Complete Parent`s Packet

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Complete Parent`s Packet
CUB-BOO-REE
Long Beach Area Council
Pumpkin Contest – Archery- BB’s
All NEW this year:
Boy Scout ‘Carnival Games’
Costume Contest
Trunk or Treat contest
Pumpkin Chunkin’
Movie Night on Saturday!
TWO nights of fun...
October 23-25
Firestone
Reservation
19001 Tonner
Canyon Rd, Brea
92822
Early Bird pricing (until 10/15)
Scouts and Siblings: $25
Adults: $15
Scouts and siblings are $30 after 10/16 and $35 after the 19th!
Questions? Contact Rebekah Havard at [email protected]
or Event Chair Samantha McIntosh at [email protected]
--------------------------tear here------------------------tear here----------------------Scouts/Sibling Name(s): ____________________________________________________
_________________________________________________________________________
Adults Name(s):___________________________________________________________
Total persons attending: _____=$_____
REF# 1-6801-690-20
!
Cu b - BO O - Re e 201 5
Sch e d u l e of Eve nt s
Presented by:
The Long Beach Area Council
Friday to Sunday, October 23rd- 25th , 2015
Firestone Scout Reservation
Friday
4:00 – 7:00 Check-in and Campsite Assignments
9:00
Leader’s Cracker Barrel at HQ
10:00pm
Lights Out
Saturday
7:00 – 8:15
8:30 – 8:45
9:00am
9:00 – 12:00
12:00 – 1:30
1:45 – 3:45
4:00 – 5:45
6:00 – 7:15
7:15 – 8:00
8:15 – 9:45
10:00pm
Breakfast / Check-in open for Saturday arrivals
Flag Ceremony and announcements
Check-in closed
Activities open
Lunch
Activities re-open
Dinner
Costume Serpentine and Trunk n’ Treat
Campfire
Movie
Lights Out
Sunday
7:00 – 8:15
8:30 – 9:00
9:15 – 10:00
10:00
Breakfast
Scouts Own – A non-denominational worship service
Pumpkin Chunkin’ and Closing Ceremony
Break Camp / Check out
Home before 12 noon…. Happy Halloween!
!
Pac k i n g L i s t I
Wh a t t o b r i n g. . .
What to bring to Cub-BOO-Ree:
o Scout Spirit
o Medical forms Parts A & B
o FSR Firearms Permission slip
o Sneakers or hiking boots. Open toed shoes or sandals are not acceptable due to the terrain.
o Pack T-shirts are OK for activities
o Broad brimmed hat for sun protection
o Sunscreen
o Pumpkin
o Pumpkin carving knife/ kit (must be child safe)
For camping you should have:
o Uniform for travel to & from the reservation and at the campfire
o Tent
o Sleeping bag, pad, air mattress, or cot & pillow
o Sleep wear
o Flashlight & Spare batteries
o Complete change of spare clothing
o Long Pants for evening and cool mornings
o Sweater and/or warm jacket
o Rain gear
o Personal medications & prescriptions
o Toiletries
o Toothbrush & tooth paste
o Sun Block – minimum SPF 15
o Chapstick
o Soap & hand towel
o Camp chairs
o Easy up (campsites have no shade)
o Camp table
o Camp Stove (propane only) OR Charcoal BBQ (at least 6 inches off the ground.)
o Food for the weekend
o First aid kit
!
Im p or t a n t Not e s :
Food:
All Packs are to provide their own food for the weekend. It is suggested to have
dinner before arriving to camp.
Firearms Permission Slip:
Completed for ALL participants doing any shooting sports such as archery, BB guns, and
slingshots.
SEE ATTACHED PERMISSION SLIP
Parking Permit:
Required on all cars staying on the property during Cub-BOO-Ree.
SEE ATTACHED PERMIT
All cars must be parked facing out, parking permit must be displayed. Keys must be in
drivers pockets at all times.
