Riverwinds Community Center

To the Attention of: at:

SCUBA SCOUTING REQUEST FORM

 PLEASE READ CAREFULLY & COMPLETE IN FULL PRIOR TO SUBMISSION.  The Individual Requesting Services, who completes this form, should be that adult who assumes full responsibility for its appropriate, accurate completion, dissemination to participants, and responsibility for the troop as a whole. Individual Requesting Services (hereafter referred to as IRS): Name: ______Leader/Parent/Scouter/Other (Please Circle) Complete Mailing Address (include Street, City, and Zip):______Email: ______Phone Number of IRS on Day of Activities: ______BSA Troop #: ______Town Troop Chartered From: ______Adult in Charge on Day of Activity (if required); include Name, Address, and Phone Number: ______

Activity Information: Estimated Number of Participants:______Ages of Participants: ______Requested Dates of Activity (assuming 25 hours):______Requested Time of Activity: ______Important Information ~ Please Initial All Points Prior to Submission; Reservations Will Not Process Until Complete ___ Bookings will not be made until $300 SCUBA Merit Badge fee is remitted, along with this Scouting Request Form complete in its entirety. (Tour permits not required.) ___ Liability Waiver Forms (one per person going past the turnstyles regardless of membership status) are due at check-in, legibly signed by both the scouter AND parent (if scouter under 18). ___ Requests will be denied if forms are not filled out completely. ___ All participants agree to abide by rules and regulations of the facility as stated on Liability Waiver Form and Scouting Request Form, and understand their participation is at their own risk. ___ Activity Fees are refundable only if request is made, in writing, 72 or more hours prior to orientation. ___ Troops and scouters are directed to meet in the facility lobby 15 minutes prior to aforementioned activity start time for check-in and banding. Late arrivals and delayed check-in will reduce allotted activity time, and the RWCC and its staff can not guarantee additional time can be made available to make up missed skills for some or all participants. If participants arrive past the reserved start time, they must check in at the Front Desk, aware that will have missed portions of the activity and advancement may not be earned. ___ Non-participating adults may only go past the turnstyles into the pool area if appropriate Day Pass Guest Fees have been remitted ($11). Non-participating youth may only go past the turnstyles into the pool area if appropriate Day Pass Guest Fees have been remitted ($8). ___ Smoking and gambling are not permitted in any part of the facility at any time. Food and drink may only be consumed in designated areas. ___ SCUBA Badge Council Sessions include both classroom- and pool-based activity. Total time spent in either section is dependent on PADI curriculum standards, group size and behavior, facility maintenance, weather, et. al. ___ SCUBA Badge Council Sessions are pool-based activities which may be hindered by weather, maintenance, et. al. In the event that the pools are unusable at the time of the scheduled activity due to lightning, training will relocate to the classroom. If required pool time is hindered for an entire day due to weather, fecal matter discharge, etc., one make-up date will be mutually agreed upon by both RWCC staff, badge counselor, and IRS for no additional fee. RiverWinds is not responsible for additional dates beyond the agreed upon make-up date to accommodate original participants unable to attend the make-up date. ___ All pool activities will be suspended in the event of lightning. For SCUBA Badge Council Sessions, additional classroom-based theory will be provided in this instance. ___ SCUBA Badge Council Sessions are not swimming lessons. When an individual’s ability level does not meet the standard for certification, time does not allow for individual assistance (by way of mechanics instruction), and that scouter may not earn the specific requirement(s). ___ Some SCUBA Merit Badge requirements, such as open water check out dives, can not be completed at RWCC. The IRS is expected to communicate with the badge counselor to specify which requirements will be covered, what supplies should be furnished from troop/scouter, what requirements may not be completed without required supplies, et. al. ___ Any BSA-approved item, such as Blue Cards, Badges, Commitment Cards, etc. must be provided by the Troop, and are not made available by the RWCC. ___ If adults who are not participating are present during pool and/or classroom time, they are only to silently observe, and not disrupt the session by interrupting the lecture or enter the water unless having been pre-approved by the Badge Counselor to specifically complete skills for advancement or to serve as an assistant to a disabled Scouter. Please note that while non-participating adults are welcome to observe, the attendance of too many present in the room or pool area ultimately becomes a distraction to scouters. Please coordinate with leaders and parents accordingly. **RWCC recommends no more than two non-participating adults present during Badge Council Session lecture and practice for observation only, though there is no existing rule requiring more or less. ___ Most scout troops have additional individuals in leadership positions (i.e. leaders, Patrol Leaders, etc.) who may possess certain health and safety and/or aquatic certifications. Please note that during SCUBA Badge Council Sessions, “help” or “co-instruction” from said individuals is not permitted for time, organizational, and liability purposes. ___ No claim shall be made against West Deptford Township or the RWCC due to injury or for the cancellation or postponement of an activity or activities due to weather, maintenance issues, group or individual behavior, et. al. ___ The RiverWinds Community Center reserves the right to terminate any activity at any time due to improper behavior by youth or adults. Refunds will not be furnished under these circumstances (determined at the discretion of the Badge Counselor). ___The IRS, (or, in his/her absence, Adult in Charge on Day of Activity, if required), accepts responsibility for the individual or troop during the activity and the above information. ___ The aforementioned IRS assumes all responsibility for the individual or troop, including the imparting of all included information to all youth and adult participants, or non-participating adults,, and is expected to be present for check-in; in the event said individual is not present, it is expected that (s)he has provided the Adult in Charge on Day of Activity (if required) with all pertinent information, rules, and regulations as outlined on Scouting Request Form and Liability Form (in this instance, bringing an IRS signed troop copy of this SCUBA Scouting Request Form is recommended). ___It is understood that the RWCC assumes the IRS has made all Scouters, their parents, et. al. aware of said information and these terms and conditions have been agreed upon by attending Scouters, their families, et. al. These standards will be adhered to during the activity regardless of group agreement.

Signed by: Name and Position (Leader, Parent, etc.)______Date: ______

SUBMIT COMPLETED FORMS WITH PAYMENT TO THE ATTENTION OF: Aimee Maska Boucher, Program Coordinator 1000 RiverWinds Drive, West Deptford, NJ 08086 (856) 251.0990 x103 Phone; (856) 251.0790 Facsimile [email protected] *Individuals Requesting Services are encouraged to make and save a copy for troop records

OFFICE USE ONLY

Date of Initial Request: MRF RSV’d w/cpy & lyt att: Date Activity Fee Paid: Attached Waiver Form Confirmation Call: Attached Receipt Rcpt Sent w/ltr: Fee Posted RvRpt: Session Indicated: RT RSV’d # and Date: Guest Fees Posted RvRpt: