 April2013, at a training barracks on
    Fort Leonard Wood. Building number 651 (Map attached)

 b. Instructors and Chaperones will ensure that all cadets dress and act appropriately in the designated sleeping areas.

 c.   Cadets/Schools must provide their own sleeping bags.
 d. Male and Female showers are available.

 e.    Friday evening meals are on your own. There are numerous eating establishments right off post. The breakfast
      meal will be served in the 2/10 Infantry Bn. Dining facility. The will be a nominal fee of $2.10 per person.
      Instructors are asked to pay for their teams as they enter the dining facility.

 f.   Lunch for competing cadets and coaches on Saturday is MRE and is provided by Fort Leonard Wood 3 Chemical
      Brigade. They will be issued to the team prior to the competition. No lunch is provided for chaperones and
      spectators. Lunch will be consumed as allowed and at the discretion of team commanders during the competition.
      Lunch should not slow or hinder the progress of the meet.


 a. SAIs/AIs must ensure that each cadet participating in the Pioneer Raider Competition understands the requirements
    for medical coverage.

 b. Raider competitions are a physically and mentally challenging event. Instructors should ensure that their cadets are
    physically capable of competing in this event.

12. Direct any questions, issues or comments to 1SG Scott Hildenbrandt ( or COL
    Charles Williams ( or phone (573)774-6106 Ext 5054 or 5063, respectively.

                                                \\\\\\\\\ORIGINAL SIGNED/////////
                                                SCOTT A. HILDENBRANDT
                                                1SG (Ret), US Army
                                                Army Instructor


 a. Army Physical Fitness Test          (Annex A)

 b. 10K Road March              (Annex B)

 c.   One-Rope Bridge           (Annex C)

 d. PECS Course                         (Annex D)

 e. Monkey Fist                         (Annex E)

 f.   Gauntlet                  (Annex F)

 g. Ultimate Raider                     (Annex G)

 h. Pre-registration Form               (Annex H)

 i.   Registration Form         (Annex I)

 j.   Covenant Not to Sue               (Annex J)

 k.   Statement of Physical Condition (Annex K)

 l.   Maps


                               ARMY PHYSICAL FITNESS TEST

Each team member will be evaluated physically by taking the Army Physical Fitness Test (APFT).

      1. Scored Task:

              a.     Push-Ups

              b.     Sit-Ups

              c.     2-Mile Run

      2. Uniform:

             I. ACU bottoms, T-Shirt, running shoes.

      1.   The standards and instructions in FM 21-20 will be adhered to.

      2.   The event supervisor is the timer. For Push-Ups and Sit-ups, the supervisor will call out the
           time remaining every 30 seconds and every second for the last 10 seconds of the four total
           minutes. Two minutes of push-ups will be executed first, then two minutes of sit-ups
           immediately following. Time will not stop prior to switching exercise. NOTE: Remember
           push-up and sit-up will be done back to back for a total of 4 minutes. Totals will be recorded
           on the scorecard just as if the standard separation of the 2 events were used.

      3.   SAI’s/AI’s may assist scorers in identifying team members during the APFT 2 mile run.

      4.   Scoring will be used on the 17-21 year old age group. Extended Scale will be used for
           individual scores only. The standard scale will be used to determine team averages.

      5.   Medals will be awarded to the top three males and top three females overall in the APFT

      6.   It is the team advisor’s responsibility to ensure that all team members are familiar with and
           understand the standards for this event. Abbreviated instructions will be given at the event.
           If a non-Army team needs a copy of the standards and instructions contained within FM 21-
           20 then email for a copy.


                                 10 KILOMETER ROAD MARCH

       Each team must complete the 10K Road March with all team members. This is a timed event
with a shotgun start. All teams will begin the road march together, there will be no intervals between

     1. Uniform:

             a. ACU/BDU Uniform (Blouse, Bottoms, Boots)

             b. Pistol Belt and Canteen completely full of water. Hydration systems are authorized
                for use as long as the entire team uses the same equipment. Either all are using
                canteens or hydration systems.

     2. Equipment:

             a. One rucksack containing the team’s rope bridge equipment (Team provided)

   1. Each team will start within the vicinity of the FLW troop trail.

   2. All eight team members must finish together within a 10 meter mark on the ground.

   3. A five 5-minute penalty will be assessed for every team member outside the 10 meter mark.

   4. If any team member is unable to finish, the team will be disqualified from that event only.

   5. Team will supply and carry one rucksack. The rucksack must include all the team’s rope
      bridging equipment. Team members have the option of carrying their individual Swiss/Aussie
      seats and distributing the contents of the rucksack amongst team members.