**Please note there will be a $35 environmental impact fee charged for any campers or RV type
vehicles 35ft in length or larger and not required for ADA purposes. While RV’s are allowed on
property, they should not be parked directly in the campsites and MUST CHECK IN at Admin to
determine the best location for their vehicle.
Pac k i n g L i s t I I
Wh a t NOT TO BR I NG. .
For your safety and the safety of others, please DO NOT bring:
! Alcoholic beverages
! Radios
! Play or real weapons
! Firearms
! Archery equipment
! Sheath knives
! Slingshots
! Saws, axes, hatchets
! Fireworks or pyrotechnics of any sort
!
Frequently Asked...
1. Can I bring my other children along on to this event?
YES, siblings are able to attend for an additional cost.
2. I have a lot of equipment to bring with me- will I be able to drop it at the campsite?
MAYBE, this depends on where your campsite is and what parking is available. Please come prepared
to carry or cart your gear 50 yards if need be.
3. Are meals included with the event price?
NO, meals are not included, and are the responsibility of yourself and/or respective Scout units.
4. Can I cook my own food at the event?
YES, you are welcome to cook your own food via allowable means (either charcoal pit or portable stove
- ABSOLUTELY NO OPEN FLAMES), but it is highly recommended you coordinate with your Scout's
unit regarding meals for the Scouts.
5. Is there a discount for attending only one day of the event?
NO, there is no discounted rate. If you elect not to check-in and camp on Friday that is your option.
You will still be able to check-in on Saturday morning.
6. What time is check-in for this event?
Check in schedule for camp is as follows:
FRIDAY evening, check-in will be from 4:00 pm to 10pm; and
SATURDAY check-in will be from 7am to 9 am.
7. What equipment should I bring for this event?
See PACKING LIST above.
8. Are Scouts/siblings allowed to bring items to “entertain” themselves if they get “bored”?
It is recommended that no toys of any kind are brought to the campsite, as the area and terrain are not
conducive or safe for running around or playing on. Attending Scouts will have more than enough
events/activities to participate in and keep them busy while at camp. Parental supervision and discretion
are strongly recommended for all additional attending siblings.
9. Can I wear sandals to this event?
NO, all attendees are required to wear closed-toe shoes or boots at all times while on the campsite.
10. Will I be able to make cell phone calls at the campsite?
To the best of our knowledge, the location of the campsite will affect reception to some degree. This will
most likely vary depending on the carrier you use as well as the particular cell phone you use.
11. Can I bring a (gas-powered) generator to this event?
NO, generators are not allowed or needed, as there is no need to bring any type of equipment or items
along with you to this campsite that would require that much electricity.
!
12. Can we wear costumes to this event?
YES! We’ll have a costume contest at the Saturday campfire. Please remember that this is a
FAMILY camp- dress appropriately! Costumes in bad taste will be asked to be removed.
13. Trunk or Treat??
All new this year! Scouts can dress in costume and parade to each campsite (via serpentine) for trick
or treating. There will be a prize for the best decorated campsite/trunk/pumpkin display as well, bring
your own candy. Same guidelines for costumes- please decorate FAMILY-FRIENDLY!
14. Pumpkin Chunkin?
YES! New this year- we’ll be launching pumpkins from each unit to see who has the farthest shotfor bragging rights! Please be prepared to help clean up afterwards if you participate; you may launch
a decorated pumpkin or a plain one, your choice. Depending on entries, signups may be limited to
represent all units; a signup sheet will be at HQ.
__________________________________________
We hope that this supplemental list of FAQ's will answer most, if not all, of your questions regarding
attendance at Cub-BOO-Ree. And, as always, if you still have any unanswered questions, please don't
hesitate to contact our Event Coordinators:
Samantha McIntosh at [email protected]
Staff Advisor, [email protected]
See you there!
The End! ... Go to next page for permission slips
Firestone Reservation Parking Rules and Regulations:
This permit must be on your dash and readable by Camp Staff.
