OMMS Eagle Trek 2005-2006

Document Sample
OMMS Eagle Trek 2005-2006 Powered By Docstoc
					        OMMS Eagle Trek 2005-2006
                                  Kayaking Adventure
Dear Parents,

Thank you for allowing your child to participate in OMMS Eagle Trek. Eagle Trek is a club whose aim is to
provide an opportunity for OMMS students to experience outdoor activities with their peers in a non-
competitive environment. Eagle Trek is open to all OMMS students (grades 6 through 8) and their families.
Each Eagle Trek event is an independent activity, and participation (or non-participation) in one event does not
require or preclude participation in others. We hope you enjoy your involvement in our group.

Our first adventure is a SCUBA Diving Certification Program. If you are interested in certification, and you are
not already signed up to participate, contact Jeff Denney at jdenney@shelbyed.k12.al.us or by calling 682-5210.

Our second adventure this year will be a kayaking trip down the Coosa River (in Wetumpka) on Sunday,
October 23. We kayaked this river last year with great success. The outfitter, Coosa River Adventures (334-
514-0279), has “sit-on-top” kayaks (not the “climb inside” type) and canoes. Last year all students used kayaks
instead of canoes because they are easier to maneuver and easier to remount if overturned. Everyone is required
to wear life jackets, and there are no hydraulics (strong currents that will draw objects/people to the bottom of
the river and hold them there) along this part of the Coosa. We will not be conducting a practice run this year.
Although several of our Eagle Trek staff have had life guarding experience, none of our certifications are
current. If you want to go as our certified lifeguard, we will pay for your trip. However, with the requirement
that all participants wear life jackets, the easy navigation of this stretch of the river, and the experience of our
staff, we feel that the chances of injury to your child are minimal. There is always some risk involved with any
outdoor activity, and the decision to accept these risks is ultimately yours. As for the Eagle Trek staff, we are
going kayaking and would love to bring your child along. Parents (and siblings if accompanied by a parent) are
welcome to join us if you wish.

The cost of the river trip is $45/participant and can be paid in cash or check (payable to OMMS) to any Eagle
Trek Staff member. Attached are several forms that need to be completed before joining us on Sunday. Please
fill them out completely for each participant and return them with copies of their/your insurance cards and $45
by next Friday, October 7. The Coosa River Adventures Release Form has many lines, but you only need to fill
out one line for each member of your family that is coming.

Eagle Trek will provide transportation to the Coosa River on Sunday, October 23 (by school bus). Participants
on that day are required to eat a good breakfast and arrive at OMMS by 8:00 am in the shared parking lot with
OMES. We expect to be home by 4pm. Please be on time to pick up your child.

On October 23, participants should bring appropriate clothing (loose fitting clothes and shoes that can get wet),
a dry change of clothes & shoes, a lunch in a watertight, zip-lock baggie (including drink), and a snack for the
ride home (including drink).

Email any questions you may have to agudmundsson@shelbyed.k12.al.us or jdenney@shelbyed.k12.al.us
We are looking forward to a great trip!

The Eagle Trek Staff (Jeff Denney, Brent Buckner, Amanda Gudmundsson, Chris Golliver, Katie Zielinski,
Janet Murphree, Cecila Patterson, Anthony Marino)

[Every effort is made to estimate the cost of our activities accurately. In the event, however, that a surplus
should occur, that money will be added to the general Eagle Trek account, which is used to purchase equipment
and services for Eagle Trek members and staff.]
             Oak Mountain Middle School Eagle Trek Warning Statement, Emergency Information, Proof of
                                        Insurance, & Consent to Participate



           Last Name                   First Name                    MI              Sex    Birth date                          Current Grade




           Address                                                                                                              Social Security Number




           City                       State       ZIP


As a participant/parent in the OMMS Eagle Trek program, I/we understand that participation in any outdoor activity can be dangerous and includes MANY RISKS OF INJURY.
I/we further understand that there are serious risks including and not limited to brain damage, cardiac arrest, snake bite, insect bite, broken bones, serious injury or impairment to
other aspects of the student’s general health and well-being, or death. I/We understand that the dangers and risks of participating in outdoor activities also include the potentially
high cost of medical care and impairment of the student’s future ability to earn a living, to engage in other business, social and recreational activities, and generally to enjoy life.
Recognizing theses risks, I/we consent to the participation of my/our son/daughter in the Eagle Trek program offered at OMMS. I/We also agree to comply with all rules,
regulations, and recommendations of administrators, sponsors, emergency medical personnel, and doctors concerning injury prevention and care. I/We hereby consent to any and
all health care providers designated by OMMS to provide my/our child any necessary medical care as a result of injury or illness.



