Department of the Army s25

DEPARTMENT OF THE ARMY CLINTON HIGH SCHOOL 600 EAST CLINTON STREET CLINTON, MISSOURI 64735

ATOW-CHS-MO May 28, 2008

MEMORANDUM FOR SAIs, AIs and Raider Challenge Commanders

Subject: 1st Annual Golden Valley “Raider Challenge”, 13 Sep 2008

1. Purpose. The purpose of this letter is to publish the events, guidance and sequence of events for the 1st Annual Golden Valley Raider Challenge hosted by the CHS JROTC Cardinal Battalion. This event will be held on Saturday the 13th of Sep 2008 at National Guard Armory in Clinton MO. The 6 events included in the Golden Valley Raider Challenge will be:

a. Army Physical fitness test (Encl # 1)

b. One-Rope Bridge (Encl # 2)

c. Biathlon (includes marksmanship) (Encl # 3)

d. 10-K Road March (Encl # 4)

e. Raider Challenge Course (Encl # 5). Consists of:

(1) Knot tying (8 stations 1 per cadet)

(2) 25ft Rope Climb

(3) Sand Bag Shuffle (30 yards)

(4) Rope Traverse

(5) Board Walk

(6) Casualty Evacuation. W/dummy on stretcher and obstacle course

(7) Truck Pull

(8) Map Reading Test (8 stations 1 per cadet)

f.. Surprise Event (No Enclosure - Explained on site)

Clinton High School Page 1 of 27 26 June 2008 Change 1 Subject: 1st Annual Golden Valley “Raider Challenge”, 13 Sep 08

2. General Information:

a. Sequence of Events. Friday, 12 Sep 2008

121800SEP08 In process

Teams that are NOT available to arrive after 1800 hrs on 13 Sep will be in processed at 0500 hrs 13 Sep 08.

Saturday, 13 Sep 2008

130530SEP08 Commanders’ Call

130600SEP08 Movement to PT field

130615SEP08 APFT

130800SEP08 Breakfast, Issue meals, Recovery and prep time and move out to events

130900SEP08 Begin Events

131530SEP08 Closing and award ceremonies

b. Administrative Notes.

(1) Someone will be at the Clinton National Guard Armory to register teams between 1800 hrs and 2000 hrs, Fri, 12 Sep 08 and 0430 hrs, Sat, 13 May 08 until just prior to the Commanders’ Call.

(2) Instructors Responsibility. Must bring Covenant Not to Sue, Medical Release Form, statement of Health, and statement verifying rifle instruction, rifle exam and safety pledge for each cadet participating.

(3) Team Size. Each team will consist of 8 members. Schools may enter up to as many teams for competition. Teams must start and finish with all 8 members for the entire course. If for some reason a raider gets hurt and cannot finish any event, a penalty of 20min will be added to the event time.

(4) Safety: Safety precautions are required at all times during the competition. Team Advisors are requested to enforce safety rules and use general caution at all times. Please report any accidents and incidents to the Raider Challenge Command Center (RCCC), in case emergency medical assistance is

Clinton High School Page 2 of 27 26 June 2008 Change 1 Subject: 1st Annual Golden Valley “Raider Challenge”, 13 Sep 08 needed. IAW routine JROTC procedures, schools must submit a "Convent Not to Sue Form", for each of their participating cadets. Clinton High School and the Clinton National Guard will not be held responsible for accidents or injuries. Team advisors MUST bring all release forms, properly completed, and turned into the Toc prior to the competition. There are NO exceptions to this liability waiver issue.

c. Uniform/Equipment:

(1) Instructors. Uniform for this event is complete BDU/ACU uniform.

(2) Raider Challenge Team Members.

(a) Uniform for this event is complete BDU/ACU uniform.

(b) Pistol belt w/ 1 quart canteen and cover.

(c) For the APFT, cadets will wear brown/tan undershirt or team t-shirts, belt, BDU/ACU trousers and athletic shoes.

(3) Chaperones. Civilian clothes.

