Camporee 2020 Leaders Guide Sept

CAMPOREE 2020 LEADERS GUIDE SEPT. 25th-27th, 2020 REGISTER YOUR TROOP!

Registration ends September 22nd 2020, the cost for registration is 15.00$ per person.

This event is open to all Scouts BSA participants, and Webelos 1&2.

Registration must be paid before arrival at camp or at the check-in tent on the camp entrance road by Golightly.

Fee covers the cost of registration, patches, insurance and program materials.

Every registered scout will receive a commemorative patch.

PLEASE MAKE SURE TO READ THIS LEADERS GUIDE FOR COVID-19 GUIDELINES

for questions and additional information contact:

Jordan Ash John Beach Nikki Reeder [email protected] [email protected] [email protected] Co-Director Co-Director Co-Director Camporee Camporee Webelos

John Trobough (Chief RSO) Alfred Burford (Chief RSO) Co-Chair ScoutsBSA Co-Chair Cubs Scouts Shooting Sports Shooting Sports Arriving at Camp Currier

Camp sites will be assigned closer to the event, based on requests in Tentaroo and will also be distributed based on camp needs.

Upon arriving at Camp Currier, please proceed to the pop up tent next to the Golightly Cabin to Check-In and Medical Checks. (Please have Documents listed)

What will you need to bring for check in:

-A roster for your troop -A separate roster for Webelos -Proof of registration -Medical forms A and B for EVERYONE, should be present at check-in. -Payment/Receipt of payment.

CRACKER BARREL (INFORMATIONAL IN CAMPSITE)

In place of Cracker Barrel we will do an informational drive around. You will receive information at check in. We will meet you at your campsite to confirm any information needed with the unit leadership and SPL. Please limit this interaction to only 2 adult leaders, the SPL and Camporee Staff team (1-2 people).

-Masks must be worn at all times while at events, and in group settings. No exceptions.

-When you do take your mask off please do so in a safe and socially distanced area.

-One youth per tent.

-Sanitizer and hand washing is a must. We will have Sanitizer provided at each event station. Sanitizer is required to be used before and after each event and before leaving your campsite.

-Scoutmasters are to take and record their temperature and their youths temperature each morning, and turn them in at flag. (Bring your own contact-less thermometer)

-We will have well defined social distance waiting areas for events, please obey the lines.

-Campfire seating areas will be assigned per group, you are required to wear masks at all times during camp fire.

-Minimize mixing groups, do not mix with troops and patrols that are not your unit. - Develop safe dining protocols for your unit. (Check SAFE document)

-Sanitizer and Hand Washing Stations are required even in your campsite. -If you feel sick you are mandated to report the illness to medical staff.

-Always reference the MS- Dept of health Guidelines and the SAFE return to scouting Guidelines.

IF YOU HAVE ANY QUESTIONS, CONCERNS, OR NEED TO REPORT AN ISSUE PLEASE CALL (901)849-6983

Failure to wear masks, obey guidelines or practice safe social distancing will result in the end of your camporee experience. There will be no refunds if you are asked to leave camp for failure to maintain safety protocols.

Friday, Sept. 25, 2020

4:00pm - 9:00pm Troop Arrival/ Check -in Cracker

9:00pm - 10:00pm Barrel

10:00pm 10:30pm Leaders Meeting Taps - All Quiet

Saturday, Sept. 26, 2020

6:30 am - 8:00 am Reveille/Troop Breakfast Please refer to the COVID-19 8:00 am - 8:30 am Opening Ceremony Guidelines, Camp Rules, and (Patrol Leaders Should Bring Patrol Parking Rules included in this guide Flags) for camp guidelines. Please make sure you are adhering to all safety Camporee Events guidelines and camp rules, no 8:30am - 11:30am exceptions.

