Camp Cherry Valley - Greater Los Angeles Area Council
Transcripción
Camp Cherry Valley - Greater Los Angeles Area Council
3450 E. Sierra Madre Blvd. Pasadena, CA 91107 626-351-8815 Ext 249 San Gabriel Valley Council Boy Scouts of America San Gabriel Valley Council - Camp Cherry Valley About Camp Cherry Valley Camp Cherry Valley is know for: Great Staff—Their goal is for your unit to have an amazing time at camp! Located on the leeward side of the west end of Catalina Island, twenty-two miles from the Southern California Coast, Camp Cherry Valley has much to offer. Unique, native wildlife roams the 157 acre camp under the canopy of the native Catalina Island Cherry trees. The calm, crystal-clear cove waters are a safe haven for hundreds of species of marine life. Great Food—Wonderful meals, full salad bar. Our staff makes sure you and your scouts don’t go hungry. Established in 1921, the camp was originally operated by the Pasadena Council by Camp Director Skipper Robison. He established traditions that are still alive today, most notably the Tribe of Torqua, the Camp Cherry Valley Honor and Leadership brotherhood. Scouts who return to Cherry Valley advance within the ranks of the Tribe. Great Program— Staff take pride in delivering a top knock program. Leaders MeetingApril 27, 2013 9 am Smiser Scout Center 3450 E. Sierra Madre Blvd. Pasadena, CA 91107 Camp Program areas include the Rifle and Archery ranges, Nature and Outdoor Skills areas, and Camp Cherry Valley's famous Waterfront. There is always something to do with activities to suit your liking, regardless of age or ability. You can take a self-guided nature trail tour while identifying native plants along the way. You can join your troop on a snorkel tour, led by the knowledgeable and friendly staff. You can even experience marine wildlife up close in our Aquarium. After kayaking around the cove, you can challenge your friends to a shootoff at the rifle range to see who can make the dime club. Of course, there are always merit badges to be earned as well- from Pioneering to Environmental Science and from Lifesaving to Geology. www.sgvcbsa.org Inside this guide: Payment/Refund Policies 2-3 Travel Information 4 Packing List 5 Camp Rules, Procedures 6-8 Camp Facilities 9-10 Program Opportunities 10-21 Scuba Form 22-23 Week at a Glance 24 Merit Badge Form (sign up) 25 Permission Form 26 Merit Badge & Trask Form 27 Medical Form (complete) 28-49 Map with Boat times Campers stay in platform tents on raised deck campsites, where cots and mattresses are provided. Nearby are the restroom and shower facilities. The Camp Store provides snacks and souvenirs, just a trails turn from the Archery and Rifle ranges. The Health Lodge is located centrally, as is the Program Office- the central hub of camp information. The Dining Hall can accommodate 160 campers at once, where meals are done in two shifts. 50 Welcome to camping with the San Gabriel Valley Council! This guide will help answer your questions about what your week at camp will be like. In the following guide you will learn about our camp, the grounds, how the programs operate, and everything that you will need to bring to make this a trip to remember. This guide is set up to give you information about Camp Cherry Valley on Catalina Island. 2013 Camp Cherry Valley Dates Week 1—June 9-15 canceled Week 4—June 30-July 6 Week 7—July 21-27 Week 2— June 16-22 Week 5—July 7-13 Week 8—July 28-Aug. 3 Week 3—June 23-29 Week 6—July 14-20 Week 9—August 4-10 NONDISCRIMINATION CLAUSE The San Gabriel Valley Council and their Camp staff maintain a policy of nondiscrimination. Camp Cherry Valley Getting Set For Camp….. Camp Payment Plan: Work yard fence with signs units have made and left at camp to show they were there. 1. Deposit of $200 per unit is required at the time of making a reservation. This deposit is nonrefundable, but is applied to your final total. 2. First payment of $100 per person is due no later than Wednesday, October 31, 2012. This payment is non-refundable but transferable only to a replacement scout or adult in your troop. If you neglect to make a payment, your unit’s reservation will be dropped and you will forfeit all money paid. 3. Second payment of $100 per person is due no later than Thursday, January 31, 2013. This payment is non-refundable but transferable only to a replacement scout or adult in your troop. If you neglect to make a payment, your unit’s reservation will be dropped and you will forfeit all money paid. 4. Third payment of $100 per person is due no later than Thursday, February 28, 2013. This payment is non-refundable but transferable only to a replacement scout or adult in your troop. If you neglect to make a payment, your unit’s reservation will be dropped and you will forfeit all money paid. 5. Fourth payment of $100 per person is due no later than Thursday, March 28, 2013. This payment is non-refundable but transferable only to a replacement scout or adult in your troop. If you neglect to make a payment, your unit’s reservation will be dropped and you will forfeit all money paid. 6. Early payment discount of $10 per paying person is available if the entire reservation is paid in full by Wednesday, May 1, 2013. Otherwise, final payment of all balances is due no later than thirty (30) days prior to the start of your camping week. 7. There is one free adult with each reservation. Please note that your statement reflects only the paying adults. Your total number of adults is the number on the statement plus one. All additional adults pay the full fee. 8. There is a $10 discount for pairs of brothers attending camp together. The price per pair can be reduced by $10 (or $5 per brother). This is applicable to scouts only. Cherry Valley Leaders Guide Payment methods include cash, check, VISA, MasterCard, Discover or American Express. Checks should be made payable to SGVC – BSA. Please note - the above payments are non-refundable and are transferable only to a replacement scout or adult in your troop. Your help in following this schedule will allow the scouts in your troop to budget for camp, as well a helping our council provide the maximum number of spaces possible to scouts who wish to attend. Thank you for your help! Payments should be mailed to: San Gabriel Valley Council, BSA 3450 E. Sierra Madre Blvd., Pasadena, CA 91107 For more information or questions, please don’t hesitate to contact the camping department at 626 3518815 ext 249 for Sonia Unit Loyalty Plan Starting the summer of 2013, the San Gabriel Valley Council will offer units a reward for attending camp! Attend Cherry Valley 3 consecutive years in a row and receive the following: Year 2 (2014) of attendance – 1 extra free adult Year 3 (2015) of attendance – 1 extra free adult and 1 free Senior Patrol Leader More unit signs on display... Page 2 Please Note: Missed payments can result in the loss of your reservation. Total camp fees are due 30 days prior to your scheduled arrival at camp. All troops who pay total fees by Wednesday, May 1st will receive the $10 per person discount. All campers who have not paid in full by Wednesday, May 1st will have to pay full campers fees, thus negating the discount. San Gabriel Valley Council Camp Fees With each reservation there is one free adult. All other adults pay full price. All payments must be made 30 days prior to the start of your camp week. Brother discounts are $10 off the second and third pairs of brothers who attend together. This discount should be taken at time of final payment, please call us to adjust your statement and provide the correct amount of your final payment. Adults who replace leaders during the week can share fees. Adults coming to camp who do not replace a leader in their troop will be charged at a rate of $65 per person per day (this includes room, board, and meals). Please notify program office of any leadership changes during the week. New leaders must check-in upon arrival. The BSA summer camp fee for: In Council is $585 per person Out of Council is $625 per person **All campers who travel to and from camp on other than the boats reserved by the council are responsible for covering their own transportation costs.