(4) Raider Team Equipment.

(a) 1 Each Compass.

(b) 1 Each Rucksack

(c) 1 each 100-120 ft Rappelling Rope (carried in the rucksack)

(d) 8 ropes for Swiss Seats (carried in the rucksack)

(e) 10 Snap Links (carried in the rucksack)

(f) 8 Pair of Leather Gloves (optional)

(g) First Aid Kit

d. Logistics.

(1) Check-in will be at Clinton National Guard Armory. (Strip Map/Instructions to follow).

(2) Cots and showers will be available for teams wishing to arrive the night before. There are separate bays for males and females.

(3) The Clinton National Guard will provide breakfast on Sat, 13 Sep 08. The Clinton National Guard will provide Heater Meals/MRE’s for cadets for the noon meal on Sat, 13 Sep 08. The Heater Meals/MRE’s will be issued during breakfast on Sat, 13 Sep 08.

Clinton High School Page 3 of 27 26 June 2008 Change 1 Subject: 1st Annual Golden Valley “Raider Challenge”, 13 Sep 08

3. Trophies and Awards.

Overall Team Trophy: 1st through 3rd Place

Army Physical Fitness Trophy: 1st through 3rd Place

One Rope Bridge Trophy: 1st through 3rd Place

Biathlon Trophy: 1st through 3rd Place

10K Road March Trophy: 1st through 3rd Place

Raider Challenge Course Trophy: 1st through 3rd Place

Surprise Event: 1st Place Overall

A medal will be awarded to each member on the 1st, 2nd and 3rd place overall teams.

A certificate for each cadet on the 1st through 3rd place teams for each event.

All cadets participating will receive a participation certificate.

4. Entry Requirements. A basic Entry Fee per 8 member team will be $100.00. Fees must be paid in full during in processing. Please make checks payable to "CHS JROTC". Entry fee must be submitted with the Registration Form at Enclosure # 6.

5. Our number one priority is safety. We are also committed to have fun and share camaraderie in a safe environment. Anytime we can get JROTC Cadets together is a great training day.

6. POC this memo is: Technical Questions – 1SG (Ret) Wayne W. Cogdill at (660) 885-2247 ext 126, or email [email protected]. Admin Questions – MAJ (Ret) Norm King at (660) 885-2247 ext 126, or email [email protected] . ORIGINAL SIGNED Encl: WAYNE W. COGDILL Jr. 1-APFT First Sergeant, U.S. Army (Retired) 2-One Rope Bridge Army Instructor 3-Biathlon 4-10 K Road March 5-Raider Challenge Course 6-Entry Form 7-Statement of Physical Condition 8-Covenant Not to Sue 9-Consent to Medical Treatment Clinton High School Page 4 of 27 26 June 2008 Change 1 GOLDEN VALLEY RAIDER CHALLENGE

EVENT: ARMY PHYSICAL FITNESS TEST (APFT) ENCL#1

TASK: Each team member will take the APFT. This is a scored event.

CONDITIONS:

1. Uniform:

a. Brown/tan undershirt or team T-Shirt.

b. BDU/ACU Trousers

c. Black cotton web belt with black belt buckle/riggers belt..

d. Running shoes with socks.

2. Scored Tasks:

a. Push Ups

b. Sit Ups

c. 2 Mile Run

3. Scorecards: Will be issued out at registration and will become the responsibility of the team captains.

STANDARDS:

1. Standards will be IAW FM 21-20, Chapter 14. (All scores IAW youngest age group).

2. Males will be scored using the Male Scoring Table.

3. Females will be scored using the Female Scoring Table.

4. Winning teams will be determined by using the highest team’s total averages.

5. In the event one or more teams have the same total average, the highest team average for Push Ups will be used, then Sit Ups, 2 mile run.

