RELEASE AND WAIVER OF LIABILITY AGREEMENT

Similar documents
Dear Parents, Students and Leaders,

SANTA FE CLIMBING CENTER LLC SUMMER CAMP REGISTRATION FORM (Please complete and print legibly)

Parental Consent and Permission Form and Waiver For Child Participating In Snowboarding/Ski Trip

Please note: Campers with incomplete/missing forms will not be allowed to participate in REC Kids Camp. You do not need to submit this page.

FALLS CREEK 2017 STUDENT PACKET

Those wanting to participate MUST provide some type of entertainment value within their unit and are encouraged to have a patriotic theme.

Dear Parents, Students and Leaders,

HERC Tour Group Information

Rush Copley Health-Plex Lock-In!!! Lowaneu Allanque Lodge is Inviting You!

Welcome. Family Outdoor Day. on Saturday, June 1, 2013 at. Hunting Hills in Dilliner Pennsylvania!

Weekend on Ropes DAVID COMSTOCK MEMORIAL. October 13-15, 2017 LEADER GUIDE REGISTRATION

Camp Triple J July 27 31, 2015

Cross Country Meet Sunday, October 9, 2016

Sincerely, SUMMER CAVE STAFF

Kit guide. London to Paris 24

2015 Warhawk Bowling Camps

YMCA-YWCA of Winnipeg Kimberly Kids School Age Child Care Summer 2018 Parent Information Guide

Revised 1/22/18. Ride Partners

Welcome to Catalyst Camp 2017

ALL Birthday Party Reserva ons must be made AT LEAST 14 days in advance of the event

Bellingham Yacht Club Youth Sailing 2015 Medical Waiver Form and Class Registration

MICHIGAN AMATEUR HOCKEY ASSOCIATION

SAINT VASILIOS GREEK ORTHODOX CHURCH

Lost Lake Nature Park Kayak Rental Policy (08/15/2016) Keep for your records.

EASTWOOD YOUTH LACROSSE

Skate Park Registration Form

A responsible steward of its lands through a balance of conservation, education and recreation.

Trail to a Cure Ride/Walk/Run Saturday Event Participant Packet Participant Instructions:

Dear 8 th grade students and guardians,

Montana Volleyball Griz Team Camp

A responsible steward of its lands through a balance of conservation, education and recreation.

2015 Ride Guide BEST ON A BIKE THE AUGUST 1-2, 2015 AUGUST 1-2

Race Guide. Indianapolis. Check-In Party. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Location: Time: What s in the Packet?

TRIP DETAILS // MIDDLE FORK

National Tournaments

Caving Club at Indiana University Membership Manual 11 February 2015

Round Denmark Bike Race release and. waiver of liability:

Championship Softball Summer Mini Camp

10 TH ANNUAL. Location: 2614 FM1585 (130 th and University) Muddy, messy fun for a great cause COMMUNITIES IN SCHOOLS OF THE SOUTH PLAINS

Youth Sailor Information

202 TRACKROCK CAMP RD. BLAIRSVILLE, GA REGISTRATION FORM. Name of Camper: Enrolling for:

FIELD TRIP PERMISSION SLIP KINNIKINNICK KIDS CARE KINNIKINNICK CCSD #131

Mercer Area District 2017 Fall Camporee Information Packet Whitewater Rafting Plus October 6 to 8

Runways End Year 4 Residential Monday 30 st March Wednesday 1 st April 2015

getting on bucking stock. This policy helps us control distractions and was put in place to protect your investment.

Race Guide. Arizona. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Road Runner Sports 43 S McClintock Dr Tempe, AZ 85281

Down Wind Sports JR. Mountain bike team

OUTDOOR ED. Huntingtower Year 10 Climb. Student and Parent Information Booklet. 23 rd 27 th Feb 2015

Neil Armstrong s Color Run!! Contests & Prizes

Autumn Antics Open Play Day Horse Show

Canyon Rio Rafting Upper Salt River Day Trip Information Packet

*(Must be a WCRMHC member to ride horseback to the winery) 4/30/17 (insert number attending)

Huntingtower Year 9 Alpine Challenge

John Paul II High School 3036 Saratoga Corpus Christi, Texas 78415

CRAZY CARDBOARD BOAT OFFICIAL BOAT REGISTRATION FORM Saturday July 19, PLEASE PRINT Boat Name: Captain:

After School Bike Club Flying Wheels INFORMATIONAL PACKET. Wednesdays at 3:45pm 5:30pm. * no riding Nov-Feb. All skill levels welcome!

BIG ISLAND JUNIOR GOLF ASSOCIATION ENROLLMENT AGREEMENT CONSENT AND AUTHORIZATION

FRESNO RIVERSPORT CENTER THE PADDLESPORT CAMP

2017 ALS TDI TRI-STATE TREK HANDBOOK PARTICIPANT HANDBOOK

ONU Cheerleading Tryouts

HANMADANG. Faith West Academy Saturday February 5, 2011 Katy Texas. Matted Rings Electronic Scoring Medals Sanctioned by: THE AMATUER ATHLETIC UNION

Hanabi Judo Olympic Week Training Camp

June 11 th 15 th, Information & Registration Packet

Bears, Bears and Bears Oh My! July 21-28, 2019 Lake Clark National Park, Alaska

Race Guide. Buffalo. Check-In Party. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Location: Time: The Color Run Store

Have fun while learning the basic skills, techniques and rules of golf. Beginners and Advanced Players ages 5-15

The arrival of the colder weather marks the countdown to our Year 9 Jindabyne camp.