** Scouts walking back to their campsite from the water- Camp Refund Policy Please note - the above payments are non-refundable and are transferable only to a replacement scout or adult in your troop. Payment-in-full is expected no later than 30 days prior to the start of your camp week. Any drop in the number of scouts or adults, after that point, will result in no refund of money already paid and the remaining balance is still owed. Camperships Funds are available to supplement Scout fees for those who are MEMBERS OF THE SAN GABRIEL VALLEY COUNCIL and can demonstrate a need for this support. Information and applications are available through the San Gabriel Valley Council website www.sgvcbsa.org. “Come for summer camp, get the adventure of your life” Leadership Requirements The role of adult leaders at summer camp is very important. In planning, supervising, teaching, and participating, their influence and support is critical. Start recruiting your leaders early and have alternates standing by. Two registered adults are required per troop. Usually the Scoutmaster and Assistant Scoutmaster attend; however, if other adults will be bringing the Scouts to camp, start preparing them early. At least one adult must be 21 years of age or older; the other must be at least 18 years old. Adult supervision is a critical component of a successful youth program. The leadership and guidance you provide your Scouts during your stay will maintain their safety. We ask our staff to lead by example and would ask you to do so as well. Please help us follow all written, spoken, and implied rules and regulations as they are in place to protect the children, adults, staff, facility, equipment, property, and environment.. WE RECOMMEND, BUT DO NOT REQUIRE, A HIGHER ADULT TO CAMPER RATIO FOR YOUNGER SCOUTS. FOR SCOUTS UNDER 13 WE RECOMMEND 1 ADULT TO EVERY 8 SCOUTS. OVER 13 WE RECOMMEND 1:10. THE BSA ONLY REQUIRES 2 DEEP LEADERSHIP AT ALL TIMES. Page 3 Waterfront view... Camp Cherry Valley Tour Plan The BSA National office requires that troops file a tour plan when traveling to activities. Contact your local Scout Office for the proper form and further information. Please have a copy of your completed and approved tour plan to show the staff. Special Requests FOOD: If you have special dietary needs, please let us know in writing and/or by telephone at least two weeks before your arrival. We are happy to do what we can to meet your needs. However those with very restrictive diets will need to make arrangements to bring specialty items to camp. Arrangements will be made to store and prepare foods brought to camp for those individuals. Cherry Valley Dock The San Gabriel Valley Council cannot be responsible for lost, stolen, or damaged articles while in transport or while in camp. Please mark all property plainly. Getting to Camp… Travel Information PARKING: Parking is $15 per 24 hours and an additional $15 for any part of 24 hours after the first day. Payable via Cash, MasterCard, or Visa. There is an ATM machine available at the terminal. Troops will arrive on Catalina Island via Catalina Classic Cruises. The boat fare is included in the cost of camp. The boat will depart from the Catalina Express Terminal, near the Queen Mary, at the Port of Long Beach, 1046 Queens Highway, Long Beach, CA. Departure times are located on the map at the back of this guide. As in all activities at Cherry Valley, you should be punctual. One hour early is not too early. Upon arrival, you will be met by two staff personnel who will take your official troop count and give you boarding instructions. The trip across the Channel takes approximately two hours. Any additional transportation costs are not provided. Travel mid-week back to the mainland, or water taxis from Two Harbors to Camp must be paid for out of pocket. Any Adult leaders or parents who have arranged a mid-week visit or leadership swap should arrange their tickets with Catalina Express. They should call as early as possible to secure a reservation. There are usually tickets available, but there are luggage restrictions. Their number is 310-519-1212. TO MAKE RESERVATIONS TO TRAVEL MID-WEEK, CALL AS EARLY AS POSSIBLE. STANDBY SEATS ARE USUALLY AVAILABLE. ALL SERVICES REQUIRE EARLY CHECK IN AND HAVE LUGGAGE RESTRICTIONS. ALL COSTS ARE THE RESPONSIBILITY OF THE INDIVIDUAL. BE SURE YOUR BOAT IS TRAVELING TO TWO HARBORS FROM SAN PEDRO. THE CATALINA EXPRESS TELEPHONE NUMBER IS: (310) 519-1212. COMING FROM A LONG DISTANCE? Troops can stay at Camp Trask before or after their trip. Sleep under the stars; enjoy swimming, dinner and breakfast before you leave for your Cherry Valley adventure! Additionally, we are now offering an optional sack lunch to take with you to the boat. A reservation form is available at the end of this guide. We will send directions to Camp Trask with confirmation of your reservation. MONDAY TRAVEL We are happy to arrange for Monday travel for those troops in need. Troops arriving in Camp on Monday will be met in Two Harbors by the camp truck for the transporting of their gear to the camp. One adult leader will be driven to the camp for the purpose of registering their troop, while the rest of the troop hikes into camp. Remember, returning from camp on Saturday will be via Long Beach on the Boy Scout boat, so accommodations will need to be made to have transportation from Long Beach back to your vehicles in San Pedro. ARRIVING AT TWO HARBORS: Scouts walking back into camp from the waterfront. Page 4 Once in Two Harbors all Scouts and adult leaders will have their luggage transported by camp vehicles, while scouts and leaders hike the 1.5 miles into camp. Any leader or Scout with a disability that prevents them from hiking into camp will be transported to camp by van. Shore boats to camp are available at about $5 per person each way. Please know that this service is provided only for those people who are unable to make the hike. San Gabriel Valley Council PLEASE MARK EVERYTHING WITH YOUR NAME AND UNIT What to Bring to Camp Personal Equipment List: (Please identify luggage with a RED tag) Gear Bags - military type duffel bag is best Sleeping Bag—50° degree or warmer Jacket or Hoodie Class A Scout uniform - must be worn while traveling to and from camp Swim trunks and beach towel Shower towel Toilet kit: toothbrush and paste, soap, shampoo, lip balm, eye care, etc. Personal medication Flashlight w/ extra batteries Change of clothes- long pants, shorts, and shirts Socks—bring more than you think you’ll need Hat—preferably wide brimmed Scout Handbook Sun Screen Watch Canteens or water bottles COMPLETED MEDICAL FORM Small personal first aid kit Day pack—large enough to fit food and water for a day Lace-up Hiking Shoes– NOTE: slip on shoes are not hiking shoes Water Shoes or sandals—for water activities and when showering Notebook, Pen or Pencil for merit badge work Fishing Pole, bait & tackle (optional) Teepee at Cherry Valley near merit badge class area by mine and waterfront. Troop equipment list: Please bring a collapsible pole for your troop flag. Troops must provide their own flag pole. 1. Troop flag and flagpole—must be in a hard case. 3-4” PVC pipe works great. Mark with CCV and red tape. DO NOT BRING TO CAMP Anyone who brings any of the below listed items is subject to removal from camp at their own expense Weapons—firearms, spears, machetes, etc. Fireworks Valuables Spear guns Matches or flammable liquids Alcohol and Drugs Animals Personal Sporting Equipment, including bicycles Propane or liquid gas lanterns or stoves Ice Chests Tents Tarps or poles Pole Spears Sheath Knives “Remember, you are in for a week of adventure!” Cell Phones—Scouts Vehicles Packing your gear Mark your gear with a red ribbon or tag, and the letters CCV. Once you get to Long Beach, your gear will be moved around many times and will not be under your supervision until you get into camp. Do not attach anything to your bag. Fishing poles must have a hard case. Use your day pack to carry items you will need with you on the boat and on your hike into camp. This may include food, or snacks, but every scout should carry at least one water bottle. The Scoutmaster must collect all troop Medical Forms before crossing the channel and will redistribute them to every camper upon arrival in camp. This will ensure that every camper has their medical form in hand at the time of check-in. The Scoutmaster must also carry the troop roster and any fee payment receipts. Page 5 Merit Badge instruction Camp Cherry Valley Camp Rules, Procedures and Policies Please understand that the purpose of camp rules is to ensure the safety of all those who will be living together at camp. Emergency procedures and information As part of the first flag ceremony, the camp will participate in the camp’s emergency alarm. Any other alarms during the week will be real. If you hear the alarm, walk to the parade grounds, join up with your Troop, and ensure all are accounted. Further instructions will be presented at the parade grounds. Fire is the greatest danger facing the camp and special attention needs to be applied to ensure that all campers understand this threat. A Scout is prepared! First Aid The Health Lodge is designed to meet the emergency needs of our campers. We are ready with emergency support and will make necessary contact with the Emergency Medical System in the area. We will store all medications that require refrigeration and will assist with dispensing as needed. Because of the high cost of medical supplies for common ailments, it is important that all Scoutmasters bring over-the-counter medications and first aid supplies for Scouts in their troops who get colds, headaches, sore throats, or coughs. Some of these medications will be available for sale in the Trading Post to any adult leader, but it is best to bring your own. They will not be available in the Health Lodge except in emergency situations. WE ENCOURAGE EACH SCOUT TO BRING THEIR OWN PERSONAL FIRST AID KIT TO CAMP AND EACH TROOP TO BRING A TROOP FIRST AID KIT. MINOR CUTS AND FIRST AID ISSUES PROVIDE OPPORTUNITIES FOR SCOUTS TO PRACTICE THEIR FIRST AID SKILLS. AND SHOULD BE TAKEN CARE OF IN THE CAMPSITE BY THE SCOUT OR ADULT LEADERS. Youth Protection Cherry Valley Leaders Guide The Boy Scouts of America is a leader in the fight