6. Team trophies will be awarded for 1st, 2nd, and 3rd places.

Clinton High School Page 5 of 27 26 June 2008 Change 1 GOLDEN VALLEY RAIDER CHALLENGE

EVENT: One Rope Bridge ENCL#2

TASK: The team must properly construct a one-rope bridge using the proper knots and equipment. Move all team members and equipment across the bridge(s) and deconstruct the bridge(s). This is a timed event.

CONDITIONS:

1. The time will start when the command “GO” is given and the time will stop when all team members have crossed the obstacle and all knots on the one-rope bridge have been untied snaplinks removed.

2. Equipment: In addition to the assigned uniform (ie, BDU/ACU Cap, BDU/ACUs, Boots, etc), the team must have:

a. one (1) 120 foot Rappel Rope

b. 8 sections of rope to construct Swiss Seats

c. 8 pairs of Leather gloves (optional)

d. 10 each snap links

e. one each 30 pound rucksack

3. The far-side anchor must have at a minimum two (2) round turns and two (2) half hitches.

4. The near side anchor must use an approved transport tightening system knot and have at a minimum two (2) round turns and two (2) half hitches.

5. The first team member and the last team member of the team will be required to wear an Aussie Seat. The remaining 6 team members must wear a properly constructed Swiss-seat with snap link.

6. A boundary line will be marked on the ground near the far side anchor and the near side anchor. The area between these 2 marks is considered a restricted area and may not be touched by team members except for the first and last team members during their crossing.

7. One team member must cross the rope with the 30 pound rucksack (provided).

Clinton High School Page 6 of 27 26 June 2008 Change 1 STANDARDS:

1. The team constructing a one-rope bridge, moving across the bridge, and removing the bridge in the fastest time, including penalties, will be the winner. Trophies will be presented for 1st, 2nd, and 3rd places.

2. PENALTIES:

a. A (1) minute penalty will be added for every knot improperly tied.

b. A (1) minute penalty will be added for each member of the team who crosses the obstacle and touches the ground, or any part of their equipment touches the ground.

c. A (1) minute penalty will be assessed for every piece of equipment that drops while negotiating the obstacle.

NOTE: Each team will bring its own rope bridge equipment and carry it throughout the course of the challenge. Field Packs are the responsibility of each school.

EVENT: BIATHLON (Rifle Change 1) ENCL#3

TASK: All team members will line up behind the start/finish line. On the command of “GO,” the clock will start and the first four members will secure a sandbag, run to the firing line, take up a good prone position, aim, take the rifle off safe, shoot at a target located 10 meters from the firing line, place the rifle on safe, open the bolt, lay the rifle on the mat, run back to the start/finish line and tag another team member who will then repeat the process. The time will stop when the eighth team member crosses the finish line.

CONDITIONS:

1. Uniform: The assigned uniform for the entire event (ie, BDUs, Cap, Pistol Belt with Canteen, etc)

2. Rucksack: May be left at the start/finish line during this event.

3. Sandbags: Each team member will carry a sand bag from the start/finish line to the firing line and bring the sandbag back from the firing line to the start/finish line. Each sandbag will weigh 10 pounds.

4. Air Rifle: Will be stationary at the firing line.

5. Loading and Pumping the Air Rifle: The Range Safety Officer/Judge will ensure that the rifle is loaded, pumped, and pointing down range prior to the first team member firing and the Range Safety Officer/Judge will quickly load and pump the rifle between firers. The sights will be zeroed by the CHS SAI for both elevation and windage. Raiders shooting the air rifles WILL NOT shoot sighting rounds. Shooters will not use shooting gloves or slings.

6. Rifle Malfunction: The event OIC/NCOIC will ensure that a backup air rifle(s) is on sight (at the Firing Line) in the event of a rifle malfunction. This/these backup rifle(s) will remain loaded and ready to be fired. In the event of a malfunction, the Range Safety Officer/Judge will take the malfunctioned rifle from the team member (keeping the barrel pointed down range), secure it and provide the shooter with a ready rifle. When the team finishes the event, the Range Safety Officer/Judge will inform the Official Scorer of the malfunction and 20 seconds will be deducted from the overall team’s time for each malfunction that was determined not to be due to operator head space.