PLEASE OBSERVE 15MPH IN CAMP
•
•
•
•
•
•
Drive Safely on ALL camp roads and observe speed limit of 15MPH.
No trailers/RVs in the camping area.
Park your vehicle “HEAD OUT” in case of emergency evacuation.
DO NOT PARK OR LEAVE YOUR VEHICLE IN CAMP.
Vehicles may enter camp ONLY to load or unload gear.
If you park blocking another car, and the Ranger or Staff cannot find you, it
will be necessary to tow your vehicle. No “In and Out Parking” except for
emergencies.
• LBAC is NOT RESPONSIBLE for items lost or stolen from vehicles.
ALL DRIVERS MUST KEEP KEYS/PHONE ON THEIR PERSON AT
ALL TIMES
Fold here and place on dashboard with Parking Permit side up
---------------------------------------------------------------------------------------------------
FSR Parking Permit
Campground: ___________________ Time into Campground: ___________
Your Name: _____________________________________________________
VEHICLES WITHOUT SIGNED PERMIT WILL BE TOWED
Unit Type: _________ Unit #: _____ Cell Phone Number: _____________
Disabled Parking: ___________________________ (Must be signed by Camp Staff)
Part A: Informed Consent, Release Agreement, and Authorization
High-adventure base participants:
Full name: _________________________________________ Expedition/crew No.:________________________________
DOB:
_________________________________________
Informed Consent, Release Agreement, and Authorization
I understand that participation in Scouting activities involves the risk of personal
injury, including death, due to the physical, mental, and emotional challenges in the
activities offered. Information about those activities may be obtained from the venue,
activity coordinators, or your local council. I also understand that participation in
these activities is entirely voluntary and requires participants to follow instructions
and abide by all applicable rules and the standards of conduct.
In case of an emergency involving me or my child, I understand that efforts will
be made to contact the individual listed as the emergency contact person by
the medical provider and/or adult leader. In the event that this person cannot be
reached, permission is hereby given to the medical provider selected by the adult
leader in charge to secure proper treatment, including hospitalization, anesthesia,
surgery, or injections of medication for me or my child. Medical providers are
authorized to disclose protected health information to the adult in charge, camp
medical staff, camp management, and/or any physician or health-care provider
involved in providing medical care to the participant. Protected Health Information/
Confidential Health Information (PHI/CHI) under the Standards for Privacy of
Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc.
seq., as amended from time to time, includes examination findings, test results, and
treatment provided for purposes of medical evaluation of the participant, follow-up
and communication with the participant’s parents or guardian, and/or determination
of the participant’s ability to continue in the program activities.
(If applicable) I have carefully considered the risk involved and hereby give my
informed consent for my child to participate in all activities offered in the program.
I further authorize the sharing of the information on this form with any BSA volunteers
or professionals who need to know of medical conditions that may require special
consideration in conducting Scouting activities.
or staff position:____________________________________
With appreciation of the dangers and risks associated with programs and
activities, on my own behalf and/or on behalf of my child, I hereby fully and
completely release and waive any and all claims for personal injury, death, or
loss that may arise against the Boy Scouts of America, the local council, the
activity coordinators, and all employees, volunteers, related parties, or other
organizations associated with any program or activity.
I also hereby assign and grant to the local council and the Boy Scouts of America,
as well as their authorized representatives, the right and permission to use and
publish the photographs/film/videotapes/electronic representations and/or sound
recordings made of me or my child at all Scouting activities, and I hereby release
the Boy Scouts of America, the local council, the activity coordinators, and all
employees, volunteers, related parties, or other organizations associated with
the activity from any and all liability from such use and publication. I further
authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage,
and/or distribution of said photographs/film/videotapes/electronic representations
and/or sound recordings without limitation at the discretion of the BSA, and I
specifically waive any right to any compensation I may have for any of the foregoing.
!