against child abuse. We must do everything in our power to prevent physical, emotional, and sexual abuse. To protect youth and adults we must be extremely careful and follow the BSA TWO-DEEP LEADERSHIP policies. We will not tolerate any activity that can, in anyway, be interpreted as abusive. If you are aware of anything questionable please report it at once to the Camp Director. Do not become directly involved as an individual unless there is an immediate physical threat to the camper. Campsite Procedure The campsite is your Troop home at camp. Your Camp Friend and Commissioner are there to assist you, if necessary. The Troop’s conduct, while in the site, will be the responsibility of the units’ adult leaders. Please instruct your Scouts to respect other Scouts and troop campsites. Do not enter them unless invited. Failure to respect other troop campsites and personal belongings could result in individual or troop expulsion from camp. Control noise, respect quiet hours, and leave other people’s personal property alone. Damage to tents and campsite equipment will be charged to the Scout troop. Quiet Hours We are required to provide all campers with at least eight hours of quiet time. Between 10:00 PM and 6:00 AM each day we ask that you enforce this quiet period. If there is a problem in your campsite or with campers from another troop, please notify one of the commissioners living in the cabins adjacent to the campsites. Please do not take matters into your own hands to solve the problem. View of a campsite Cleaning Squad Immediately following breakfast and dinner, one camper from each troop is asked to meet the Ranger to help clean the Grove restroom facility and shower house. Further information regarding time and meeting places will be given to you by your commissioner upon arrival at camp. Page 6 San Gabriel Valley Council Alcohol and Smoking Policies for Adult Leaders No Alcohol is allowed in camp. The Camp Director will expel anybody violating this rule. Los Angeles County fire code requires all smoking to be done in the one designated smoking area of camp. In addition, the San Gabriel Valley Council’s policy on smoking is the same as the BSA - always to be done with discretion and not in the presence of the Scouts. Checking out of Camp The council requires the following of adults leaving camp: 1. 2. 3. Adequate adult leadership remains in the camp to oversee the needs of the Troop. Note: The twodeep leadership policy must always be followed. Adults should check out with the Program Office; so in the case of an emergency the adult can be located. Scouts leaving camp early must be picked up at camp by a family member authorized in their camp paperwork. A phone call must be placed to the parent or guardian who signed the release to confirm that the Scout is authorized to leave with that adult. Scout Law path Campsite and Program Equipment The Commissioner and Scoutmaster will conduct an inventory of all campsite equipment when arriving in camp. Damage that may occur during the week will be assessed with the Troop. Report any damage as soon as it is noticed. Campers must do their best to keep campsite equipment in working order. Adult leaders should monitor the campsites to assure no intentional damage comes to campsite tents, tables, decks, or signage. Program Equipment The San Gabriel Valley Council provides all troops with the opportunity to use high quality program equipment during a week of camp. Normal “wear and tear” of equipment is expected. Careless or intentional mistreatment of equipment will not be tolerated. Campers should take care of, and have respect for, all camp wide equipment and facilities including: 1. Shower and restroom facilities, camp buildings, and structures 2. Other camper's personal belongings. 3. Program equipment and facilities, including: Waterfront Masks, snorkels, fins, PFDs, and rescue equipment Boats- Kayaks, Rowboats, Canoes, and Sailboats Fences, lines, buddy-boards, and structures Page 7 Aquatic life and tanks in the Sea Lab “A week of camp life is worth six months of theoretical teaching in the meeting room.” Shooting Sports Rifles and ammunition, Bows and Arrows Fences, lines, and structures Lord Baden-Powell Nature and Outdoor Skills Handicraft tools and work-benches Nature signs, trail markers, and posters The San Gabriel Valley Council is proud of its camp equipment and facilities. All campers are asked to use the equipment as intended and to have a great time in doing so. Equipment, facilities, and property will need special attention to keep it in good working order and available to all campers throughout the year. Campers who intentionally or maliciously break camp equipment will be expected to pay for the cost of replacing the product. Please contact the Camp Director if someone in your Troop damages equipment. Waterfront equipment Camp Cherry Valley Phones Public phones are not available in camp. If campers wish to contact their parents, they need to use their adult leaders’ cell phone. A charging station will be available for Adult Leaders only. Do not bring your own power strip. All leaders charging cell phones are responsible for their security. Camp Cherry Valley is not responsible for cell phones that are lost or stolen. Scouts are encouraged to not bring cell phones to camp. If there is an emergency, please feel free to use our business number at camp is (310) 510-2895. When leaving a message for a camper please include the name and troop number of the person. Scout should NOT bring their cell phones to camp. Wi-Fi Policy WIFI is available in Camp. Check with the program office for more details. Day Visitors Cherry Valley Leaders Guide All Day visitors must immediately report to the program office to check in and receive a visitor pass. This is part of our intrusion policy and shows our staff you are an authorized guest. All Day visitors to camp may buy meal tickets per person, which will be paid to the Business Manager in the Program Office. Any visitor who does not come with a completed and signed BSA medical form, will not be permitted to use the camp program equipment. Camp Mail Mail delivery to the island varies with the weather and other factors. It is suggested that those parents wishing to mail their Scout a letter or care package do so the Thursday or Friday before the Troop leaves for Camp. Most packages mailed later than this will not arrive in camp during the week of camping. Please do not mail money, as it may get lost in the mail. An ATM is located in the town of Two Harbors for emergencies. Please address mail as shown below: How to address your packages and letters: Scout Name Unit Number Camp Cherry Valley Send a care package PO Box 5067 Avalon, CA 90704 Page 8 San Gabriel Valley Council Ecology at Camp 1. Animal Conservation: Please make certain that all Troop members understand the delicate balance of plant and animal life on Catalina Island. Everyone should do their best to ensure that no animals are harmed or killed. This applies to marine as well as land life. Please walk only on designated trails and roads. 2. Pets: No pets of any kind should be brought to camp. Pets are a threat to wildlife and are in danger themselves. 3. Plant Conservation: The vegetative life on the Island and in the sea is very fragile. Please make every effort to stay on the trails, do not pick the flowers, or collect specimens. Do not gather firewood or use natural materials for camp construction projects. The cherry trees are our special charge. Please do all you can to prevent name carving, hammock hanging, and other acts that damage the trees. 4. The Salina is an environmentally protected area that is vital to the health and wellbeing of the cove. Please help us keep the Scouts from walking through it or destroying it in any way. Waterfront view 5. Fire: The smallest spark is a deadly threat to wildlife and campers. No fireworks, open fires, flame utilizing lamps, or other equipment can be allowed in camp. 6. Please help us keep the campers on the roads and designated trails, as this will help protect the animal habitat and plant life from destruction. Camp Facilities “The camp is full of wonder, you just have to find it” Camp Store CCV has a great store, which provides books, camp gear, snacks, and program supplies. Other items available are batteries, stamps, toiletries, soda, and camp memorabilia. The camp will provide each camper with the current year’s patch and a leather totem to collect beads. The average Scout will spend between $45 and $60. The Trading Post will open at 6am daily to serve coffee and morning snacks to adult leaders. WIFI service is available at the trading post. Shower and Restroom Facilities CCV provides shower and restrooms for all campers. Women, Men, and boys all have separate shower and toilet facilities. Swim trunks and water shoes or sandals must be worn in group shower facilities at all times. These facilities are always available to campers, but should be used before quiet time- 10:00pm. Maintenance of the facility is the responsibility of all who use it and all will be given the opportunity to assist in cleaning it. Report any malfunctions to Staff Personnel at once. It is highly recommended that each troop organize and implement troop shower times. By having an adult posted outside the boy's shower facility, the boys will be less likely to engage in horseplay. If there are any difficulties with other campers, report it to staff. Page 9 Separate showers for women, men and boys. Camp Cherry Valley Dining Hall The camp will be split into two groups for meals. The Starboard Watch will eat first at each meal, followed by the Port Watch. Each troop will be assigned to a watch for all meals throughout the week. All members of your troop must eat at their assigned watch. During your meal time, your troop will be assigned specific tables to eat at during the week. WAITER DUTY Dining Hall Each unit should provide one scout for every table used by their Troop to serve as a waiter for each meal. The waiters will: 1. Report to the Dining Hall fifteen minutes before the troop’s watch. 