7. Cease/Stop Firing: In the event someone sees an unsafe act or condition and calls a Cease/Stop Firing on the range, the team will start over with a fresh target. Clinton High School Page 8 of 27 26 June 2008 Change 1 STANDARDS:

1. Official Team Time: Will be from the command of “GO” until the eighth team member crosses the finish line plus any penalty time added, minus any malfunction time.

2. Scoring of Targets: Will be IAW the Civilian Marksmanship Program (CMP) rules. Each pellet hole will be scored as 0-10 points using the BMC target. Maximum score for a team is 80 points. All air rifle targets will be retained for verification after each team completes the event. Three seconds will be subtracted from the team time for each point scored on Marksmanship.

3. Penalties:

a. Dropped Equipment (i.e., BDU Cap, Canteen, etc): 1 minute added to the overall time for each item.

b. Forgetting a Sand Bag: 1 minute added.

c. Targets: Three seconds will be subtracted from the team time for each point scored on Marksmanship.

4. Winner: The team with the shortest time wins. If one or more teams have the same time, then the winners will be decided by the team scores from the targets. Team trophies will be awarded for 1st, 2nd and 3rd place.

5. Certification: Schools will provide a signed letter of certification indicating raider team members are approved to shoot air rifles IAW the rules and regulations established by Cadet Command.

NOTE: SAFETY IS OUR #1 PRIORITY

Clinton High School Page 9 of 27 26 June 2008 Change 1 EVENT: BIATHLON (Dart Throw Change1) ENCL#3

TASK: All team members will line up behind the start/finish line. On the command of “GO,” the clock will start and the first four members will secure a sandbag, run to the firing line, secure a dart, and throw one dart at a target (BMC) located at a distance of 3 meters. After throwing the dart each team member will run back to the start/finish line and tag another team member who will then repeat the process. The time will stop when the eighth team member crosses the finish line.

CONDITIONS:

1. Uniform: The assigned uniform for the entire event (ie, BDUs, Cap, Pistol Belt with Canteen, etc)

2. Rucksack: May be left at the start/finish line during this event.

3. Sandbags: Each team member will carry a sand bag from the start/finish line to the firing line and bring the sandbag back from the firing line to the start/finish line. Each sandbag will weigh 10 pounds.

4. Darts: Will be stationary at the firing line.

5. Scoring: The dart must stick to the target or a hole must be visible when the target is held up to the light.

6. Malfunction: There are no malfunctions for dart throwing.

7. Cease/Stop Firing: In the event someone sees an unsafe act or condition and calls a Cease/Stop Firing on the range, the team will start over with a fresh target.

STANDARDS:

1. Official Team Time: Will be from the command of “GO” until the eighth team member crosses the finish line plus any penalty time added. Dart throwers will each have 8 seconds added to their time due to the non requirements of assuming a prone position and operating a rifle.

2. Scoring of Targets: Will be IAW the Civilian Marksmanship Program (CMP) rules. Each pellet hole will be scored as 0-10 points using the BMC target. Maximum score for a team is 80 points. All dart targets will be retained for verification after each team completes the event. Three seconds will be subtracted from the team time for each point scored on dart throwing.

Clinton High School Page 10 of 27 26 June 2008 Change 1 3. Penalties:

a. Dropped Equipment (i.e., BDU Cap, Canteen, etc): 1 minute added to the overall time for each item.

b. Forgetting a Sand Bag: 1 minute added.

c. Targets: Three seconds will be subtracted from the team time for each point scored on Marksmanship.

4. Winner: The team with the shortest time wins. If one or more teams have the same time, then the winners will be decided by the team scores from the targets. Team trophies will be awarded for 1st, 2nd and 3rd place.

5. Certification: Schools will provide a signed letter stating that they have no marksmanship program.

NOTE: SAFETY IS OUR #1 PRIORITY BMC TARGET

Target not to Scale. Actual Target is approximately 6 inches in diameter.

