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Venture Crew CAMPOUT PERMISSION SLIP Submit this form back Suntan Lotion

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Venture Crew CAMPOUT PERMISSION SLIP Submit this form back  Suntan Lotion Powered By Docstoc
					                                    Venture Crew 572 CAMPOUT PERMISSION SLIP
                                 Electronics permitted, iPod, game system, music device, cell phone, etc.
                                                           No lighters permitted


Event:                           Crew 572 Canoeing Shake-Down

Location:                        Potomac River/Knoxville, MD (River & Trail Outfitters)

Date:                            Saturday, May 15

    Return this signed permission slip and payment to Will or Diane Crain no later than April 25, 2010.

As the parent or legal guardian of ________________________________________ , I hereby

   give my permission for her/him to participate in the above stated outing with Crew 572.

   I will be able to provide transportation for scouts. My vehicle holds _______ passengers including driver.

   I will be able to provide transportation for gear. Type of vehicle: _________________________________
         Transportation:           Out              Return            Both Ways

   Parent(s) planning to attend. Name(s): ____________________________________
     (Adults must be registered adult leaders to participate.)
          ___________________ Parent’s Cell Phone #

   Funds attached: $_______             ($31) or ____ Scout Account: $_____________
   I know that my son/daughter will need to bring a sack lunch and water bottle.


I give permission to the leaders of Venture Crew 572 to render First Aid, should the need arise. In the event of an
emergency, I also give permission to the physician selected by the adult leader in charge, to hospitalize, secure proper
anesthesia, order injection, or secure other medical treatment, as needed. I further agree to hold the above named unit and its
leaders blameless for any accidents that might occur during this outing except for clear acts of negligence or non-adherence
to BSA policies and guidelines.

In case of emergency, I can be reached by phone at _______________________, or ________________________.

If I cannot be reached, please contact            _____________________________________ at ____________________________.

   My son/daughter weighs less than 90 lbs.

My son/daughter has

   the following medical condition(s) that adult leaders must be aware of: ________________________________.

   no medical conditions.

My son/daughter requires

   the following medication(s) that adult leaders must supervise and assist in administering: (Provide time & quantity)
    _________________________________________________________.

   no medications.


Signed: _________________________________________ Date: _______________
         (Parent or Guardian)

                  >>>>Submit this form back to Will or Diane Crain by April 25, 2010<<<<
WAIVER AND RELEASE OF LIABILITY (please read carefully)

In consideration of River & Trail Outfitters’ furnishing services and/or equipment to enable me to participate
in River & Trail Outfitters’ activities, I agree as follows:
I fully understand and acknowledge that outdoor recreational activities have: (a) inherent risks, dangers and
hazards and such exists in my use of River & Trail Outfitters’ equipment and my participation in River & Trail
Outfitters’ activities; (b) my participation in such activities and/or use of such equipment may result in injury
or illness including, but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis,
death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the
negligence of the owners, employees, officers or agents of River & Trail Outfitters; the negligence of the par-
ticipants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. Risks
and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, guide decision
making, including that a guide may misjudge terrain, weather, trail or river route location, and water level,
risks of falling out of or drowning while in a raft, canoe, kayak, or tube and such other risks, hazards and dan-
gers that are integral to recreational activities and/or use of equipment. I hereby assume all risks and dangers
and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or
other conduct of the owners, agents, officers, or employees of River & Trail Outfitters, or by any other person.
I, on behalf of myself, my personal representatives and my heirs hereby voluntarily agree to release, waive,
discharge, hold harmless, defend and indemnify River & Trail Outfitters and its owners, agents, officers and
employees from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss
of services or otherwise which may arise out of my use of River & Trail Outfitters’ equipment or my participa-
tion in River & Trail Outfitters’ activities. I specifically understand that I am releasing, discharging and waiv-
ing any claims or actions that I may have presently or in the future for the negligent acts or other conduct by
the owners, agents, officers or employees of River & Trail Outfitters.
The Venue of any dispute that may arise out of this agreement or otherwise between the parties to which River
& Trail Outfitters or its agents is a party shall be either the Circuit Court, State or District Court in
Hagerstown, MD.
I permit the use of any photos, slides, films, or sketches taken during the day’s activities for publicity, advertis-
ing, promotion or other commercial purpose.
I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE. IT IS MY INTEN-
TION TO EXEMPT AND RELIEVE RIVER & TRAIL OUTFITTERS FROM LIABILITY FOR PERSONAL
INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER
CAUSE.