11:30 am - 12:30 pm Lunch OA callout elections — (Please see an OA representative to set this up)

12:30pm - 3:30 pm Camporee Events (Only Hamilton Events)

3:30pm - 5:30pm Scout Olympics

5:30pm - 7:00pm Iron Chef Cook-Off

5:30pm - 7:30pm Dinner and Clean Up at Troop Campsite

Campfire/Awards Presentation and OA 7:45pm - 9:30pm Call Out (All Scouts Should Attend in Class A Uniform) 10:30pm Taps/All Quiet

Sunday, Sept. 27, 2020

6:30am - 8:00 Reveille /Troop Breakfast and Clean Up in Troop

9:00am - 9:30 am Campsite Inter-Faith Service

9:45am - 11:00am Check-Out/Depart Camp SCHEDULED EVENTS! PATROL COMPETITIONS :

*SIGNED PERMISSION SLIPS WILL BE REQUIRED FOR - Scout rescue SHOOTING SPORTS AND COPE ACTIVITIES AND WILL - First aid NOT BE PROVIDED AT THE EVENT!YOU MUST PRINT - Compass course THEM, FILL THEM OUT, AND BRING THEM WITH YOU - Knot Relay TO THE RANGE!* - Flag etiquette *ALL SCOUTS WANTING TO PARTICPATE IN - Lashings - Fire building - Skits - Bear bag - Rescue rope - Campsite inspections.

SCOUT OLYMPICS: All Patrols will compete in the afternoon Olympic activities. Winners of each event will move on to the next challenge until one patrol reigns supreme!!

RANGE ACTIVITIES a signed permission form is required to participate - Rifle Shooting (Scouts BSA Only) - Archery (Scouts BSA and Webelos) - BB Gun (Webelos) Please refer to the COVID-19 Guidelines, Camp Rules, and C.O.P.E. ACTIVITIES Parking Rules included in this guide for camp guidelines. a signed permission form is required to participate Please make sure you are adhering to all safety guidelines - Climbing and camp rules, no exceptions. - Rappelling DUTCH OVEN CHILI COOKOFF

Unfortunately due to the COVID 19 Guidelines we have had to cancel the Chili cook-off for the safety and wellbeing of the staff and youth.

SUNDAY SERVICE Inter-Faith service will be held at 9:00am in Hamilton Meadows Restart Scouting Checklist As always, the safety of our Scouts, volunteers, employees and communities is our top priority. This checklist outlines several minimum guiding protocols that adult leaders/ volunteers must consider while working with local and state health departments, local councils, chartered organizations and Scouting families on when and how to resume meetings, service projects, camping and all other official Scouting activities.

If it is not practical to meet these minimal protocols, do not restart in-person activities.

S = Supervision ❑ Understand local and state guidance on SAFE Risk-Free preventing COVID-19 exposure. ≠ ❑ Engage your chartered organization and As the response to the pandemic shifts to a local council on necessary adjustments. state-focused, phased approach, the Boy Scouts of America advises local councils to consult with ❑ Conduct the “before you gather” protocols. their local and state health departments, as well as local chartered partners, to implement appropriate protocols to help keep our members, A = Assessment volunteers and employees safe. ❑ Identify participants who fall under the Precautions and mitigation strategies are CDC’s group of higher-risk individuals. important, but they cannot eliminate the Notify all participants about the risks of potential for exposure to COVID-19 or any other illness when in-person activities resume. participating since COVID-19 exposure cannot be eliminated. People with COVID-19 may show no signs or ❑ Verify that the planned activity, gathering symptoms of illness, but they can spread the virus. Some people may be contagious before or group sizes are not prohibited by local their symptoms occur. The fact is that someone or state orders. with COVID-19 may pass the required health screenings and be allowed into program activities.