2. Set tables, wipe down table, and clean the area around tables after the meal. 3. Accept further direction from the dining hall staff. DINING PROCESS Each troop will be assigned to either the Starboard or Port Watch to eat every meal. Starboard Watch always eats first; Port Watch always eats second. Fifteen minutes before every meal, the troop must send one scout per table to serve waiter duty. They will prepare their table before the meal and clean it up afterward, as per the instructions from the Food Service staff. Troops will assemble at the parade grounds just before each meal time. Grace will be offered and then the troops will move inside for their meal. Troops will move through the front doors of the dining hall and receive their food cafeteria style. A breakfast bar with fruit and cereal is available at breakfast and a salad bar at lunch and dinner. The waiters will have already prepared tables with punch and condiments. It is very important that each unit sits at the table assigned. If you are sharing a table with another Troop, please coordinate a waiter rotation schedule with them. Cherry Valley Leaders Guide Program Opportunities Along with the great locations and staff, our camp programs are the best anywhere! Scouts and leaders will be challenged to fit merit badge courses, free-time elective activities, and special programs into a busy week of camp. Pre-planning is essential! Check out our great programs. Camper Totem Each Scout will be given a leather totem. Throughout the week, each camper will be recognized for participation in programs. This is done by presenting colored beads for each activity they have participate d in. While some beads will be earned through program participation, other beads are elective. As part of our camp Intrusion Policy, the camp asks that each adult camper wear their totem at all times. This allows staff to quickly discern between adult campers and unwanted visitors. Totem Bead Color Chart View from camp Page 10 COLOR ACTIVITY COLOR ACTIVITY Red Opening Campfire Blue Honor Trail Yellow Scouts own Turquoise Ocean Adventure White Service Project Brown Kybo Orange Tuesday night Cobbler Gold Grace at a meal Black Hike Day Clear Sparkle Flag Ceremony Green Commissioner Games Dark Blue Sea Lab Tour Light Blue Waiter Duty “Special” TBA San Gabriel Valley Council Tribe of Torqua The Tribe of Torqua is Camp Cherry Valley's leadership and honor society. For over 90 years, scouts and adults who come to Cherry Valley have advanced within the tribe, through the ranks of Brave, Warrior, Medicine Man, Chief, and Tribesman. The Senior Patrol Leader is responsible for keeping track of each scout's progress throughout the week. Should a scout fulfill the requirements, he will be inducted into the Tribe. Inductees will be given an Arc patch at the end of the week. The Arcs go around the round Torqua patch available for sale in the Trading Post. Campfires The Camp hosts three campfires during the week. The camp staff perform in the opening and closing campfire for the campers. The Commissioner Campfires on Wednesday night are opportunities for the scouts to perform in front of the camp. Your troop should come with skits or songs prepared, but if your troop does not know any appropriate campfire skits or songs, your troop friends can aid you. Each troop will be given the opportunity to perform 2-3 skits or songs. The Commissioner will pre-screen and approve all skits and songs. Sailing Troop Service Project We provide opportunities for your Unit to perform service projects while in camp. The camp will tailor projects to your Troop's age and skill level. We are always looking for people who would like to help our camp become even better. Anyone interested in joining our support team, please notify the Camp Director. Honor Troop Award (Ribbon) Each troop will have the opportunity to earn the Camp Cherry Valley Honor Troop Award as they participate and progress through the programs during the week. This award honors those Troops who take an active role in promoting the values of Scouting through their service to the camp. This is not a competition between troops, but against the standard of the tradition and excellence of the Camp. Scoutmaster, Commissioners, Senior Patrol Leaders, and Camp Friends will work together to ensure success. Ribbons will be presented to each Troop to designate the level of excellence they have obtained. The forms for tracking in-camp advancement and recognition will be given as part of the check-in material when you arrive at camp. “See things from the boy’s point of view. Lord Baden-Powell Highland Games Thursday night is a special night for our campers. The Highland Games have been a Cherry Valley Tradition for years. Campers participate in friendly competition with others, featuring challenging and rowdy games, like Tug of War, the rope game, arm wrestling, and Bat & Moth. Since 2011, troops can also forge the perfect team for a camp-wide challenge- the Scout Skills Relay. Scouts team up to identify native plants, set up tents, tie knots, shoot arrows, perform first aid, and perform various team-building exercises. Highland Games Honor Trail After the Highland Games and the Scout Skills Relay have been completed, the troops move onto the Honor Trail. Hiking at dusk up along the road that encircles Camp Cherry Valley, scouts will hear from the four commissioners, who will speak regarding the Scout Oath. Drawing on their personal experiences, each commissioner will relate to the troops how scouting has changed their life. This opens the door for serious, profound discussion back in your campsite. Page 11 Photo by Aimee Barker Camp Cherry Valley Hike Day Hiking on Catalina Island is a unique experience. The Island boasts spectacular vistas and easy or difficult terrain. Wednesday is hike day for Cherry Valley campers. Each troop selects one of several locations and spends the day hiking with experienced Troop friends. The hikes we offer differ in difficulty, length, and terrain, so be sure to work with your Senior Patrol Leader and troop to select a hike that works for everyone. Each scout will be given a lunch to pack on the trail, with a sandwich option of Turkey, Ham, or Peanut Butter and Jelly. Program areas will be closed all day, but the Trading Post will open in the afternoon. Pack inspections will be done by Troop Friends to ensure that every scout has the proper equipment for their hike- (i.e. suffiMap of the island. cient water, proper hiking shoes, a hat, first aid kit, etc.). Hike day patches are available in the Trading Post, including rockers for each hike accomplished! Silver Peak Hike Day This is a 17 mile hike to the highest peak on the West End of Catalina Island, an altitude of 1804 ft. The hike takes the better part of the day, even for the physically fit. Hats, canteens, proper, broken-in hiking shoes and sunscreen are necessary equipment and must be brought to camp by the hikers. This hike requires training prior to arrival at camp, it is NOT for scouts NOR adults who do not regularly hike or are not in hiking condition. Troop friends will inspect packs, shoes, footwear and water supply prior to departure from camp. The hike to silver peak offers many scenic vistas of the west end sights that most tourists do not see. This includes fabled Iron-Bound Bay, the impressive Eagle Rock, and Land's End- (the westernmost tip of Catalina). Scouts participating in the ACE program for the week, may use Silver Peak as their ACE hike. Shark Harbor View of the dock. Page 12 This 16 mile hike is a challenging but highly rewarding hike. Starting early in the morning, hikers walk into Two Harbors, then follow the Banning Trail road up 1200' to the ridgeline. They then follow the ridge, traveling south-east until they reach Little Harbor. On clear days hikers may see San Clemente Island on the way. Once to Little Harbor, it's a short distance to neighboring Shark Harbor, where the swells from the open ocean will greet them. Various water toys- (boogie boards, skim boards, etc.), will be available for play once they arrive. After lunch and water time, hikers will travel back to camp by the main road, through the interior of Catalina Island. It is not uncommon for Shark Harbor hikers to come across Catalina's famous bison. The ACE program will do this hike every week. Adults or scouts over 14 wishing to join the ACE hike may do so, even if they are not participating in the rest of the ACE program. Proper adult leadership is expected to be with the rest of the troop. Although not as physically demanding as the Silver Peak hike, it is required that all hikers be in hiking shape, with the proper hiking attire and gear- (hat, broken-in hiking shoes, canteen, etc). San Gabriel Valley Council Emerald Bay A moderately flat 6 mile hike round trip. This adventure allows the scouts to combine an ocean war-canoe adventure with a hike along the scenic West End coast hills. Units will be assigned by their commissioner either to hike to the beach and take a boat back, or to boat to the beach and hike back. The boats are war canoes, in which all scouts and adult leaders will be on their knees or bottoms in the canoe. The canoes do not have seats. The paddle takes approximately 20-30 mins. Campers should take their swimming gear, dry hiking boots, and water shoes. Plan to enjoy the beautiful beach and waters of Emerald Bay. We do recommend bringing your snorkeling gear. This is a great hike for first year scouts, or those looking to enjoy a day in the water and relaxing on the beach. *Goats Whiskers Loop may be added if a more difficult hike is preferred.