NOTE: Due to the nature of programs and
activities, the Boy Scouts of America and local
councils cannot continually monitor compliance
of program participants or any limitations
imposed upon them by parents or medical
providers. However, so that leaders can be as
familiar as possible with any limitations, list any
restrictions imposed on a child participant in
connection with programs or activities below.
List participant restrictions, if any:
!
None
________________________________________________________
I understand that, if any information I/we have provided is found to be inaccurate, it may limit and/or eliminate the opportunity for participation in any event or activity. If I
am participating at Philmont, Philmont Training Center, Northern Tier, Florida Sea Base, or the Summit Bechtel Reserve, I have also read and understand the supplemental
risk advisories, including height and weight requirements and restrictions, and understand that the participant will not be allowed to participate in applicable high-adventure
programs if those requirements are not met. The participant has permission to engage in all high-adventure activities described, except as specifically noted by me or the
health-care provider. If the participant is under the age of 18, a parent or guardian’s signature is required.
Participant’s signature:_________________________________________________________________________________________ Date:_______________________________
Parent/guardian signature for youth:______________________________________________________________________________ Date:_______________________________
(If participant is under the age of 18)
Second parent/guardian signature for youth:_______________________________________________________________________ Date:_______________________________
(If required; for example, California)
Complete this section for youth participants only:
Adults Authorized to Take to and From Events:
You must designate at least one adult. Please include a telephone number.
Name: _______________________________________________________
Name: _______________________________________________________
Telephone: ___________________________________________________
Telephone: ___________________________________________________
Adults NOT Authorized to Take Youth To and From Events:
Name: _______________________________________________________
Name: _______________________________________________________
Telephone: ___________________________________________________
Telephone: ___________________________________________________
680-001
2014 Printing
Part B: General Information/Health History
High-adventure base participants:
Full name: _________________________________________ Expedition/crew No.:________________________________
DOB:
_________________________________________
or staff position:____________________________________
Age:____________________________ Gender:_________________________ Height (inches):___________________________ Weight (lbs.):_____________________________
Address:_________________________________________________________________________________________________________________________________________
City:___________________________________________ State:___________________________ ZIP code:_______________ Telephone:_______________________________
Unit leader:_________________________________________________________________________________ Mobile phone:__________________________________________
Council Name/No.:___________________________________________________________________________________________________ Unit No.:_____________________
Health/Accident Insurance Company:__________________________________________________ Policy No.:____________________________________________________
!
Please attach a photocopy of both sides of the insurance card. If you do not have medical insurance,
enter “none” above.
!
In case of emergency, notify the person below:
Name:____________________________________________________________________________ Relationship:____________________________________________________
Address: _____________________________________________________________ Home phone:________________________ Other phone:__________________________
Alternate contact name:_____________________________________________________________ Alternate’s phone:_______________________________________________
Health
History
Do you currently have or have you ever been treated for any of the following?
Yes
No
Condition
Diabetes
Explain
Last HbA1c percentage and date:
Hypertension (high blood pressure)
Adult or congenital heart disease/heart attack/chest pain
(angina)/heart murmur/coronary artery disease. Any heart
surgery or procedure. Explain all “yes” answers.
Family history of heart disease or any sudden heartrelated death of a family member before age 50.
Stroke/TIA
Asthma
Last attack date:
Lung/respiratory disease
COPD
Ear/eyes/nose/sinus problems
Muscular/skeletal condition/muscle or bone issues
Head injury/concussion
Altitude sickness
Psychiatric/psychological or emotional difficulties
Behavioral/neurological disorders
Blood disorders/sickle cell disease
Fainting spells and dizziness
Kidney disease
Seizures
Last seizure date:
Abdominal/stomach/digestive problems
Thyroid disease
Excessive fatigue
Obstructive sleep apnea/sleep disorders
CPAP: Yes £
List all surgeries and hospitalizations
Last surgery date:
No £
List any other medical conditions not covered above
680-001
2014 Printing
Part B: General Information/Health History
High-adventure base participants:
Full name: _________________________________________ Expedition/crew No.:________________________________
DOB:
_________________________________________
or staff position:____________________________________
Allergies/Medications
Are you allergic to or do you have any adverse reaction to any of the following?