F = Fitness and Skill The Centers for Disease Control and Prevention (CDC) states that older adults and people of ❑ Review Annual Health and Medical Records any age who have serious underlying medical and consider using a pre-event screening conditions are at higher risk for severe illness for all participants. from COVID-19. If you are in this group, please ensure you have approval from your health care provider prior to resuming in-person Scouting E = Equipment and Environment activities. ❑ Verify that handwashing, hygiene and Every member, volunteer and cleaning supplies are available and used family must evaluate their unique properly. circumstances and make an ❑ Monitor social distancing, interactions informed decision before attending and sharing of equipment and food among in-person activities. participants. We hope this information will be ❑ Monitor participants for changing health helpful as you make that choice. conditions. For updates, please monitor ❑ Use the “as you gather” protocols. https://www.scouting.org/coronavirus Before you gather: As you gather:

❑ Consult your council and chartered organization to ❑ Minimize group sizes. Small groups of participants understand community standards and protocols in place. who stay together all day every day, remain 6 feet apart ❑ Communicate to all parents and youth that the Boy and do not share objects are at the lowest risk. Think of a Scouts of America recommends that no one in the den or patrol that does not mix or gather with other dens higher-risk category take part in person. Continue to or patrols, with supervision that stays with the small group. engage virtually. Scouting’s Barriers to Abuse always apply. ❑ Communicate that anyone who feels sick must stay ❑ Stay local to your geographic area and groups for unit home. If you become sick or develop symptoms, isolate activities. If you must travel, limit mixing with others along yourself then go home and seek care. the way. ❑ Educate and train all participants on appropriate social ❑ Minimize mixing with parents or siblings unless they distancing, cleaning and disinfecting, hand hygiene and are part of the unit activity. For example, the same parent respiratory (cough or sneeze) etiquette before meeting for picks up and drops off youth, and stays in the car. No guests the first time. Periodically reinforce the behaviors or visitors who have not been through the pre-gathering as needed. protocols and screening should take part. ❑ Before attending, upon arrival and at least daily for ❑ Have hand sanitizer, disinfecting wipes, soap and water, longer events, all participants should be screened for any of or similar disinfectant readily available for use at meetings, the following new or worsening signs or symptoms of activities and campouts. possible COVID-19: ❑ Minimize the use of common areas and shared tools. • Cough If unavoidable, they should be thoroughly cleaned and disinfected between uses. • Shortness of breath or difficulty breathing ❑ Develop dining protocols (including but not limited to): • Chills • No self-serve buffet meals or common water coolers. • Repeated shaking with chills • Use of disposable utensils, napkins, cups and plates. • Clean and disinfect eating and cooking gear after • Muscle pain each use. • Headache ❑ Develop tenting protocols for the group: • Sore throat • Minimize use of fans or devices that stir the air. • Campers should sleep head-to-toe in bunks or cots • Loss of taste or smell spaced as far apart as possible. • Diarrhea • Individual tents, hammocks and bivys may be considered. • Feeling feverish or having a temperature greater than or equal to 100.0 degrees Fahrenheit ❑ During program activities: • Equipment that must be shared should be disinfected • Known close contact with a person who is before and after each use. lab-confirmed to have COVID-19 • Where possible, assign activity-related protective ❑ As appropriate, participants should have face equipment for the duration of an event to a single coverings available to wear when gathering or when in individual (life jacket, gloves, harness). public areas or venues. Several coverings per person may • Effective handwashing before and after each program be needed. area use. ❑ Communicate that those who take part in person ❑ In case of an injury or illness, promptly report the should avoid contact with higher-risk individuals for 14 days incident, including COVID-19 exposures. Utilize Incident after the event. Reporting Resources, including COVID-19 instructions.

When you get home: ❑ Avoid contact with higher-risk individuals for 14 days. ❑ Monitor for any signs of illness for 14 days, and ❑ Communicate with your unit leadership should you develop symptoms.

