Parent/Guardian Special Permission Statements - 2010
Spring Camp Winona, Teen Treks, Winona 1, & Winona Teen

Instructions:  Use this form only if you:

Check all that apply for your camper.  If Not checked and initialed, we assume no permission and camper will Not participate in activity.  Person will sit on the side watching if short activity, or parent will be called to pick up if field trip.  Mail vendor waivers (for horse riding and rafting activities) to the Registrar.

*Camper's First Name:

*Camper's Last Name:

Camper ID:

   (found on email sent to parent, by camper's name)

Email

*Camp::

T-shirt size
   
Some activities are considered high risk by GSUSA Safety-Wise standards and require parent initials to complete permission statements.  These activities are marked below.
Parent/Guardian, Check and initial all activities as applies for your camper.  Some activities may not be available at your camp.  This form covers all activities for all camps.
 
IF AVAILABLE  Check and initial as applies: 

Ice Skating - (grades 4-12 only) I give permission for person herein described to go ice skating at Capital Clubhouse rink in Waldorf.  A school bus will take girls to/from activity site.
Parent Initials (high risk)
 Water related activities- IF AVAILABLE

  Swimming ability (required for aquatic activities):  
 none    Level 1    Level 2    Level 3   Level 4   Level 5   Level 6    Red Cross Skill Level chart

Paddle boating (grades 2-12 only) - I give permission for person herein described to participate in paddle boating at Gilbert Run Park, if available. Personal Floatation Device (PFD) will be worn at all times. An adult or teen aide will be in the boat with younger girls.
Parent Initials (high risk)

Swimming - (grades 4-12 only) I give permission for person herein described to participate.  Lifeguards may give water test for pool use at site; and may or not be Girl Scouts, depending on pool used.
Parent Initials (high risk) 

Canoeing and Kayaking (grades 4-12 only)- I give permission for person herein described to participate in canoeing and kayaking at camp, if available.  A Personal Floatation Device (PFD) will be worn at all times. 
Parent Initials (high risk)
 
IF AVAILABLE Check above as applies:

Archery - (grades 4-12 only) I give permission for person herein described to participate in Archery at camp.  Parent Initials (high risk)

Horse Riding -(grades 4-12 only)  I give permission for person herein described to travel to A Moment in Time horse farm near Leonardtown, MD via school bus for horse riding/activities. 
Parent Initials (high risk).  Vendor waiver required.

**Mail/FAX/Email vendor horse waiver to camp Registrar with camp fee (waiver links also found on main registration page). Waiver is required.

Climbing Wall (grades 4-12 only) - I give permission for person herein described to travel to Capital Clubhouse in Waldorf, MD to use their climbing wall.
Parent Initials (high risk).  Vendor waiver required.

**Mail/FAX/Email vendor waiver to camp Registrar with camp fee.  (waiver links also found on registration page)

Bowling - (grades 6-12 only) I give permission for person herein described to travel to AMF Bowling Alley in Waldorf via school bus to bowl.
Parent Initials

Museum trip and boat ride - (grades 6-12 only) I give permission for person herein described to travel to Calvert Marine Museum in Solomons, MD  via school bus.  Girls will walk through museum seeing exhibits and take a 1 hr boat ride.
Parent Initials
 
IF AVAILABLE  Check above as applies, plus:

Late Afternoon, evening activity - (grades 6-12 only) - I give permission for person herein described to stay after camp one evening, either to catch for summer Teen only activities. 2010: going to NAS Patuxent River for swimming. Ends at 7:30pm. Bus to go to 1 stop/county afterwards.

Dinner Theater - I give permission for person herein described to see live theater.  She can travel to Toby's Dinner Theater in Columbia, MD for a buffet brunch and live stage show.  A bus will take girls to/from activity site, returning at end day. 
Parent Initials

Overnight - (Teen only) - not available 2010, I give permission for person herein described to spend the night at camp after Teen Trek late theater activity.  
Parent Initials
Some activities are considered high risk by GSUSA Safety-Wise standards and require parent initials to complete permission statements.
Parent/Guardian, Check and initial as applies for your camper - IF AVAILABLE. Mail/FAX/email waivers.

Snow Tubing - I give permission for person herein described to participate in Snow Tubing @ Liberty or Whitetail Resort. 
Parent Initials (high risk).  Vendor waiver required.

Low and High Ropes Course (Teen only) - I give permission for person herein described to go to Upward Enterprises near Poolesville,  MD, for an all day ropes course.  May include zip line, team building, climbing tower.  A school bus will take girls to/from activity site.
Parent Initials (high risk).  Vendor waiver required.

**Mail/FAX/Email vendor high ropes waiver to camp Registrar with camp fee.  (waiver links also found on registration page)

(River tubing activity not available 2010. Skip to next activity.)

**River Tubing - (Teen only) I give permission for person herein described to travel to western MD, for a tube trip on Antietam Creek.  All equipment will be supplied by the vendor.  There will be trained guides in each group of girls.  A vendor waiver is required in addition to this permission.   A school bus will take girls to activity site during camp time.  Bus will return in the late evening for parent pick-up at designated stops.  A list of what to wear and what to expect will be posted on the Teen Activity web page under Winona Teen. Girl should be aware of and agree to the program before signing up for this activity.
Parent Initials (high risk)

**Mail/FAX/Email vendor tubing waiver to camp Registrar with camp fee.  (waiver links also found on main registration page).  Waiver is required.

**Whitewater Rafting - (Teen only) I give permission for person herein described to travel to western MD, for a raft trip on the Shenandoah and Potomac Rivers.  Helmets will be supplied by the vendor.  There will be a trained guide in each group of 6-8 girls.  A vendor waiver is required in addition to this permission.   A bus will take girls to activity site, and will return in the late evening for parent pick-up at designated stops.  Girl should be aware of and agree to the program before signing up for this activity.
Parent Initials (high risk)

**Mail/FAX/Email vendor rafting waiver to camp Registrar with camp fee.  (waiver links also found on main registration page). Waiver is required.
 

Signature of Parent/Guardian giving permissions checked above: //name//
Date Signed:  (mm/dd/yyyy)