EVENT: 10 KILOMETER ROAD MARCH ENCL#4

TASK: The team must complete the 10K Road March with all team members in order not to be penalized. This is a timed event.

CONDITIONS:

1. Uniform for this event is: Complete BDU/ACUs uniform. Pistol Belt, and Canteen full of water (canteen must be full at the beginning of the event).

2. Each team will start from the start/finish line.

3. Time will start on the command “GO” and stop when the last team member crosses the start/finish line.

4. All eight-team members must finish together within the 20 meter mark on the ground at the finish line.

5. The team will carry one rucksack weighing 30 lbs provided at the start point.

STANDARDS:

1. For each item of equipment missing at the end of the 10K Road March, 1 minute will be added to the team’s overall time.

2. Teams must cross the finish line with all members within 20-meters of each other. Failure to do so will result in a 20 minute penalty.

3. All 8 members must finish the 10K. There is a 20 minute penalty added for each team member not completing the 10K.

4. Winners: The teams with the shortest times, including penalties, will be the winners. Trophies will be presented for 1st, 2nd, and 3rd places.

NOTE:  SAFETY IS OUR #1 PRIORITY  Guides and water points will be placed along the route.

EVENT: Raider Challenge Course ENCL#5

TASK: Each team will negotiate eight different stations, while carrying assigned equipment, throughout the course. This is a timed event.

CONDITIONS:

1. Uniform: Complete BDU/ACU uniform

2. Equipment:

a. Individual.

(1) Pistol Belt

(2) 1 Quart Canteen with Cover

(3) 1 pair Leather Gloves (OPTIONAL)

(4) 1 Snap Link

(5) 1 Swiss Seat

b. Team.

1. One each 30 pound rucksack

2. One each 120 fool Rappel Rope

3. Two each Snap Links

3. Upon the command “GO”, time will start and teams will move out on the course carrying assigned equipment with them.

4. Teams will negotiate all events.

5. Throughout the course, teams will encounter stations where they will have to perform skills of strength, endurance, accuracy, and knowledge. Penalty (minutes) will be added to course run time according to performance of the team at each station. Stations will include:

Clinton High School Page 13 of 27 26 June 2008 Change 1 Knot Tying (8 stations 1 per cadet) 25ft Rope Climb Sand Bag Shuffle (30 yards) Rope Traverse Board Walk Casualty Evacuation. w/dummy on stretcher and obstacle course Truck Pull Map Reading (Written) (8 stations 1 per cadet)

6. Time will stop when the team has completed all 8 stations and crosses the finish line with all equipment and team members.

STANDARDS:

1. Winners: The team with the lowest time after penalties have been calculated will be the over all winner.

2. If there is a tie the winner will be determined by the least amount of penalties.

3. Trophies for 1st, 2nd, and 3rd places will be awarded.

EVENT: Raider Challenge Course

STATION: Rope Traverse

TASK: At this station there will be a 1 inch rope tied to 2 trees. Each team member will cross the rope without touching the ground inside the designated area.

CONDITIONS:

1. Uniform:

a. BDU/ACU complete.

b. Pistol Belt w/Canteen full of water

STANDARDS:

1. If a cadet touches the ground out side the safe area the cadet will have the choice to start over or get a 5 Minute Penalty.

STATION: Board Walk

TASK: At this station teams will be required to have all 8 members standing on two 12-foot boards with ropes in both ends. The team will stand on the boards and using the ropes, will walk 50 feet.

CONDITIONS:

1. Uniform:

2. When the team captain gives the command “GO”, the team will walk while staying on the boards for a distance of 50 feet. The lane grader will give the command of "STOP". The team will then proceed to the next station.

STANDARDS: If a raider touches the ground between the start and finish lines the team must start over.

STATION: Casualty Evacuation with dummy on stretcher and obstacle course

TASK: Each team will evacuate 2 casualty’s using the stretchers provided through the designated course.