Deputy Chris Parsons

Towels, wash cloths and toilet articles (soap, shampoo, razor, Extra pair of shoes and additional clothing due to recreational

Youth Group Caving Information for Youth Group Leaders and Parents

GALLATIN COUNTY FAIR PIG WRESTLING REGISTRATION FORM

Risk rating. Hazard Risk Likelihood Consequ ences. Who is responsib le for risk control Leader. Examples of Risk Controls

Registration Due: Thursday, August 23 rd, 2018, 12:00pm To the Henninger Front Desk. Mud Volleyball 2018 Saturday, August 25 th 9:00 a.m.

WALESBY FOREST. The Best in Outdoor Adventure. A Not-for-Profit Organisation

2017 VYF&C REGISTRATION CARD

OUTDOOR ROCK CLIMBING ADVENTURES

guide Youth Aquatics Spring into Action Spring 2019 Table of Contents

American Youth Basketball TOURTM Rules & Regulations

CENTRAL ONTARIO REGION SPRING WORKING RALLY 2018 May 25, 26, Saddlewood Equestrian Centre, Bethany. ENTRIES DUE Tuesday May 1 st, 2018

CAROUSEL PARK & EQUESTRIAN CENTER

Burbank Sister City Committee Burbank Public Library 110 N Glenoaks Blvd. Burbank CA 91502

2019 Student and Parent Handbook. Return Form and Fee by Dec. 15 th. Thursday, January 17, 2019

Down Wind Sports JR. Mountain bike team

Soccer the Brazilian Way 2018 Camp. Announcing our shore Residential Camp

River Lane Ranch Fall Finale Horse Show Gypsy Vanner Division & All Breeds Division

BIG PINE SCHOOLS SKI & SNOWBOARD PROGRAM Welcome to the SKI & SNOWBOARD YEAR!

SMG Youth Group Paintball Event

LOWER LOUDOUN BOYS FOOTBALL P.O. BOX 163 STERLING, VA 20167

2018 Open to Non-Members

TROOP 349 Falls Church, VA. Troop 349 Ski Trip

General Packing List 2. Running Packing List 6

OFFICIAL VOLUNTEER PACKET

Ft Johnson Estates Swimming Pool Club 2017 Rules, Regulations, & Liability Waiver

Montana de Oro Endurance Ride May 30, 2015 AERC Sanctioned 25/50 Mile Rides

Elizabethton Parks and Recreation Adult Coed Kickball 2017

~ TLC Middle and High School Summer Camp~ Ocoee Retreat Center 186 Hawkins Drive, Ocoee, TN Phone

2015 SCA Cheerleader Camp McNeese State University, Session II

El Molino High School The Shock Run 5k Fundraiser

Lesson Program. Thanks again for choosing the Ft. Lauderdale Diving Team!

Island Surf and Sport Flagler Beach Surf Camp 2015

Transcription:

RELEASE AND WAIVER OF LIABILITY AGREEMENT A unique cave exploration experience ( Caving ) may be available during your CHIC trip. Caving is a free and completely optional activity. This will be a wild caving experience in Kentucky. Wild caving means that there are no sidewalks, lights, handrails, or other improvements within the cave! This trip involves a variety of rigorous physical activities. These include, but are not limited to: climbing, crawling, wading, rappelling, hiking, walking, etc. If there are any medical conditions that could be affected by these or other strenuous activities, contact your physician or other appropriate medical professional for guidance. Please list any relevant medical conditions and any medications that are currently being taken by the participant: I authorize any emergency medical treatment required for the participant listed below in the event that I cannot be contacted. Emergency Contact: Name: Phone #: I (parent/guardian) authorize ( Participant ) to participate in the Caving and related activities. I understand that there are certain inherent risks in caving and related activities that can result in permanent injury or death. These risks include, but are not limited to: * Slips, trips, falls, or painful crashes due to pits, boulders, loose debris, cliffs, inclines, declines, wet areas in the cave, non-level ground and travel surfaces, and other causes. * The risk of injury by failure to wear head protection, failure of any equipment or head protection device(s), and banging my body on rock protrusions or the ceiling. * The fact that since all caves are underground they may flood and have high water levels which can cause drowning or hypothermia. * The complicated labyrinth of passages in a cave which may cause me and other members of my party to get lost or entrapped. Participant agrees to follow all instructions given by caving guides and to use all caving/safety equipment appropriately. I on my behalf and the behalf of any minor in my charge or for which I am parent, legal guardian or otherwise responsible, any heirs, personal representatives or assigns, do hereby release the Bemidji Evangelical Covenant Church, Christ s Outreach for the Blind, and any persons or organizations involved with this activity or trip from all liability and waive any claim for personal injury, property damage, or wrongful death occurring to me and/or any minor in my charge or for which I am parent, legal guardian or otherwise responsible from any cause whatsoever. Participant Signature Parent/Guardian Signature Participant Printed Name Parent/Guardian Printed Name Date Date