* Sailing in the wide blue ocean. Parson’s Landing An approximate 8-mile round trip hike; along the scenic West End coast hills, to one of the more popular west-end beaches. Campers should take their swimming gear, dry hiking boots, and water shoes. Plan to enjoy the sandy beach and waters of Parson’s Landing. *Goats Whiskers Loop may be added if a more difficult hike if a more difficult hike is preferred.* Little Fisherman’s “In Scouting, a boy is encouraged to educate himself instead of being instructed” Lord Baden Powell An approximate five mile round trip hike up the Goat Whisker trail and down into Catalina Harbor. From Cat Harbor, you will hike around and past Two Harbors to Little Fisherman’s. Bring your snorkel gear and experience sea life that the Pacific has to offer. Bring Frisbees or footballs for a fun day in and out of the water on the beach. Then change back into your hiking clothes for the short 2 mile hike back to camp. *Goat Whisker’s Loop This hike adds approximately 2 miles round trip to either the Emerald Bay hike or the Parson's Landing Hike. Campers will begin their hike day by summiting the peak that overlooks Cherry Cove. At an altitude of 1224 feet, enjoy scenic views of Isthmus harbor, Cat Harbor, as well as stunning views of the windward side of the island. Continue down the fire break road until you meet the west end road and enjoy the remainder of your hike through the canyons of the West End. Page 13 Taking out the canoes. Camp Cherry Valley Leadership Training Throughout the week, our senior staff will conduct Round Tables, which are open to all adult leaders. Those adult leaders needing to certify or re-certify in Safe Swim Defense, and/or Safety Afloat can do so upon request. Please contact the Camp Director or Program Director for this information. Duty to God The Boy Scouts of America is a Non-Denominational organization, which encourages each member to actively participate in his religious beliefs and responsibilities. Our camp has a chaplain on duty and provides a chapel for individual scouts or groups. A Non-Denominational religious service is an optional part of our Sunday evening program, and all are encouraged to attend. Grace or Prayers will be said before each meal, and all campers will be given an opportunity to participate. Please let your Scouts know they should feel free to pray as they have been taught, and remind them of the importance of showing respect for all forms and traditions of prayer. Advancement at Camp The primary responsibility for rank advancement is that of the unit leaders and the unit committee. Our camp staff will assist Unit leadership by providing the finest in instruction and counseling. Although staff instructors and counselors will provide accurate records for information covered and skill accomplished, it is the responsibility of each unit leader to mark rank advancements in each boy’s individual record (usually in his handbook). Camp counselors will also sign merit badge cards, but the Unit is responsible to ensure they are properly recorded in each boy’s permanent record. Cherry Valley Leaders Guide Canoes COUNCIL’S ADVANCEMENT POLICIES 1. All advancement will be in accordance with BSA National Standards. 2. Merit badge counselors must be supervised 18 years of age or older. 3. No substitutions for any requirements will be allowed. 4. Blue card for completed merit badges will be provided by camp staff. 5. Those not completing all requirements for a specific merit badge will be given partial completion slips. 6. Boards of Review may be conducted in camp if adequate adult leadership is available. Appropriate adult representation on the board, however, is the responsibility of each Unit. 7. The Scoutmaster, Coach, or Skipper, is responsible for preparing, monitoring, and verifying completion of the Scout’s advancement. 8. Scouts are encouraged to prepare for each merit badge they plan to work on at camp. Work done before camp is encouraged. 9. Any Scout receiving a merit badge from our camps will know the subject matter and have learned the practical skills associated with the merit badge. NOTE: Unit leaders are given an opportunity to review all advancement records before leaving camp and are encouraged to review them at home and give the cards to the Unit Advancement Chairman. Page 14 San Gabriel Valley Council Advancement at Camp Cont. Merit Badges are at the core of learning new skills at camp. In keeping with Scouting's great traditions, merit badge classes are taught by passionate, knowledgeable staff. Merit badge requirements are taught to the letter and scouts will receive their merit badge applications (blue cards) at the end of the week. Some of the merit badges offered at our camps cannot be completed while at camp without some work prior to arriving. Those merit badges are marked on the next page. Scoutmasters should advise each scout, who plans to take such specified merit badges, to complete those requirements prior to arriving at camp. Partial Merit Badges will be awarded at the end of the week for those who do not pass off all of the requirements. Unlike some other summer camps, Camp Cherry Valley does not focus solely on the completion of Merit Badges. We believe Merit badges serve to enhance the scout camp experience. We recommend that Scoutmasters and Adult Leaders encourage scouts to accomplish 3 merit badges each. This will ensure they have time to complete the badges they are working on and allow them ample time to participate in other activities. Out in the wide open ocean having fun! When a scout signs up for the Handicraft class, he will have the opportunity to earn the Basketry, Leatherwork, Art, and Woodcarving merit badges during the week. These classes require a scout to purchase supplies in the Trading Post. If a scout only wishes to earn one of these, it is recommended he come to the Handicraft area during free time to earn it. Handicraft badges are very hands-on and allow a scout to go at his own pace, but will likely require a scout to work on projects outside of merit badge and free time. Some merit badges are more difficult than others. We suggest that only boys 14 and older sign up for these classes. They have been marked on the next page. One of the most popular merit badges at Camp Cherry Valley is Small-Boat Sailing. The sailing on Catalina Island is truly wonderful with predictable winds and manageable swells. However, our sailing resources are limited. We require that scouts who wish to take the merit badge class, be at least 14 years old and have at least one other boating merit badge. This ensures that the scouts who take the merit badge class are mentally and physically prepared to meet the challenges and reap the rewards that sailing has to offer. Due to the high volume of material learned, the class is taught over the 2 nd and 3rd merit badge hours. “Merit badges are at the core of learning new skills at camp!” Sailing, however, is for everybody! During free time all are welcome to come to the Waterfront and get on a sailboat. Our knowledgeable sailing instructors will take groups of scouts out of the cove and into the bay to teach and demonstrate basic sailing techniques. We have five, 14-foot monohull Lido boats and two, 16-foot Hobie Catamarans. ACE participants, earning the ACE patch, must sail on the Catamarans sometime during the week. It is wise to look for merit badges that are not normally offered in your hometown and sign up for those while at camp. Try new things and look for variety! Proper planning between the Scout, their adult leader, and parents offers great support. Read the merit badge book before coming to camp. There is too much fun going on at camp to spend time reading merit badge books! We will NOT be doing online merit badge sign ups this year. Please complete the form in the guide and bring it with you to camp to be turned in with medical forms and permission slips. Waterfront supplies Page 15 Camp Cherry Valley Merit Badges Offered *OFFERED AT