BIN 680-693 June 2020 CAMP CURRIER Chickasaw Council 558 • Eudora, Mississippi CAMP RULES CAMP • Individual troop camping leaders CHECK IN WITH THE RANGER. • Camporee attendees check in at location designated by Camporee Director. CURRIER IS… • Units will follow the guidelines on Guide to Safe Scouting (#34416), BSA Health and Safety Guide (#34415), Youth Protection and Age-Appropriate Guidelines • A LEAVE NO for Scouting. • Scout conduct, youth and adult, is the responsibility of the adult leader in charge. TRACE FACILITY. Scouting units are responsible at all times for the behavior of the scouts in their For more info go to care, adult unit leaders and non-member persons associated with the unit both www.LNT.org inside and outside of your assigned campsite. The Scout Oath and Scout Law are the best guides. First aid and safety are the responsibility of the unit adult leader • A TOBACCO in charge. FREE FACILITY. • NO VEHICLES IN CAMPSITES. Please refer to parking rules for more information. This includes smoking, • PARK IN DESIGNATED PARKING AREAS. smokeless tobacco products • DO NOT BLOCK ROADS. Leave enough room that emergency vehicles can and vaping products. move freely throughout camp in case of emergencies. • No digging in campsites. • AN ALCOHOL • Fires are allowed at campsites unless there is an issued burn ban. One campfire per campsite. Please used established ground fire locations. AND ILLICIT DRUG If there is no established ground fire location, use a fire ring. All fires must be FREE FACILITY. completely extinguished before leaving. Burn rings should be emptied and Persons found with or near the road for pick up. Proper safety elements should be in place and youth consuming alcohol or members should be monitored by a capable adult. illicit drugs will be • PACK IT IN! PACK IT OUT! Do not bury or burn any trash. Dumpster space is escorted off property. limited. If dumpster is full you must take you trash of camp with you. • Water activities require qualified supervision. Those adults supervising must have the proper training and certification for the activities. Notify the Ranger • A PET FREE FACILITY. or Campmaster before beginning any water activities. Pets are not allowed on camp. • COPE COURSE IS STRICTLY OFF LIMITS. COPE Course elements may only be (Service dogs are exempt.) used when qualified instructors are present. • Bath houses are for your convenience. Please keep them clean and in order. Bath houses used by your unit should be policed and cleaned as part of your check out process. • Dining Hall should be used only by the units that reserve the facility. Please refer to Dining Hall Rules. • Please conserve water. Report leaks and broken spigots to the Ranger, Campmaster or Camporee Staff. • Please do not cut any live vegetation without approval from the Ranger. • Picnic tables in campsites may be moved within that campsite. • When ready to check out, remove all gear and police your entire area. This includes campsites, latrine, parking area and any facilities that were used. Contact the Ranger, Campmaster, or Camporee Site Inspector for check out. • If you see anything that needs repaired, doesn’t look right or have suggestions, please let the Ranger, Campmaster, or Camporee Staff know as soon as possible. CAMP CURRIER Chickasaw Council 558 • Eudora, Mississippi PAR PLC PARI Camp Currier is a Leave No Trace facility. This is a park and walk camp. AREAS Please be aware of the camp site set-up and parking rules. Parking lots are found throughout camp… • CENTER ROAD VEHICLES The lot on Center road • Vehicles are not allowed in the campsites; not even to load near Golightly serves as and unload. parking for the South end • Park vehicles parallel to the edge of the road leaving room for of West Road. other vehicles to pass when loading and unloading camping • MAGDOVIT ROAD supplies. Parking lot by the Dining Hall • Park vehicles in designated parking areas. (Tomahawk Lodge). • No “emergency” vehicles will be allowed to park at campsites. • WEST ROAD Main lot is halfway down West Road across from W8. EUIPMENT TRAILERS • Equipment trailers may be parked in campsites when ground Limited parking across conditions are favorable. During wet ground conditions, trailers from W5, at the entrance to are barred from campsites as well. The Ranger, Campmaster, A2 and next to the dam by or Event Coordinator will advise if trailers are not allowed. the lake. • Trailers should only be backed into campsites. Do not pull your • NORTH ROAD trailer through the campsite. Main lot at North Road • Trailers are to be parked to the side of campsites as to minimize Bathhouse. damage to the campsite. Limited parking at N10 • If the pull vehicle is left with the trailer, it must be connected to the trailer. If you wish to disconnect the pull vehicle, it must then • EAST ROAD be parked in a designated parking area. Main lot on East Road across from E2.