NOTE: SAIs/AIs/Chaperones and non-competing cadets are NOT allowed to go with their
teams but may be on the course for safety. It is recommended that one member of the team
carries a cellular phone in case of an emergency.


                                   ONE-ROPE BRIDGE

1) General Scenario:
a. Rope bridges will be constructed in accordance with the spirit and intent of a real rope bridge
situation. The basic premise must be that it be done as seriously and accurately as if a gorge or a
river were actually being crossed.
b. 8-members of the team must compete and complete the bridge construction and crossing.
c. The uniform for this event: ACU pants and Jacket, t-shirt & boots.
d. All teams will provide ALL of their own rope bridge equipment. Teams may use any kind of
rope they choose – rope MUST BE 150 feet minimum! (NOTE: YOU MUST HAVE YOUR
OWN150’ ROPES or make arrangements to borrow a rope from another team).
2) Specific Details:
a. No loops, bights and or pre-tied knots will be allowed on the rope. Swiss seats will be pre-tied
in order to save time. Swiss seats will not be graded, only inspected for safety.
b. Swiss seats and waist seats will be tied prior to reporting to the rope bridge site. All
participants will wear a rappel seat (swiss seat). The first and last team members can wear
sling ropes properly tied around the waist (minimum two wraps around the waist secured
with square knot and tied off with an overhand knot on each side of the square knot (Aussie
c. Upon arrival at the Start Point, the team will have their rope “back coiled” inside a ruck sack.
Only the end of the rope may be outside the bag at the start line. There cannot be any knots of
any kind pre-tied in the rope prior to the start of the event. This will cause the team to be
disqualified if the team is found to have pre-tied knots. On the command GO, the clock will start
and the team will run to the near side anchor point, and immediately build a 1-rope bridge. Team
will then cross the river as outlined. Time will continue to run until:
i. the entire team and all equipment is out of the water, across the river and on the far bank
(to include the rope!)
ii. all knots are out of the rope
iii. the team has announced, “TIME!”
d. The team with fastest time to include any penalty points added will be the winner.
e. The only knots allowed on the near side anchor point will be the following:
iv. Wireman’s Knot, Figure 8 Slip Knot OR Butterfly
f. The only knots allowed on the far side anchor point will be the following:
i. Round Turn with TWO Half Hitches
ii. Tension Anchor (A minimum of FOUR wraps on anchor)
g. Quick release for the second half hitch is recommended on both sides.
h. End of the line bowline or any figure 8 is used to attach the rope to the first person to cross
the gorge and must be attached to the seat or waist rope with a snap link or bowline and/or figure
8 over the shoulder.
i. A rope bridge that fails will not be counted or scored and will disqualify that team from that
segment of the event. Judges will notify the team immediately to end their effort and avoid

j. There is no limit on the number of snap links used in the transport knot.
k. There is no limit on the number of cadets on the rope.
l. All team members that cross the rope bridge must be hooked onto the rope and pull
themselves across the obstacle. One foot and one hand must be kept in contact with rope at all
times when crossing. If the members cross their feet over the top of the rope without touching
the rope, it is acceptable. One leg can drag on the rope, or both legs can drag on the rope while
crossing. All team members that cross the rope bridge must be hooked onto the rope with
carabineer and pull themselves across the obstacle using a rappel seat method. Progress is
made rotating under the rope and pulling with the hands and arms. There will not be a penalty
if feet fall below the rope while crossing).


       1. A thirty (30) second penalty will be assessed for every piece of
          equipment that touches on or between the boundary lines.

       2. A thirty (30) second penalty will be assessed for every knot improperly

       3. A thirty (30) second penalty will be assessed for team members that
          touch on or between the boundary lines.


                                   PECS Course

      Teams must negotiate obstacles and stations that will test their endurance,
knowledge, accuracy, and physical fitness.

     1. Uniform:

           ACU Uniform/team t-shirts

     2. Teams will be grouped with 2 to 3 other teams and will be walked through the
        course by cadre. The course and expectations for teams running through will
        be explained during the walk-through. Teams will then negotiate the course at
        staggered intervals. The fastest time will win.


      Failure to properly negotiate an obstacle (3 minute penalty) explained during

      Entire team not finishing within a 10 meter span (3 minute penalty)

      All 8 members do not complete the course (disqualification)

                                      Monkey Fist

       -Given upon arrival at the station.