           Signature of Parent/Guardian                              Date                                Signature of Student                         Date

                                                                        Emergency Information


Parent/Guardian Name                                                                         Home Phone




Father’s Work                     Father’s Cell                      Mother’s Work                       Mother’s Cell                     Other Numbers




Preferred Hospital                                                   Doctor’s Name                                              Doctor’s Phone Number

Health Insurance Information:     NOTE:       THIS MUST BE COMPLETED. You must have medical insurance to participate



Insurance Carrier                                                    Policy Number                                              Group Number



Policy Holder’s Name                                                             Relationship



Medical History (List any allergies or medical conditions of which we should be made aware)




                  STAPLE A COPY OF                                                                           STAPLE A COPY OF
                  THE FRONT OF                                                                               THE BACK OF YOUR
                  YOUR INSURANCE                                                                             INSURANCE CARD
                  CARD HERE                                                                                  HERE


IN CASE OF EMERGENCY, if parents cannot be contacted notify:



Name                                                     Phone #’s                                                              Relationship
                           Permission Form
                              Eagle Trek
               Coosa River Kayaking Trip (October 23, 2005)


Student’s name:                                                 Grade:
Parents:

In case of emergency on the above trip date, I can be reached at:
Home phone:                             Cell phone:


If parents are unavailable, please contact:
                                    phone:

I hereby give my permission for the above named student to attend and
participate in the Coosa River Kayaking Trip on October 23, 2005,
including transportation there and back (by bus or by privately owned
vehicle). I release from liability the Shelby County Board of Education or
any employee or representative thereof for action, claim, or damage that
may arise as a result of my child’s participation. I give my permission for
any authorized employee to obtain the services of and/or advice from an
available physician or other medical personnel for my child in case of
illness or injury, including any necessary transportation for such emergency
care. I hereby agree to assume ALL responsibility for any costs as a result
of such medical care.

Signed:                                                 Date:
          Parent or Legal Guardian



          Parent’s Email address:________________________________________
                                         Please print clearly
                   COOSA RIVER ADVENTURES, Inc.
DATE: ___________________                                   FLOW RATE: _________________________
Liability Release Statement - In signing this form, I acknowledge this is a high-risk event and understand
that Coosa River Adventures Inc., (CRA) owners and employees, are not liable for any accidents, mishaps or
injuries that may occur. I assume all risks of injury, loss of life and damage to persons and property during such
activity, fully realizing that Coosa River Adventures Inc., or its agents, employees, successors and assigns are
held harmless from all liabilities, claims, demands, costs, losses, expenses or compensation of whatever nature
for loss, damage or injuries to persons and property sustained by me, my heirs, personal representatives,
successors and assigns and all other person, resulting from or in anyway connected with transporting or use of
equipment furnished by Coosa River Adventures Inc., or its agents whether directly or indirectly caused or
contributed to said injury, loss of life or damage to persons or property by their negligent acts, gross negligence
or recklessness. I further agree to reimburse Coosa River Adventures Inc., for all court costs and attorney fees in
defending an action. I, as a parent or guardian or supervisor of a minor child, make this agreement individually
and on behalf of this minor child to induce Coosa River Adventures Inc., to allow this child to participate in this
activity. Personal Flotation Devices (PFDs) should be worn at all times! Lost property of CRA will be
reimbursed as follows: PFDs $15.00 ea., canoe paddles $25.00 ea., kayak paddles $35.00 ea., and lost,
abandoned, or damaged boats will be assessed on a case-by-case basis. Coosa River Adventures Inc. have taken
every precaution to make your adventure as safe as possible, however, river and weather conditions can change
without notice. CRA requests you accurately assess your abilities and physical conditioning before deciding on
a paddling trip. Embarking on a paddling trip is done so at your own discretion and risk.
I HAVE READ THE ABOVE LIABILITY RELEASE STATEMENT AND ACKNOWLEDGE THE
RISKS INVOLVED IN THIS CANOE/KAYAK ADVENTURE. I HAVE GIVEN UP SUBSTANTIAL
RIGHTS BY SIGNING IT AND SIGN IT FULLY AND VOLUNTARILY WITHOUT ANY
INDUCEMENT.

  NAME                           PHONE                      SIGNATURE              DATE
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
         Thank You for Paddling with Coosa River Adventures, Inc.