CLASS TIME AND FREE TIME **CANNOT BE COMPLETED WITHOUT PREREQUISITES BEING DONE PRIOR TO COMING TO CAMP SUGGESTED FOR SCOUTS 14 AND OLDER $$ means there is cost for a kit or materials (buy at trading post or scout shop before coming to camp) PREREQUISITES MERIT BADGE MERIT BADGES: cannot be completed in camp without prerequisites being completed ARCHERY PREREQUISITES MERIT BADGE MAMMAL STUDY* ART*/** 4 OCEANOGRAPHY ASTRONOMY*/** 6 ORIENTEERING* BASKETRY* $$ of kits PERSONAL FITNESS* CANOEING EMERGENCY PREPAREDNESS*/** cannot be completed in camp without prerequisites being completed 6,7&8 PIONEERING* 1, 2C, 6C, 8A-C, 9B ENVIRONMENTAL SCIENCE* RIFLE SHOOTING ROWING $$ Must sign at least up 1 month before FIRST AID Cherry Valley Leaders Guide FISHING*/** SCUBA DIVING 9/CAN NOT COOK FISH AT CAMP SOIL AND WATER CONSERVATION*/** GEOLOGY* SWIMMING $$ of kits LEATHERWORK* LIFESAVING Page 16 7 WEATHER* WILDERNESS SURVIVIAL KAYAKING Many to chose from….. SMALL BOAT SAILING FORESTRY* INDIAN LORE* MUST COMPLETE SIGN UP FORM IN GUIDE $$ of kits WOODCARVING* $$ San Gabriel Valley Council Trail to First Class Policies Camp Cherry Valley is the perfect camp for scouts of all ages and the Trail to First Class program is designed with the newest scouts in mind. The class is offered during each merit badge period and during free time. Scouts who sign up for the class during merit badge time ,will work with the camp instructors to pass off requirements for the Tenderfoot, Second Class, and First Class rank. Scouts needing a few specific requirements passed off can attend during any free time to pass them off. At the end of the week, the instructors will fill out and submit to the scoutmaster a checklist of requirements passed off by each individual boy. It is then up to the Scoutmaster to sign off the requirements in the boys' Scout Handbooks. Trail to First Class Schedule Monday- “Helmsman” CCV Trail to First Class Pass off most requirements dealing with compass use. Knots will be started and the rules of safe hiking will be covered. Monday Requirement Tenderfoot 4a, 4b, 4c, 5, 9 Tuesday- “Rambo” 2nd Class 1a Knot tying will be completed. Scouts will cover Leave No Trace Principles, then move on to safe handling of knives, axes, and saws. Scouts will also go over requirements dealing with cooking fires and meal preparation. 1st Class 1, 7a, 7b, 8a Tuesday 2nd Class st 1 Class 2, 3c, 3d, 3e 4a, 4c, 4d Thursday- “Fire Marshall Bill” Thursday On this day, scouts will go over all requirements related to First Aid. They will learn fundamentals in CPR and emergency situations. Tenderfoot 12a, 12b 2nd Class 7a, 7b, 7c Friday- “Baywatch” 1st Class 8b, 8c, 8d Scouts will meet at the Waterfront to learn the principles of water safety. Safe swim defense and water rescues will also be taught and practiced. Friday 2nd Class 8a, 8b, 8c Free Time- 1st Class 9a, 9b, 9c Scouts can meet any time during free time to pass off any requirement taught during class– with the exception being Friday, when they will meet at the beach during free time. Special free time for Trail to First Class activities include the mile-long orienteering course, instruction in Tote'n Chip, and the Firem'n Chit. Free Time Page 17 First Class rank 1st Class Firem'n Chit Tote'n Chip 2 The open-air is the real objective of Scouting and the key to its success. Lord Baden Powell Camp Cherry Valley Additional Programs Swimming Camp Cherry Valley has the most premiere swimming areas on the entire West Coast! The Waterfront is operated in strict accordance with the BSA policies and is used for general swims during free time, merit badge classes, and rank advancement instruction. If you have scouts that are beginners or non-swimmers, they will have the opportunity, during free time, to work with our waterfront staff to pass their swim check. It is the goal of the camp director and waterfront director for every scout at Camp Cherry Valley to pass their swim check. Swimming! To pass the BSA Swim Check you must jump feet first into water over the head in depth. Level off and swim 75 yards in a strong manner using one or more of the following strokes: sidestroke, breaststroke, trudgen, or crawl; then swim 25 yards using an easy, resting backstroke. The 100 yards must be completed in one swim without stops and must include at least one sharp turn. After completing the swim, scouts rest by floating. Boating Cherry Valley provides sailboats, canoes, rowboats, and ocean kayaks. These are available for use during free time sessions on Tuesday, Thursday and Friday afternoons. CCV also offers sailing opportunities on sailboats or catamarans each afternoon. Come on down and enjoy! This is a great opportunity for Scouts and leaders to practice their boating skills or just have fun. Certified swimmers may use the canoes and kayaks. Everyone must use a PFD. An orientation and demonstration of ability is required to use equipment. Please remember that all persons in the water are responsible for their actions and care must be taken around the anchored yachts in Cherry Cove. The sailing merit badge will take up two merit badge class times, so plan accordingly. “Come on in, the water’s fine” Nature Area and Trail Camp Cherry Valley area offers many opportunities to discover and learn about our environment and Catalina Island’s unique plants and animals. We offer a nature trail, which is set up to be staff-led or selfguided. Eagle’s Nest Snorkel Each afternoon the staff provides a guided excursion to Eagle’s Nest. Snorkeling equipment is available to check out, or you may bring your own. Along the coastline, you will have the opportunity to snorkel, under careful supervision, in kelp forests, along the edge of the cliffs, and along an open channel which team with fish and other wildlife. Rifle and Archery Ranges Rifle and archery ranges are available for use. All participants must receive a safety orientation and skill training. Ammunition and arrows are provided at the range. In order to use the ranges, leaders must have signed permission slips from the parent of the Scouts (See attached document at the back of this guide). Shooting archery Page 18 San Gabriel Valley Council Fishing Program Camp Cherry Valley is a great place to fish the clear waters of the San Pedro Channel. We practice the catch-and-release method of fishing and require Scouts to do so also. CCV does not have facilities to clean and prepare fish for eating and County prohibits us from cooking game fish in our kitchen. Anyone wishing to fish, and who is 16 years or older, will need to have a current California fishing license. We are able to issue poles and tackle on a limited basis. In order to have a successful fishing adventure at camp, it is advised that you bring your own equipment. We also require that you use barb-less hooks for easy release of the fish that you catch. Artificial tackle will be sold in the trading post. Mile Swim Off the dock This is an individual activity. Participants will need another Troop member to supervise and count laps. The BSA Mile Swim Award is a progressive award. Scouts or adult leaders can earn the BSA Mile Swim. To do so they must pass the swim check and swim the ¼ mile, ½ mile and full mile during the week at camp. They can complete these swims during afternoon free-time on Tuesday, Thursday and Friday. The free-time period is from 2-5pm. Swimmers wishing to complete the BSA Mile Swim Award are encouraged to meet with the Waterfront Director at the beginning of free-time on Tuesday to get started. BSA Lifeguard This program is for older Scouts (14 and up) and adults. It will take approx. 40 hours to complete during the week and will require the person to miss most of the free time activities and merit badge opportunities. The candidates will participate, with our trained Waterfront Staff, throughout the week in all aspects of our waterfront operation. If interested, please contact the Waterfront Director. Special Opportunities The following are special opportunities for boys to improve their skills and serve others. To have a chance to earn special recognition in these fields you must meet the requirements written next to the award. Those who participate and complete the requirements will be recognized at the end of camp and be eligible to purchase the patch or carry the BSA certification card. Firem’n Chit-Taught in the Handiland or Trail to First Class area during the free-time and is available to all adults and boys. BSA Lifeguard- See BSA Lifeguard requirements above. Snorkeling BSA- Taught by the ACE program and is available to all adults or boys 14 years or older. Mile Swim BSA- Available to all Scouts. See Mile Swim requirements above. Totin’ Chip- Taught in the Handiland or Trail to First Class area during the free-time and is available to all adults and boys. Scouts must have this certification before they can handle knifes at camp. Kayaking BSA- Taught by the ACE program and is available to all adults or boys 14 years or older. Page 19 Camp Cherry Valley Scuba Camp Cherry Valley offers an introductory dive program for youth and adult campers as well as a full PADI Scuba Certification and Scuba Diving Merit Badge. You will find the reservation form at the end of this guide. Photo by Aimee