_________________________________________ ___________ _________________
SIGNATURE                                 AGE         DATE

_________________________________________ _____________________________
NAME (PRINTED)                            GROUP NAME

________________________________________________________________________
STREET ADDRESS

_________________________________________ ___________ _________________
CITY                                      STATE       ZIP

Sign up to be on our E-mail list to receive a few emails a year with details on special trips, tours, and sales!
We DO NOT sell our list or spam. (print neatly)
Email____________________________________________________
                                  PARENT/GUARDIAN PERMISSION FORM
                                     (This form to be used for minors only)

I hereby grant permission for my child, __________________________________,to participate in whitewater
rafting, kayaking, canoeing, tubing, biking, camping, climbing on a portable rock climbing wall and hiking or
cross country skiing, with River & Trail Outfitters Inc. And I hereby agree as follows:

   I fully understand and acknowledge that: (a) risks and dangers exist in my child’s use of rafting, kayaking,
canoeing, tubing, biking, camping, climbing on a portable rock climbing wall and hiking or cross country ski-
ing equipment and my child’s participation in rafting, kayaking, canoeing, tubing, biking, camping, climbing
on a portable rock climbing wall and hiking or cross country skiing activities; (b) my child’s participation in
such activities and/or use of such equipment may result in injury or illness or death or damage to personal
property (c) these risks and dangers may be caused by other participants, or by accidents, or by the forces of
nature or other causes. Risks and dangers may arise from foreseeable or unforeseeable causes including, but
not limited to, selection of trail or river route, water level, weather conditions, risks of falling out of, from, or
during a raft, kayak, canoe, tube, bike, portable rock climbing wall, hiking or cross country skiing and such
other risks, hazards and dangers that are integral to recreational activities that take place in a wilderness, out-
door or recreational environment; and (d) I hereby accept and assume these risks and dangers.

    I have been advised that my child must wear an approved personal flotation device at all times while on the
water. I affirm that my child will not be under the influence of alcohol or controlled substance, and will not
carry, use, or consume these substances before or during his/her scheduled activities. Any claims or dispute
arising from my child’s participation in River & Trail Outfitters’ activities or use of River & Trail Outfitter’s
equipment shall be venued in the Washington County District Court for the State of Maryland.

    My child is in good health and is at or above the minimum age stated in River & Trail Outfitter’s advertis-
ing for each activity in which he/she will participate. I understand that strenuous physical exertion may be
required and my child has no known physical disabilities or health problems, which will present any risk to
his/her participation in the activities. Information on my child’s physical handicaps or medical problems
which I feel River & Trail Outfitters should know about will be given in writing in advance of the scheduled
trip. I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to
my minor child’s involvement or participation in these programs as provided above, even if arising from the
negligence of the releasees, to the fullest extent permitted by law. Furthermore, I permit the use of any photos,
slides, films, or sketches, of him/her taken during the day’s activities for publicity, advertising, promotion or
other commercial purpose. The above agreement shall be binding on my heirs, successors, assigns, adminis-
trators and executors.

 I HAVE READ THE ABOVE AND BY SIGNING IT AGREE. IT IS MY INTENTION TO GRANT PER-
MISSION FOR MY CHILD TO PARTICIPATE IN RIVER & TRAIL OUTFITTER’S RAFTING, KAYAK-
ING, CANOEING, TUBING, BIKING, CAMPING, PORTABLE ROCK CLIMBING WALL AND HIKING
OR CROSS COUNTRY SKIING ACTIVITIES, AND TO ASSUME AND ACCEPT ALL RISKS ASSOCIAT-
ED THEREWITH.

Group Name (if applicable) ________________________________________________

Parents Name (Print) _______________________Signature_______________________

Street and Apt. Address: ___________________________________________________

City: _________________________ State: _________ Zip Code: __________________

Child’s Name: ____________________________ Age: ______ Trip Date: ___________

Child’s Signature: _________________________________________________________

DO NOT LOSE—PLEASE GIVE COMPLETED FORM TO YOUR GROUP LEADER
What to wear/bring:
       Sack lunch for yourself. Waterproof bag recommended.
       Water bottle
       Water
       Sunscreen

Wetsuits are available to rent for $15 if weather is very cold. Call ahead to
reserve proper size. 888-446-7529

How to dress for river
activities:

What to bring:

   1.   dry change of clothes
   2.   towel
   3.   suntan lotion
   4.   glasses strap
   5.   water bottle




River and Trail Outfitters Store
Supplies:

       Snacks and drinks
       Trip Souvenirs such as t-
        shirts, hats, and patches
       Items you might forget like
        suntan lotion, inexpensive
        river shoes
       Quality outdoor gear such as
        kayaks, canoes, and
        paddling gear

				
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Description: Venture Crew CAMPOUT PERMISSION SLIP Submit this form back Suntan Lotion