Limited parking at A3. UNITS WITH VEHICLES PARKED AT CAMPSITES FOR • RANGE ROAD ETENDED PERIODS REPEATED VIOLATIONS MOVING OR Limited parking next BYPASSING BARRIERS WILL RISK BEING BARRED FROM to R1 and at R3. USE OF COUNCIL PROPERTIES INDEFINITELY.

Parking lot at Rifle Range. CAMP CURRIER EUDORA, MS • CHICKASAW COUNCIL

NO VEHICLES ARE ALLOWED ON THIS N8 SECTION OF NORTH ROAD. 20 NO GATE RT H RO AD R1 ACTIVITY FIELD ON THOSE OCCASIONS WHEN 30 THE RANGES ARE ACTIVE, PAVILION N5 R RANGE ROAD WILL N7 0 GATE AN

PARKING LIMITED G BE CLOSED TO D GATE E N10 OA R RANGE R O ALL TRAFFIC. N11 1 N9 A 20 30 PAVILION ACTION D N6 ARCHERY R2 20 BROKEN GATE PARKING ARROW SPILLWAY LOT BATH GATE

N POND HOUSE O E5 R 20 T 3D H LAKE FOLK R ACHERY O GATE A BOAT RAMP N4 D E4 PECKERWOOD 0 1 POINT N3 ARCHERY

BATH E HOUSE A E3 BOAT S RIFLE PICKLER T A3 HOUSE N2 N1 R COUNCIL RING 30 O 100 CUB 1 A W12 D FIELD PARKING LOT GATE W11 & W12 DOCK CLUB GATE AD HAVE NO ACCESS HOUSE RO W E TO WATER E DINING HALL E2 G S 30 AN T CUB PAVILION R R O W11 A GATE 1 D W10 10 GATE W9 N HAMILTON PARKING LOT O 10 R MEADOWS E1 LIMITED T M H 20 PARKING A M1 G R LIMITED 30 D O PAVILION O A ACTIVITY PARKING V D R3 I PARKING T BATH FIELD 30 W8 Z LOT D HOUSE A2 20 R OA 100 O T R AD EAS W7 1 LIMITED W6 PARKING PAVILION 30 PAVILION SEDGWICK C.O.P.E. FIELD W1 - SITE NUMBER WE 30 W5 ST OFF LIMITS --- # OF TENTS W4 RO 20 AD NO PASS THRU BASED ON 10’ X 10’ TENTS 12 PLACED IN CLOSE PROXIMITY. BATH W1 UNITS SHOULD TAKE INTO W3 HOUSE 30 ACCOUNT SPACE NEEDED 1 FOR DINING FLY AND TRAILER W2 CAMP- MASTER PARKING VEHICLES ARE NOT ALLOWED IN GOLIGHTLY THE CAMPSITES. NOT EVEN TO LOAD CABIN