Yes
No
Allergies or Reactions
Explain
Yes
No
Allergies or Reactions
Medication
Plants
Food
Insect bites/stings
Explain
List all medications currently used, including any over-the-counter medications.
CHECK HERE IF NO MEDICATIONS ARE ROUTINELY TAKEN. IF ADDITIONAL SPACE IS NEEDED, PLEASE
INDICATE ON A SEPARATE SHEET AND ATTACH.
Medication
YES
NO
Dose
Frequency
Reason
Non-prescription medication administration is authorized with these exceptions:_______________________________________________
Administration of the above medications is approved for youth by:
_______________________________________________________________________ /________________________________________________________________________
Parent/guardian signature
MD/DO, NP, or PA signature (if your state requires signature)
Bring enough medications in sufficient quantities and in the original containers. Make sure that they
are NOT expired, including inhalers and EpiPens. You SHOULD NOT STOP taking any maintenance
medication unless instructed to do so by your doctor.
!
!
Immunization
The following immunizations are recommended by the BSA. Tetanus immunization is required and must have been received within the last 10 years. If you had the disease,
check the disease column and list the date. If immunized, check yes and provide the year received.
Yes
No
Had Disease
Immunization
Tetanus
Pertussis
Diphtheria
Measles/mumps/rubella
Polio
Chicken Pox
Hepatitis A
Date(s)
Please list any additional information
about your medical history:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
DO NOT WRITE IN THIS BOX
Review for camp or special activity.
Reviewed by:_____________________________________________
Hepatitis B
Date:____________________________________________________
Meningitis
Further approval required:
Influenza
Reason:_________________________________________________
Other (i.e., HIB)
Approved by:_____________________________________________
Exemption to immunizations (form required)
Date:____________________________________________________
Yes
No
680-001
2014 Printing
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
This form is recommended for unit use to obtain approval and consent for Tiger
Cubs, Cub Scouts, Webelos Scouts, Boy Scouts, Varsity Scouts, Venturers, and
guests (if applicable) under 21 years of age to participate in a den, pack, team,
troop, or crew trip, expedition, or activity. This form is required for use with flying
plans and should be attached to the flying plan application. It is recommended that
parents keep a copy of the form and contact the tour leader in the event of any
questions or in case emergency contact is needed. Additional copies of this form
along with the Guide to Safe Scouting are available for download from Scouting
Safely at www.scouting.org/forms.
Se recomienda que la unidad use este formulario para obtener la aprobación y
consentimiento para los Tiger Cubs, Cub Scouts, Webelos Scouts, Boy Scouts,
Varsity Scouts, Venturers e invitados (si es que aplica) menores de 21 años que
participen en un viaje, expedición o actividad del den, pack, equipo, tropa o grupo.
Este formulario es obligatorio junto con los permisos de vuelo y deben adjuntarse
a la solicitud de permiso de vuelo. Se recomienda que los padres de familia
guarden una copia del formulario y se pongan en contacto con el líder de la
excursión si es que tienen alguna pregunta o en caso de que se necesite un
contacto de emergencia. Las copias adicionales de este formulario junto con la
Guía para un Scouting seguro se encuentran disponibles para descargar desde
Scouting Safely en www.scouting.org/forms.
______________________________________________________ _____ _____________________________________________________
First name of participant
Middle initial
Last name
Nombre del participante
Inicial del sugundo nombre
Apellido
Birth date (month/day/year) ____/____/____
Fecha de nacimiento (día/mes/año)
Age during activity ________
Edad al momento de realizar
la actividad
____________________________________________________________________________________________________________________________________________________________________________________
Address
Domicilio
City____________________________________________________________________________________
Ciudad
State __________________________________________________________
Estado
Zip _____________________
Código postal
Has approval to participate in (Name of activity, orientation flight, outing trip, etc.) __________________________________________________________________________________________________________________
Tiene la aprobación para participar en (Nombre de la actividad, vuelo de orientación, excursión, etc.)