Barker The PADI Discover Scuba Diving Program allows any camper 14 years and older the opportunity to experience scuba diving and provides one, 20-30 minute ocean dive. This is a program that requires 4 hours of the campers’ time throughout the week. Participants will spend time in class reviewing key terms and diving procedures, as well as developing their Scuba skills, by diving in the confined waters of Cherry Cove and the surrounding open water. The cost for this program is an additional $135.00 and all gear needed to participate is provided. It is recommended that scouts sign up through the camping department at least 30 days before their arrival to camp and make payment to the council. However, scouts and adult leaders can sign up and pay while at camp. If the scout’s parent/guardian is not present at camp, then the forms will have to be completed and faxed or emailed to the camp before the scout can participate. Payment must also be made to the program office before the scout or adult will be allowed to dive. The Scuba Diving Merit Badge is available to scouts 14 years and older who have passed their swim check. If your scout is already Scuba Certified, they can sign up for the Scuba Diving Merit Badge Upgrade. This program is $135.00 and includes the requirements for the Scuba Diving Merit Badge along with a guided dive. This program takes about 2 hours with a 20-30 minute dive included. “To catch the reader's attention, place an interesting sentence or quote from the story here.” If the scout is not Scuba Certified, he can sign up for a weeklong course during the merit badge periods in which he will become PADI Certified and also go through the requirements for the Scuba Diving merit badge. The cost for the PADI Scuba Certification and Scuba Diving Merit Badge Program is $325.00. Scouts must also take the PADI eLearning Course online in order to become scuba certified. The cost of the course is $120. Scouts should plan on giving themselves 1-2 months to complete the course work before they arrive at camp. Scouts must be able to complete the requirements for the merit badge. Paying the course fee does not guarantee the scout will earn the merit badge. Scouts and adult leaders who are already certified and wish to do a guided dive can sign up and pay at camp. The Guided Dive for Certified Divers costs $75. This includes all of your gear and oxygen for a 30-45 min dive in the cove. If you have a large group of divers we do recommend you call or email the council office 2 weeks before you arrive to camp so that we can facilitate your group of divers. Ready to dive Catalina, being part of the Channel Islands, is one of the top 10 dive destinations in the world! The giant kelp forests are a habitat for an abundance of marine life, including bright orange Garibaldi (the California state marine fish), giant black sea bass (a protected species), California spiny lobster, and playful California sea lions – just to name a few. Two Harbors Dive and Recreation Center is a full service PADI dive shop located in Two Harbors, just two coves east of Camp Cherry Valley. They have an outstanding dive instruction team and top-of-the line equipment to assist you in your adventure. We will have a satellite dive center set up at Camp Cherry Valley to support all the camp’s diving instruction and activities. Photo by Aimee Barker Page 20 Please complete the forms at the back of this guide and bring them to camp with you. San Gabriel Valley Council Advanced Camper Experience Program (ACE) Catamaran During each summer camp session, we offer a program geared toward the older Scout (14 years and older). The Advance Camper Experience (ACE) Program gives returning Scouts an opportunity to meet others their own age, go on high adventure activities, and experience activities they may have never done before. These scouts will stay in Troop campsites, eat, and participate in most Troop program activities and all camp wide activities. The ACE Program can take the place of merit badge classes. Those campers who participate in every ACE activity will receive a special recognition at the end of the camping week. Scouts and Adult Leaders can earn the BSA Kayak and BSA Snorkel Awards by participating in the ACE morning program activities . Photo by Aimee Barker Activities include: 1. Kayaking on the open ocean 2. 16 Mile Shark Harbor Hike 3. Ship Rock snorkeling 4. Blue Cavern snorkeling 5. Catamaran Sailing 6. Stand Up Paddle Boarding 7. Goat Whiskers hike. 8. Pirate’s Cove Snorkel Prerequisites are: “Will you be joining the ACE program? Can you ACE it?” 1. 14 years of age by the first day of the program 2. Pass the camp swim test 3. Have a signed, current medical form on file in camp 4. Unit leader permission ACE Week at a Glance Time Monday Tuesday 9:15 am Swim Checks assigned as troops Ship Rock Kayak/Snorkel Wednesday Breakfast: 6:00 AM Shark Harbor Hike Thursday Blue Caverns Snorkeling Friday Goat Whiskers Hike Hike Day BSA Snorkel 2:10 pm Pack Check Requirements Pirate’s Cove Stand-Up Paddle Snorkel Boarding/ Catamaran Sailing Page 21 Catamaran Sailing / Catamaran Sailing / Stand-up Stand-up Paddle Paddle Boarding Boarding Snorkeling Camp Cherry Valley 2013 Scuba Diving Programs DO YOU WANT TO SCUBA DIVE ON CATALINA ISLAND? The San Gabriel Valley Council, Boy Scouts of America has partnered with Two Harbors Dive & Recreation Center to offer you the underwater world. Camp Cherry Valley on Catalina Island is now offering you the opportunity to participate in a variety of scuba programs. Minimum age for these programs is 14 years old. All reservations must be done prior to coming to camp with the exception of the Guided Dive for Certified Divers. *The PADI Discover Scuba Diving program: Available for an additional fee of $100.00. (after summer camp fee) Scouts 14 and older/ Adults One dive under the direct supervision of a PADI instructor. Program takes about 4 hours. Not a certification course, but can count toward certification. The actual dive is about 20-30 minutes long. All equipment is included you just need your swimsuit. *Scuba Diving Merit Badge (uncertified) Available for an additional fee of $350.00. (after summer camp fee) Scouts 14 and older who have passed swim check Become PADI certified All requirements will be taught An open water dive Must take the PADI eLearning Course online to be certified. Cost is an additional $138.00 paid online. Guided Dive for Certified Divers: Available for an additional fee of $80.00. (after summer camp fee) Scouts 14 and older/ Adults Includes gear and oxygen for a 30-45 minute dive in the cove. *Scuba Diving Merit Badge Upgrade (already certified) Available for an additional fee of $100.00. (after summer camp fee) Scouts 14 and older who have passed swim check All requirements will be taught 2 hour program with a 20-30 minute with an open water dive Page 22 Camp Cherry Valley 2013 Scuba Diving Programs So, don’t miss out on a chance to experience Catalina Island from below the waterline. All registration MUST be done prior to arriving at camp for all programs with *. Please complete the scuba forms at the back of this guide and take them to camp with you. PADI Discover Scuba for Uncertified Divers # of persons: $100 per person Total: $ PADI Discover Scuba for Certified Divers # of persons: $80 per person Total: $ Scuba Diving Merit Badge Uncertified Scout # of Scouts: $350 per Scout Total: $ *Scuba Diving Merit Badge Upgrade Certified Scout # of Scouts: $100 per Scout Total: $ Names and Date Of Birth Names and Date Of Birth PADI Discover Scuba *Scuba Diving Merit Badge (uncertified) *Scuba Diving Merit Badge Upgrade (already certified) Guided Dive for Certified Divers: Council Troop # Week Date of camp session Contact Person Name Address City State Zip Home Phone (______) Email: $ Total Due Payment Method: __Cash __ Check __Visa __MasterCard __ American Express __ Discover Credit Card Number Exp. Date ____/_____ Cardholder Name: Cardholder Signature: CANCELLATION POLICY: UP UNTIL TWO WEEKS PRIOR TO CAMP, CANCELLATION FEE OF 25% OF TOTAL COST, AFTER THAT, NO REFUNDS CAN BE GIVEN. Mail or bring form and payment to: San Gabriel Valley Council, B.S.A., 3450 East Sierra Madre Blvd., Pasadena, CA 91107; Fax 626-351-9149 GL#711 Page 23 2013 CAMP CHERRY VALLEY WEEK AT A GLANCE 2013 SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Trading Post Hours 7:00 AM Starboard Watch Breakfast Port Inspection 7:00 AM Starboard Watch Breakfast Port Inspection 7:00 AM Starboard Watch Breakfast Flag Ceremony 7:00 AM Starboard Watch Breakfast Port Inspection 7:00 AM Starboard Watch Breakfast Port Inspection 7:00 AM Starboard Watch Breakfast & Port Final Inspection 7:40 AM Port Watch Breakfast Starboard Inspection 7:40 AM Port Watch Breakfast Starboard Inspection 7:40 AM Port Watch Breakfast 7:40 AM Port Watch Breakfast Starboard Inspection 7:40 AM Port Watch Breakfast Starboard Inspection 7:40 AM Port Watch Breakfast & Starboard Final Inspection 8:45 AM Flag Ceremony 8:45 AM Flag Ceremony 8:45 AM Flag Ceremony 8:45 AM Flag Ceremony 8:30 AM Closing Flag Ceremony Tribe of Torqua 9:15 AM Starboard Watch Swim Checks; Port Free Time 9:25 AM 1st Merit Badge Session 9:25 AM 1st Merit Badge Session 9:25 AM 1st Merit Badge