AND UNLOAD. PARK VEHICLES PARALLEL EAGLE WALK

PARKING

TO THE EDGE OF THE ROAD LEAVING ROOM PRIMITIVE CAMP SITES

LOT

FOR OTHER VEHICLES TO PASS WHEN NO VEHICLE ACCESS L E

LOADING AND UNLOADING CAMPING SUPPLIES. NO WATER S

L I

PARK VEHICLES IN DESIGNATED PARKING AREAS. F SHOTGUN L E TRAINING AREA T TRAILERS EQUIPMENT TRAILERS MAY BE PARKED IN CAMPSITES C HE WHEN GROUND CONDITIONS ARE FAVORABLE. DURING R RO WET GROUND CONDITIONS, TRAILERS ARE BARRED AD LATRINE FROM CAMPSITES AS WELL. TRAILERS ARE NOT TO BE PULLED THROUGH CAMPSITES, A1 WATER BUT BACKED INTO CAMPSITES. 0 TRAILERS ARE TO BE PARKED TO THE SIDE OF COMPOUND GATE CAMPSITES AS TO MINIMIZE DAMAGE TO THE CAMPSITE. RANGER IF THE PULL VEHICLE IS LEFT WITH THE TRAILER, IT MUST BE 304 CONNECTED TO THE TRAILER. IF YOU WISH TO DISCONNECT THE PULL TO HWY 301 VEHICLE, IT MUST THEN BE PARKED IN A DESIGNATED PARKING AREA. TO HWY 61 TO HERNANDO TO TUNICA This permission form is for those Boy Scouts, Venturing Scouts, Cub Scouts or Youth Group CAMP CURRIER Members who wish to participate in the C.O.P.E. ELEMENTS C.O.P.E. elements at Camp Currier. CLIMBI NG WALL This form MUST be completed and presented when the youth arrives at the C.O.P.E. course. NO EXCEPTIONS!! If a youth arrives at the RAPPELLING C.O.P.E. course without a completed and signed permission form he/she will NOT be allowed LOW COPE to participate. The Wall, Horizontal Spider Web, Nitro Crossing, Vertical Spider Web, Island, Trust Fall, WIld Woozie, Whale Watch, Zig-Zag, etc.

I give permission for HIGH COPE Cargo Ladder, Monkey Bridge, Log Cross, ______Postman’s Crossing, The Vines, etc. (scout’s name) to participate in the C.O.P.E. elements of the CONFIDENCE POLE facilities at Camp Currier - indicated on the chart at right. x GIANT’S LADDER

______ZIP LINES Parent or Legal Guardian

______Date This form is for Scouts BSA age CHICKASAW youth only.

COUNCILBOY scours OF ,\)11:�ICA 1 ARCHERY Participation Agreement

John Trobaugh and Shooting Sports Staff / Camporee 2020 is conducting an archery shooting sports program on SEPT.26th,2020. Scouts will be instructed how to handle and shoot Archery safely and be provided instruction to increase their shooting skills. Scouts will have classroomand range instruction in which they will shoot Archery under the supervision of a trained USA Archery Level 1 or higher certified Archery Instructor. Scouts will be required to wear arm-guard protection while on the range.

Scouts are expected to abide by all safety rules and the instructions of the USA Archery Level 1 or higher Archery lnstructor(s). I, the undersigned, give my child, ______registered in Troop / Crew# _____ , permission to participate in this program. I also give permission for the BSA to use any pictures of my child taken at this event. No names will be used without additional permission given.

I understand that participation in this activity involves a certain degree of risk. I have carefully considered the risk involved and give consent for my child to participate in this activity.

I understand that participation in this activity is entirely voluntary. I release the Boy Scouts of America, the Chickasaw Council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from all claims or liability arising out of this participation. For safety, my child and I agree that he/she will do the following or he/she will be removed from the program. 1. Complete the training offered as part of the program.

2. Wear all safety gear while on the range.

3. Follow all safety rules provided in the training class.

4. Follow the instructions of the USA Archery Level 1 or higher Archery Instructor.

5. Do not handle an archery equipment until instructed to do so by the USA Archery Level 1 or higher Archery Instructor. 6. Follow the instructions of the USA Archery Level 1 or higher Archery Instructor.

7. Is registered as a Boy Scout, Sea Scout, or Venturer.

Participant signature------Date: ______Parent/guardian signature ______Date: ______Parent/guardian printed name ______Date: ______

Home phone ______Cell phone ______

Age of the youth: ____ This form is for Scouts BSA age youth only. CHICKASAW

COUNCIL110\' srou rs OF ,11m11c:,1 RIR.ESHOOTING Participation Agreement J 0 0 ohn Trobaugh/ Camporee 2 2 is conducting a Rifle shooting sports event on SEPT. 26th 2020 . Scouts will be instructed how to handle, and shoot a Rifle safely and be provided instruction to increase their shooting skills.