CONDITIONS:

1. Uniform:

STANDARDS:

1. Evacuate the casualties using the 2 stretchers provided through the designated course without dropping the casualty. If the casualty is dropped off of the stretcher the raiders must start over from the start point.

STATION: Knot Tying

TASK: At this station each team member will tie one (1) of the following knots:

Bowline Clove Hitch Double Fisherman’s Double Sheep Bend Prussic Square knot Figure Eight Slipknot Butterfly

CONDITIONS:

1. Uniform:

a. BDU/ACU Cap

b. BDU/ACUs (Shirt and Trousers)

c. Boots

d. Pistol Belt w/Canteen full of water

2. Each team member will move to a table and look at the card and correctly tie one of the above knots on it. It will be the responsibility of the team member to correctly tie that knot. Individual must tie his or her own knot without assistance.

STANDARDS: One Minute (1) will be added to team score for each incorrect knot and attempts to assist others. The knots will stay in place until the team completes the course. The reason for this is the team captain can challenge.

STATION: Map Reading Test

TASK: At this station each team member will come to a map (1:50,000) and be required to do one of the following:

Find a feature using an 8-digit grid coordinate Measure Grid Azimuth (+/- 1 degree) Calculate distance from point to point on the map (+/- 50 meters) Find an Azimuth using a Compass (+/- 2 degrees) Measure elevation Identify a terrain feature List the 10 terrain features List the five basic colors of the map

CONDITIONS:

1. Uniform:

2. Each team member will move to a table with one of the above requirements on it. Once at the station the raider may not switch tables. It will be the responsibility of the team member to correctly answer/complete the requirement on the card. Individual team members must accomplish their assigned task.

3. Map reading materials will be provided at the station.

STANDARDS:

1. Each task is a “GO” or “NO GO”.

2. One (1) minute will be added to the team’s overall time for each “NO GO”.

STATION: Military Vehicle Pull

TASK: The team will attempt to pull a military style vehicle at a set distance.

CONDITIONS:

1. Uniform:

2. All equipment required for completion of this event will be provided at the site.

STANDARDS:

1. Time will start when the Scorer gives the command “GO” and will stop when the Scorer gives the command “STOP”.

2. Failure to pull the vehicle a set distance will add 5 minutes to the overall time.

STATION: Sand Bag Shuffle

TASK: At this station you will find 32 sandbags filled with sand stacked on a wood pallet. The team will carry each sandbag 30 yards from one (1) pallet to the other pallet and stack them.

CONDITIONS:

1. Uniform:

2. When the team moves to the first pallet the cadets will start moving the sandbags from one pallet to the other pallet.

STANDARDS: All thirty-two sandbags will moved from one pallet and be stacked on the other pallet. For each sandbag that falls off of the pallet prior to the team finishing the raider course, the team will receive a (1) minute penalty.

STATION: Rope Climb

TASK: Each member of the team will be required to climb a 25-foot rope, ring the bell at the top, come back down and tag the next team member.

CONDITONS:

1. Uniform:

2. All members of the team can assist the team member climbing the rope as far as no other team members’ feet leave the ground other than the one climbing the rope.

STANDARDS:

1. One (1) minute will be added to course run time for each violation of the instructions in the above requirements.

SAFETY:

1. Do not slide down the rope. There is no penalty but injury can occur.

Clinton High School Page 22 of 27 26 June 2008 Change 1 CLINTON REGISTRATION FORM 13 Sep 2008

SCHOOL: ______

TEAM NAME: ______

ADDRESS: ______

______

PHONE: ______FAX: ______E-MAIL: ______

INSTRUCTOR: ______

TEAM MEMBERS

NAME (LAST, FIRST MI) GENDER 1. 2. 3. 4. 5. 6. 7. 8.

Please submit this NLT 1 Aug 08. Make checks payable to CHS JROTC. Email to [email protected] or mail entries to: JROTC, 600East Clinton Street, Clinton, MO 64735.