- Cadets will run around a track (400m) with a litter (120lbs) and one ruck per cadet
(35lbs) then climb a 25’ rope and touch the monkey fist. This event will run like a relay.
Two cadets take off from the starting point and run around the track to the finish
(approximately 400 meters). They will then shed their rucks and climb 25’ ropes and
touch the monkey fist at the top. While the 2 person team is climbing the rope the next
two cadets will ruck up. When the last cadet’s foot touches the ground the next two
person group will repeat the process until all 4 groups have completed the course.
Cadets must keep the ruck on their back while running with the litter. When all 4 teams
of two have completed the course in relay fashion the time will stop. The fastest time
with penalties tabulated will win.

       1. Uniform:

              1.     ACU Uniform

              2.     Pistol Belt and Canteen or Personal Hydration System

       1. Penalties:

            I. Penalties will be briefed upon explanation of the task on site.

       2. The team that accomplishes the given task in the shortest amount of time
          after penalties are assessed will be declared the winner of the event.

       3. Forgetting the litter, forgetting a ruck, or running outside of the set course will
          result in a 3 minute penalty.

       4. Failure to climb the rope and touch the monkey fist is a 2-minute penalty for
          each cadet failing to do so

More instructions and details of this event will be given upon arrival at the



       All eight team members will move over rough terrain, up and down
hills carrying 4-35lb rucksacks and then return to the start line.


     4. Uniform:

     5. Given 4 rucksacks (35lbs each)


     6. Teams will complete the course as quickly as possible.

     7. From the starting point 4 cadets will carry 4 rucksacks weighing
        35lbs each.

     8. Teams will be scored by using the overall completion time.

     9. 10-minute penalty for any individual failing to successfully be
        carried through the event and cross the finish line.

     10. 5-minute penalty for any rucksack failing to successfully be
        carried through the event and cross the finish line.

     11. The course will be well marked with chalk lines, cones and or
        engineer tape. Additionally, course monitors will be positioned
        along the route to ensure all teams are heading in the correct
        direction and following the rules.


                      ULTIMATE RAIDER BUDDY RUN

General Scenario:
     a. Each competing school may nominate TWO individuals (any
     combination preferably your team’s top two Raiders) to compete in the
     Ultimate Raider event. These cadets must be maintained on your
     competing cadet roster to be eligible for inclusion within the Ultimate
     Raider Buddy Run.

      b.This competition will be strictly a 2-person event among the most elite
      individual cadets attending the competition. The scores are not included
      into team awards. The fastest time will be awarded individual medals. Only
      first place will be recognized.

      c.The course will be roughly 1.75 miles in length with the last part of the
      event being the PECS Course.

Specific Details:
      a. Will be explained during the walk-through of the PECS course event.


      c.The walls must be attempted a minimum of THREE TIMES before a cadet
      can choose to simply bypass the wall. Failure to do this will cause
      disqualification. After three attempts, a cadet MAY ELECT and take the
      penalty and bypass the wall (5 minutes). However, after three attempts, the
      evalutors can MANDATE the cadet to bypass the wall if they feel he/she is a
      danger to them self or others going over the wall, or if the competition at
      the wall becomes so congested his/her continued attempts will hinder
      other cadets ability to get over the wall.

      d.Spectators are allowed on virtually all aspects of the course; however the
      course will be designed to allow maximum spectator viewing of both the
      starting and finishing portions of the race. This will allow all attendees to
      cheer on their finest cadets as they start and end the race.

      e. Unlike the team competition, as stated above, team members MAY NOT
      ASSIST another runner in any manner to include dragging, carrying, etc.,
      unless they are doing this to prevent injury of the competitor. In no way
      should this assistance involve reducing the competition time of the
      assisted cadet. Failure to follow this procedure will result in a penalty up
      to and including disqualification for both the assisted cadet and the cadet
      assisting the runner.

             i. Failure to follow the course laid out will be cause for a subjective
             time penalty or disqualification depending on the infraction.
             ii. Failure to get over the walls or complete obstacles (5 minute
penalty per team and infraction).

 Annex H– Pre-registration Form

                                   DEPARTMENT OF THE ARMY
                              WAYNESVILLE CAREER CENTER JROTC
                                        400 GW LANE
                                WAYNESVILLE, MISSOURI 65583
                                   (913) 684 - 1550 Ext 182


                                                                                15 October 2012

 MEMORANDUM FOR: JROTC SAI’s, Instructors, and Raider Team Advisers
 SUBJECT: Pre-Registration form, 1 Annual Fort Leonard Wood Extreme Raider Challenge

 Please complete this form and return by email to Email is the
 preferred method but in the event that you need to fax, please fax to: ATTN: JROTC (573) 774-3355.


Number of Teams you would like to compete

Raider Adviser/Coach Name and Rank

                  Phone                             E-Mail

                                   NAME OF SAI

                  Phone                             E-Mail

             How many meals do you foresee as a           Cadets           Cadre       Chaperones
         requirement? Cadets, Cadre, Chaperones
     Will your team arrive on Friday,
        19 April and stay overnight?
Any other requirements or special requests?