Scouts will have safety and range instruction in which they will fire a Rifle under the supervision of a trained NRA Range Safety Officer and NRA certified Rifle Instructor. Scouts will be required to wear eye and hearing protection while in the shooting area. Scouts are expected to abide by all safety rules and instructions of the Range Safety Officer(s) and Rifle lnstructor(s). I, the undersigned, give my child, ______registered in Troop / Crew# ______, permission to participate in this program. I also give permission for the BSA to use any pictures of my child taken at this event. No names will be used without additional permission given. I understand that participation in this activity involves a certain degree of risk. I have carefully considered the risk involved and give consent for my child to participate in this activity.

For safety, my child and I agree that he/she will do the following or he/she will be removed from the program.

1. Complete the training offered as part of the program. 2. Wear all safety gear while on the range.

3. Follow all safety rules provided in the training class.

4. Follow the instructions of the NRA Range Safety Officer(s) and Rifle lnstructor(s).

5. Do not handle any Rifles until instructed to do so by the NRA Range Safety Officer(s).

6. Follow the instructions of the NRA Range Safety Officer(s).

7. Is a registered Boy Scout, Venturer, or Sea Scout Participant signature Date: Parent/guardian signature Date:

Parent/guardian printed name ______Date: ______

Home phone ______Cell phone ______

Age of the youth: ____ WEBELOS SHOOTING SPORTS

On the next page, we have the permission form for Cub Scout BB and Archery. Parents please make sure to fill this form out for your child to be able to participate in shooting sports. These forms are seperate from the Scouts BSA Archery and Riffle.

Webelos do not meet the age requirements to participate in Scouts BSA archery and riffle.

Please refer to the COVID-19 Guidelines, Camp Rules, and Parking Rules included in this guide for camp guidelines. Please make sure you are adhering to all safety guidelines and camp rules, no exceptions. Appendix 5 ACTIVITY CONSENT FORM AND APPROVAL BY PARENTS OR LEGAL GUARDIAN FORMULARIO DE CONSENTIMIENTO Y APROBACIÓN DE ACTIVIDAD POR PARTE DE LOS PADRES DE FAMILIA O TUTORES

The recommended use of this form is for the consent and approval El uso recomendado de este formulario es para obtener el for Cub Scouts, Boy Scouts, Varsity Scouts, Venturers, and guests consentimiento y aprobación para Cub Scouts, Boy Scouts, Varsity to participate in a trip, expedition, or activity. It is required for use Scouts, Venturers, e invitados para participar en un viaje, expedición with flying plans. o actividad. Es obligatorio para su uso con planes de vuelo.

______First name of participant Middle initial Last name Nombre del participante Inicial del segundo nombre Apellido

Birth date (month/day/year) ______/ ______/______Age during activity ______Fecha de nacimiento (mes/día/año) Edad al momento de realizar la actividad

______Address Domicilio

City ______State ______Zip ______Ciudad Estado Código postal

Has approval to participate in (name of activity, orientation flight, outing trip, etc.) ______BB Gun and Archery ______From ______to ______Tiene la aprobación para participar en (nombre de la actividad, vuelo de orientación, excursión, etc.) De (Date) a (Date) (fecha) (fecha)

INFORMED CONSENT, RELEASE AGREEMENT, AND AUTHORIZATION CONSENTIMIENTO INFORMADO, CONVENIO DE EXONERACIÓN Y AUTORIZACIÓN

I understand that participation in Scouting activities involves the risk of personal injury, including Entiendo que la participación en actividades Scouting implica el riesgo de lesiones personales, incluyendo la death, due to the physical, mental, and emotional challenges in the activities offered. Information muerte, debido a los retos físicos, mentales y emocionales en las actividades que se ofrecen. Se puede obtener about those activities may be obtained from the venue, activity coordinators, or local council. I also información sobre dichas actividades en la sede, con los coordinadores de la actividad o el concilio local. understand that participation in these activities is entirely voluntary and requires participants to follow También entiendo que la participación en estas actividades es totalmente voluntaria y requiere que los instructions and abide by all applicable rules and the standards of conduct. participantes sigan instrucciones y acaten todas las reglas y normas de conducta pertinentes.