From ______________ to ______________
De
(Date)
(fecha)
a
(Date)
(fecha)
Without restrictions
Special considerations or restrictions: __________________________________________________________________________________________
Sin restricciones
Consideraciones o restricciones especiales:
HOLD HARMLESS AGREEMENT
ACUERDO DE INDEMNIZACIÓN Y EXONERACIÓN DE RESPONSABILIDAD
I understand that participation in Scouting activities involves a certain degree of
risk and can be physically, mentally, and emotionally demanding. I have carefully
considered the risk involved and have given consent for myself or my child to
participate in this activity. I also understand that participation in this activity is
entirely voluntary and requires participants to abide by applicable rules and
standards of conduct. I release the Boy Scouts of America, the local council, the
activity coordinators, and all employees, volunteers, related parties, or other
organizations associated with the activity from any and all claims or liability arising
out of this participation.
Entiendo que la participación en actividades Scouting implica un cierto grado de
riesgo y que pueden ser física, mental y emocionalmente agotadoras. He
considerado cuidadosamente el riesgo involucrado y doy mi consentimiento para
mi mismo o mi hijo para participar en la actividad. Entiendo que la participación en
la actividad es completamente voluntaria y requiere que los participantes se
acaten a las reglas y estándares de conducta pertinentes. Libero a Boy Scouts of
America, al concilio local, a los coordinadores de la actividad y a todos los
empleados, voluntarios, partes relacionadas u otras organizaciones asociadas con
la actividad de cualquiera y todas las demandas o responsabilidades que surjan de
esta participación.
In case of emergency involving my child, I understand every effort will be made to
contact me. In the event I cannot be reached, I hereby give my permission to the
medical provider selected by the adult leader in charge to secure proper treatment,
including hospitalization, anesthesia, surgery, or injections of medication for my
child. Medical providers are authorized to disclose to the adult in charge
examination findings, test results, and treatment provided for purposes of medical
evaluation of the participant, follow-up and communication with the participant’s
parents or guardian, and/or determination of the participant’s ability to continue in
the program activities.
En caso de una emergencia que tenga que ver con mi hijo, sé que se harán todos
los esfuerzos necesarios para contactarme. En caso de que no me contacten,
autorizo al proveedor médico seleccionado por el líder adulto encargado, de
asegurarse de que se le ofrezca a mi hijo el tratamiento adecuado, incluyendo
hospitalización, anestesia, cirugía o inyecciones de medicamento. Los proveedores
médicos están autorizados para informar al adulto encargado los hallazgos de la
exploración física, los resultados de pruebas y el tratamiento otorgado con el
propósito de una evaluación médica del participante, seguimiento y comunicación
con los padres o tutores del participante y/o la determinación de la capacidad del
participante para continuar en las actividades del programa.
______________________________________________________________________________________________________________________________________________________
Participant’s signature
________________________
Date
______________________________________________________
Parent/guardian printed name
__________________________________________________________________________________________
Parent/guardian signature
________________________
Date
______________________________________________________
Area code and telephone number (best contact and emergency contact)
______________________________________________________________________________________________________________________
Email (for use in sharing more details about the trip or activity)
Firma del participante
Nombre con letra de molde del padre de familia/tutor
Código de área y número telefónico (primer contacto y contacto de emergencia)
Firma del padre de familia/tutor
Fecha
Fecha
Correo electrónico (para más detalles sobre el viaje o actividad)
Contact the adult tour leader with any questions:
Póngase en contacto con el líder adulto de la excursión si es que tiene preguntas:
Name ___________________________________________________________________
Nombre
Phone ___________________________
Teléfono
Email ________________________________________________________________
Correo electrónico
680-673
2012 Printing

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