One of the Entrances! All done! Relatively clean trip :) * We will be caving in Mt. Vernon, KY, about 2 1/2 hours south of Cincinnati. About 5 miles total out of the way to Knoxville. We will meet and prepare our equipment at Christ s Outreach for the Blind. * The Cave is about 52 F all year. We ll be in there 2-4 hours depending on what we decide to do in the cave. * We don t recommend you bring any non-waterproof electronics into the cave, the dirt is super fine and really gets into things like clothing and cameras. We ll have waterproof cameras with us to take pictures, and email to everybody. Devices that require communications with the outside world (phone, GPS, PLB, etc) won't work in the cave. * You must have long sleeves, long pants, and tennis/hiking shoes/boots (they might not ever be the same). Sometimes they are savable after 4-5 washes, but since we have the whole trip ahead of us it might be nice to just wear clothes that you no longer want, and could throw away. Garden/work gloves are optional. We would also recommend you wear thin shorts and shirt under your caving clothes, because as soon as we get out of the cave, we will be continuing to Tennessee with no showers or changing faclities. We might have a hose. Maybe. But, you ll definitely need to change before we get back on the bus. * You should bring your own LED headlamp and batteries. If you are unable to come up with a headlamp, please let us know prior to the trip we will try to find one for you. If you do not have an appropriate LED headlamp you will not be able to go caving. Something like the one below will probably be fine (around $10). You will also want a backup light and batteries, but that can be pretty much any light that you can duct tape to your helmet: * We ll split up into groups, Nancy Howard guiding one, Steve guiding the other. If Katie comes along, she will guide wherever needed. * Nancy started caving as a student teacher in 1990. Steve has been caving since 1997, and they have been taking school and church groups ever since. Katie started caving when she was seven. This will be her sixth year guiding groups.

WHAT TO PACK Below is a list of recommended items to pack for CHIC. See Standards of Conduct for more details. What to bring:!alarm clock!beach towel!bible!camera!closed toe shoes for rafting (optional)!comfortable walking shoes!insect repellent!journal and pen!long pants!medications!modest Swim Suit!Pajamas!Raincoat!Shorts!Spending money!stamps!sunglasses!sunblock!sweatshirt/light coat!tennis racket (optional)!toiletries!t-shirts!underwear!water bottle!a bag, I.e. a backpack or large tote, to carry all the supplies you will need for the day. (The campus is too large to run easily back to the dorms between activities. You should plan on carrying everything you ll need.) Items provided by University of Tenn:!Bed linens!towels!soap Skate Park Equipment CHIC will NOT provide any equipment (skateboards, in-line skates, or helmets/pads); individuals wishing to use the Knoxville Skate Park must provide their own equipment.!skateboard!in-line skates!helmet and pads Luggage: Each person is limited to: 1 pillow 1 large or 2 small bags 1 carry-on for bus travel 1 small bag for caving supplies. What not to bring: Alcohol Any dangerous weapon Controlled substances Firearms Fireworks Immodest clothing Laser pointers FOR CAVING ON THE TRIP DOWN: In a separate small carry on bag, please bring:!clothes that can be thrown away- long sleeve shirt, long pants - wear shorts and t-shirt underneath, we will be continuing to Tennessee without a shower!!tennis/hiking shoes!led headlamp,!backup light (can be any light you could duck tape to a helmet)!extra batteries!plastic bag to hold muddy/wet items when finished Excursions (special requirements): White Water Rafting: *Shoes/sandals with a back/strap on them Horseback riding: *Long pants *Closed toes shoes, no flip-flops or sandals Hiking: *Comfortable shoes to walk in *Water bottle *Rain coat/ jacket we will walk in the rain. The only money your student will need is for snacks, souvenirs, and extras so please plan accordingly. There will be music, shirts, books and other merchandise from the bands and speakers available to purchase.

CHIC 2015 Schedule! SATURDAY, JULY 11 7:00 am Leader s Meeting at Church 8:00 am Meet & Load Bus (BE ON TIME!!) 12:30 am Stop in Maple Grove Supper Madison, WI??? Driver Change in Bloomington, IL > SUNDAY, JULY 12 Morning Caving 11am-6pm Welcome Party (arrive sometime during Welcome Party) 5-7pm Dinner 6-7pm Counselor Meeting 7-7:30pm Staff Meeting Afterwards > MONDAY, JULY 13 Excursions: Paintball -1:00PM, Horseback Riding/Cave 12:45PM > TUESDAY, JULY 14 Excursions - White Water Rafting, 11:00AM

> WEDNESDAY, JULY 15 Excursions: The Lost Sea -12:30PM, Shopping 1:00 PM > THURSDAY, JULY 16 Excursions: Hiking - 1:00PM, Alpine Tower 1:00PM > FRIDAY, JULY 17 By 10am Check Out & Head Home, Breakfast on the Bus " > SATURDAY, JULY 18 9:30-10:00 am Arrive Home in Bemidji