Clinton High School Page 23 of 27 26 June 2008 Change 1 Golden Valley Raider Challenge Clinton, Missouri 13 Sep 2008

STATEMENT OF PHYSICAL CONDITION

To the best of my knowledge, my son/daughter/ward is in good physical condition. Participation in the Golden Valley Raider Challenge Course, 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 ______medication.

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)

COVENANT NOT TO SUE OFF-CAMPUS TRAINING AND PRACTICAL FIELD/HIGH-RISK TRAINING ______

DATA REQUIRED FOR PRIVACY ACT OF 1974

1. AUTHORITY: Title 10, U.S. code 2301. 2. PRINCIPAL PURPOSE (S): To release the U.S. Government, the host institution and the state in which said institution is located for 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 and high-risk training. 4. MANDATORY OR VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION: Voluntary. Failure to complete form will disqualify JROTC the cadet from participating in specific voluntary training exercises. ______

I, ______, residing at ______, (Type or print cadet's full name) (Street Address) ______, ______, (City) (State) do hereby agree that in consideration for being allowed to participate in Golden Valley Raider Challenge, conducted by the Clinton School District AJROTC, 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 hereby RELEASE AND DISCHARGE FOREVER, the United States Army, the State of Missouri, Missouri Army National Guard, and the School District of Clinton, Missouri 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, the State of Missouri, the Missouri National Guard, and the School District of Clinton, MO blameless for any and all damages which I may cause either intentionally or through my negligence.

______(Typed or printed Name of Parent or Guardian) (Signature of Parent or Guardian)

______(Relationship to Cadet) (Date)

WITNESSED BY: ______13 Sep 2008 (Age of Cadet) (Period Covered)

______(Signature of Cadet)

ATCC Form 145-14-2R, May 93

CONSENT TO MEDICAL TREATMENT

STATEMENT REQUIRED BY PRIVACY ACT OF 1974

1. AUTHORITY: Title 10, U.S. Code 2102. 2.PRINCIPAL PURPOSE(S): A statement authorizing medical care in civilian or government medical facilities while attending or traveling to or from the Clinton Raider Challenge Course. 3. ROUTINE USES: Normal Personnel Actions: Disclosure of information may be provided to proper authorities in actions regarding medical treatment, legal actions as a result of injury or death, and investigation of accident resulting from Clinton Raider Challenge Course. 4. MANDATORY OR VOLUNTARY DISCLOSURE AND EFFECT ON INDIVIDUAL NOT PROVIDING INFORMATION: Disclosure is voluntary. Failure of cadet, or parents, if a minor, to complete the form will disqualify the JROTC cadet from participating in the Clinton Raider Challenge Course.

I, ______, consent to be treated in a civilian medical facility, near or enroute to Clinton, Missouri, while attending or traveling to or from, the Golden Valley Raider Challenge, 13 Sep 2008.

This consent encompasses all procedures and treatments as are found to be necessary or desirable, in the judgment of the professional staff of any of the above-named medical facilities. I understand that this consent is of a general nature and accordingly list the following exceptions to this consent:

(If no exceptions, write "No Exceptions.") ______

I (am)(am not) on medication. (List medication if on medication.) ______

I (am)(am not) allergic to medication. (List medication if allergic)______

It is understood that this consent can be withdrawn in writing or orally at anytime. ______(Signature of witness) (Signature of cadet) ______(Typed/Printed name of witness) (Typed/Printed name of cadet) ______(Date and Time) PARENT OR GUARDIAN: (When cadet is a minor or unable to give consent).

I, ______parent/guardian of ______have read and understood the above consent to treatment and hereby expressly consent to the above described treatment. ______(Signature of witness) (Signature of Parent/Guardian) ______(Typed/Printed name of witness) (Typed/Printed name of Parent/Guardian) ______(Date and Time) 2Region Form 509-R (Rev 1 Feb 88) (All previous editions obsolete)

Clinton High School Page 26 of 27 26 June 2008 Change 1 Clinton High School Page 27 of 27 26 June 2008 Change 1