Name and Rank of Person Completing this Form

ANNEX I – REGISTRATION FORM – One form must be completed for each

                            Waynesville JROTC
           1 Annual Fort Leonard Wood Extreme Raider Challenge

SCHOOL: ______________________________________

TEAM NAME: __________________________________

ADDRESS: _____________________________________


PHONE: _______________ FAX: _____________E-MAIL: ______________________

INSTRUCTOR: ___________________________________


                                   TEAM MEMBERS
         NAME (LAST, FIRST MI)                   AGE      GENDER

Please submit NLT 19 April 2013. Make checks payable to Waynesville JROTC. Email to
registration form to , or fax (573) 774-3355, or mail to: WCC
JROTC, 400 GW Lane, Waynesville, Missouri 65583.
Fees can be paid at time of registration.

Annex J – Covenant Not to Sue
                                   COVENANT NOT TO SUE
                            OFF CAMPUS TRAINING AND PRACTICAL
                                  FIELD/HIGH RISK TRAINING
                                 DATA REQUEST FOR ACT OF 1974
            1.Authority: Title U.S. code 3201. 2. PRINCIPAL PURPOSE (S): To release the U.S.
Government, the host institution and the state in which said institution is located from liability and injury,
death, or damages for JROTC cadets participating in voluntary off-campus training programs, practical
field and high risk training. 3. ROUTINE USES: normal personnel actions. Disclosures of information may
be provided to proper authorities in actions regarding law enforcement, legal actions as a result of injury
or death, and investigations of accidents resulting from such voluntary off-campus training, practical field,
NOT PROVIDING INFORMATION: Voluntary. Failure to complete form will disqualify JROTC cadet from
participating in specific voluntary training exercises.
I,__________________________________, residing at_____________________________
         (Type or Print full name)(Address)

                     (City)                                               (State)
do hereby agree that in consideration for being allowed to participate in the 1st Annual Fort Leonard
Wood Extreme Raider conducted by Waynesville JROTC Instructors and cadre and members of the
US Army, Fort Leonard Wood on 19-20 April 2013, an Army supervised activity, and whereas I am
doing so entirely on my own initiative, risk and responsibility; and being fully aware of the risks
adhering to this type of training, I do hereby RELEASE AND DISCHARGE FOREVER, the United
States Army, the State of Missouri and Waynesville School District and all of its officers, agents, and
employees, acting officially or otherwise, from any and all claims, demands, actions or causes of
action, on account of myself or on account of any injury to me which may occur from any cause
during said activity or continuances thereof, and I do Further covenant and agree to hold the said
Government of the United States, State of Missouri and the Waynesville School District blameless
for any and all damages I may cause either intentionally or through my negligence.

______________________________________ ______________________________________
Typed/Printed Name of Parent or Guardian if       Signature of Parent or Guardian if
cadetParticipant is a MinorParticipant is a Minor

_____________________________________ _______________________________________
          Relationship to Cadet                             Date


____________________________________ ________________________________________
                                                      Age/Period Covered

                                                                    Signature of Cadet

Annex K– Statement of Physical Condition
                1st Annual Fort Leonard Wood Extreme Raider Challenge
                              Fort Leonard Wood, Missouri
                                    19-20 April 2013


Cadet’s Name:

To the best of my knowledge, my son/daughter/ward is in good physical condition.
Participation in the :1st Annual Fort Leonard Wood Extreme Raider Challenge,
in my opinion, will not have an adverse effect on his/her health and well being. I will
inform his/her JROTC Instructor of any changes.
OR      My son/daughter/ward has a history of: (please list or if none, so state)
Heart problems, Asthma, Overweight, Sinus, Rheumatic Fever, Ear Infections,
Headaches, Stomach Problems,

or other ailments, and is on
____________________________________________________________ medication.

He/she is allergic to ___________________________________________________

NOTE: Students that are found to have previous history of any type of illness, past
injury, and/or symptoms of suspected medical ailment, will be returned home if
treatment is needed or desired.

______________________________                    ______________________________
(Signature of Parent/Guardian)                       (Signature of Senior Army Instructor)


          1. I44- Exit 161 turn south on
             Missouri Ave, Go thru Main Gate

          2. Turn Right at Burger King on 4th

          3. Turn left on Buckeye (one way)

          4. Turn Left on 7th street (one way)

          5. Billeting provided in Bldg 651
             (B Co 2-10 Infantry Regiment)

          (573) 596-4355
          2-10 Infantry SDNCO


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