In case of an emergency involving my child, I understand that efforts will be made to contact me. En caso de que mi hijo se vea involucrado en una emergencia, entiendo que se realizarán esfuerzos para In the event I cannot be reached, permission is hereby given to the medical provider to secure proper contactarme. En caso de que yo no pueda ser localizado, por este medio otorgo permiso al proveedor de treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. servicios médicos para garantizar el tratamiento adecuado, incluyendo hospitalización, anestesia, cirugía o Medical providers are authorized to disclose protected health information to the adult in charge and/ inyecciones de medicamentos para mi hijo. Los proveedores de servicios médicos están autorizados a revelar or any physician or health care provider involved in providing medical care to the participant. información médica protegida al adulto a cargo, médico o proveedor de servicios médicos involucrado en la Protected Health Information/Confidential Health Information (PHI/CHI) under the Standards for prestación de atención médica para el participante. La Información de salud protegida/Información médica Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as confidencial (PHI/CHI, por sus siglas en inglés) bajo los Estándares de privacidad de información médica amended from time to time, includes examination findings, test results, and treatment provided individualmente identificable, 45 C.F.R. §§ 160.103, 164.501, etc., y siguientes, como se enmiendan de vez en cuando, incluyen resultados de reconocimientos médicos, resultados de pruebas y el tratamiento for purposes of medical evaluation of the participant, follow-up and communication with the proporcionado para fines de evaluación médica del participante, seguimiento y comunicación con los padres participant’s parents or guardian, and/or determination of the participant’s ability to continue in the o tutor legal del participante, o determinación de la capacidad del participante para continuar en las program activities. actividades del programa.

With appreciation of the dangers and risks associated with programs and activities including Con reconocimiento de los peligros y riesgos asociados con los programas y actividades incluyendo preparations for and transportation to and from the activity, on my own behalf and/or on behalf of my preparativos y transportación hacia y desde la actividad, en mi propio nombre o en nombre de mi hijo, por child, I hereby fully and completely release and waive any and all claims for personal injury, death, este conducto eximo total y completamente, y renuncio a cualquiera y toda reclamación por lesiones or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators, personales, muerte o pérdidas que puedan surgir, a la organización Boy Scouts of America, el concilio local, and all employees, volunteers, related parties, or other organizations associated with any program los coordinadores de la actividad y todos los empleados, voluntarios, grupos involucrados, u otras or activity. organizaciones asociadas con cualquier programa o actividad.

NOTE: The Boy Scouts of America and local councils cannot continually monitor compliance of NOTA: La organización Boy Scouts of America y los concilios locales no pueden vigilar continuamente el program participants or any limitations imposed upon them by parents or medical providers. List any cumplimiento de los participantes del programa o cualquier limitación impuesta sobre ellos por los padres o restrictions imposed on a child participant in connection with programs or activities below and proveedores de servicios médicos. Enumerar más abajo las restricciones impuestas a un niño participante counsel your child to comply with those restrictions. en relación con los programas o actividades.

List participant restrictions, if any: ______Restricciones del participante, si existen: ______None Ninguna

______Participant’s signature Date Firma del participante Fecha

______Parent/guardian printed name Parent/guardian signature Date Nombre con letra de molde del padre de familia/tutor Firma del padre de familia/tutor Fecha

______Area code and telephone number (best contact and emergency contact) Email (for use in sharing more details about the trip or activity) Código de área y número telefónico (primer contacto y contacto de emergencia) Correo electrónico (para informar más detalles sobre el viaje o actividad)

Contact the adult leader with any questions: Póngase en contacto con el líder adulto si es que tiene preguntas:

Name ______Phone ______Email ______Nombre Teléfono Correo electrónico

680-673 2014 Printing

Appendix 5 1