Session 9:15 PM Hike to Two Harbors 10:15 AM Scoutmaster Roundtable 10:15 AM Scoutmaster Roundtable 10:15 AM Scoutmaster Roundtable 10:25 AM 2nd Merit Badge Session 10:25 AM 2nd Merit Badge Session 10:25 AM 2nd Merit Badge Session 9:15 AM Port Watch Swim Check Starboard Free Time 11:25 AM 3rd Merit Badge Session 11:25 AM 3rd Merit Badge Session 11:25 AM 3rd Merit Badge Session 1:30 PM Check in at Long Beach 12:20 PM Starboard Watch Lunch 12:20 PM Starboard Watch Lunch 2:30 PM Depart Long Beach 1:00 PM Port Watch Lunch 1:00 PM Port Watch Lunch Monday, Tuesday, Thursday, Friday: 9 AM-7 PM Wednesday: 3 -7 PM Saturday: 7 – 9:30 AM Morning Joe Coffee 6 – 8 AM High Adventure Day Lunch on the Trail 10:45 AM Boat Departs Two Harbors 12:20 PM 12:20 PM Starboard Watch Lunch Starboard Watch Lunch 1:00 PM Port Watch Lunch 1:00 PM Port Watch Lunch 12:45- 1:15 PM Boat arrives in Long Beach 2:00 PM 1st Merit Badge Session 4:30 PM Arrive in Two Harbors; Hike-in & Orientation 3:00 PM 2nd Merit Badge Session 3:00 PM Scoutmaster Roundtable 2:00 - 5:00 PM 2:00 - 5:00 PM Free time Free time All program areas open All program areas open 4:00 Scoutmaster Shoot Troop Shoots 2:00 - 5:00 PM Free time All program areas open 4:00 PM 3rd Merit Badge Session 6:00 PM Starboard Watch Dinner 5:15 PM Starboard Watch Dinner 5:15 PM Starboard Watch Dinner 5:15 PM Starboard Watch Dinner 5:15 PM Starboard Watch Dinner 5:15 PM Starboard Watch Dinner 6:45 PM Port Watch Dinner 5:55 PM Port Watch Dinner 5:55 PM Port Watch Dinner 5:55 PM Port Watch Dinner 5:55 PM Port Watch Dinner 5:55 PM Port Watch Dinner 7:30 PM Scouts Own @ Chapel 7:00 PM Commissioners Team Building Games 6:45 PM Troop Friend Night War Canoeing 7:30 PM Flag Ceremony & Commissioner Campfires 6:45 PM Flag Ceremony and Highland Relay 7:30 PM Flag Ceremony and Closing Campfire 8:00 PM Flag Ceremony Tribe of Torqua SPL Ceremony 8:00 PM Flag Ceremony OA Speech Opening Campfire 8:00 PM Honor Trail Waiter's call is 15 minutes before each meal. Please send 1 waiter for every table. Port Watch Kybo duty after breakfast @ 8:00 AM. Starboard Kybo duty after dinner @ 5:45 PM. Page 24 ** On Saturday all luggage & gear needs to be at the loading dock before breakfast. 2013 CAMP CHERRY VALLEY– MERIT BADGE SIGN-UP SHEET Scouts 14 and older / *offered at class time and free time / **cannot be completed in camp without prerequisites being completed Note: Please only sign up for 3 classes per boy. Other badges can be taken during free time and are arranged with class instructor. BSA LIFEGUARD TRAIL TO FIRST CLASS WOODCARVING * WILDERNESS SURVIVIAL WEATHER * SWIMMING SOIL AND WATER CONSERVATION */** SMALL BOAT SALILING (COUNTS AS 2 MB PERIODS & 14 AND OLDER) ROWING RIFLE SHOOTING PIONEERING * PERSONAL FITNESS * ORIENTEERING * OCEANOGRAPHY MAMMALS STUDY * LIFESAVING LEATHERWORK * $$ INDIAN LORE * KAYAKING GEOLOGY * FORESTRY * FISHING */** FIRST AID ENVIRONMENTAL SCIENCE * EMERGENCY PREPAREDNESS */** CANOEING BASKETRY * $$ ASTRONOMY */** ART */** SCOUTS NAME: TROOP# ________ Page 25 _________ WEEK# ARCHERY Camp Cherry Valley SAN GABRIEL VALLEY COUNCIL BOY SCOUTS OF AMERICA At the council’s camps, the children have the opportunity to participate in the activities listed below. However, to participate, they must have the consent of their parent or guardian. Please indicate with a check mark, those activities which will apply to your child and the camp he/she is attending, sign and date the form and send it to camp with your child. Troop #: I give consent for ___________________________________, who is my son or ward, to use the following equipment: At Camp Cherry Valley Archery BB’s .22 Rifles _______________________________________________________________ Parent/Guardian Signature Print parent/guardian name Page 26 Date San Gabriel Valley Council 2013 Camp Cherry Valley Unit Overnight TRASK SCOUT CAMP, MONROVIA CANYON Sleep under the stars; enjoy swimming, dinner and breakfast before you leave for your Cherry Valley adventure! Additionally, we are now offering an optional sack lunch to take with you to the boat. Some troops stay there at both ends of the week! We will send directions to Camp Trask with confirmation of your reservation. Troop Number Arrival Date Council: Leader Name Estimated arrival time Address City/St/Zip Daytime Telephone: Number of people Email: $20.00 per person X # of people $ (includes dinner and breakfast) $5.00 per person for sack lunch X # of people $ $ Payment method Check Cash VISA Total enclosed MasterCard American Express Credit Card Number Discover Exp. Date Cardholder Signature *Return as soon as possible to reserve your space! There are a limited number of two person platform tents available. These tents will be assigned on a first come first serve bases. Please come prepared to sleep under the stars, you will need ground cover. #1-6701-751-21 Page 27 Annual Health and Medical Record Registro Médico y de Salud Anual (Valid for 12 calendar months) (Válido por 12 meses calendario) Policy on Use of the Annual Health and Medical Record Política para el uso del Registro Médico y de Salud Anual In order to provide better care for its members and to assist them in better understanding their own physical capabilities, the Boy Scouts of America recommends that everyone who participates in a Scouting event have an annual medical evaluation by a certified and licensed health-care provider—a physician (MD or DO), nurse practitioner, or physician assistant. Providing your medical information on this four-part form will help ensure you meet the minimum standards for participation in various activities. Note that unit leaders must always protect the privacy of unit participants by protecting their medical information. A fin de proporcionar una mejor atención para sus miembros y para ayudarles a entender mejor sus propias capacidades físicas, Boy Scouts of America recomienda que todos aquellos que participen en un evento Scouting se sometan a un examen médico anual realizado por un prestador de servicios de salud certificado y con licencia: un médico (Doctor en medicina o Doctor en osteopatía), enfermera profesional o asistente médico. Proporcionar su información médica en este formulario de cuatro partes, ayudará a asegurar que usted cumple con los estándares mínimos de participación en varias actividades. Tome en cuenta que los líderes de unidad siempre deben proteger la privacidad de los participantes al salvaguardar su información médica. Parts A and B are to be completed at least annually by participants in all Scouting events. This health history, parental/ guardian informed consent and release agreement, and talent release statement is to be completed by the participant and parents/guardians. Attach a copy of both sides of your insurance card. Part C is the pre-participation physical exam that is required for participants in any event that exceeds 72 consecutive hours, for all high-adventure base participants, or when the nature of the activity is strenuous and demanding. Service projects or work weekends may fit this description. Part C is to be completed and signed by a certified and licensed heathcare provider—physician (MD or DO), nurse practitioner, or physician assistant. It is important to note that the height/ weight limits must be strictly adhered to when the event will take the unit more than 30 minutes away from an emergency vehicle, accessible roadway, or when the program requires it, such as backpacking trips, high-adventure activities, and conservation projects in remote areas. See the FAQs for when this does not apply. Part D is required to be reviewed by all participants of a highadventure program at one of the national high-adventure bases, as well as unit-based, high-adventure backcountry activities, and shared with the examining health-care provider before completing Part C. • Philmont Scout Ranch. Participants and guests for Philmont activities that are conducted with limited access to the backcountry, including most Philmont Training Center conferences and family programs, will not require completion of Part C. However, participants should review Part D to understand potential risks inherent at 6,700 feet in elevation in a dry Southwest environment. Please review specific registration information for the activity or event. • Northern Tier National High Adventure Base. • Florida National High Adventure Sea Base. The PADI medical form is also required if scuba diving at this base. • Summit Bechtel Reserve. Las Partes A y B las deben completar, por lo menos una vez al año, los participantes de todos los eventos Scouting. Este historial médico, notificación de consentimiento y convenio de exoneración de responsabilidad por parte de los padres/tutores, y formulario de cesión de derechos lo deben completar los participantes y los padres/tutores. Anexar una copia de ambos lados de su tarjeta del seguro. La Parte C es el examen físico previo, que se requiere de los participantes de cualquier evento que exceda 72 horas consecutivas, para todos los participantes de las bases de aventura extrema, o cuando la naturaleza de la actividad es extenuante y exigente. Los proyectos de servicio o fines de semana de trabajo pueden caer en esta descripción. La Parte C la debe completar y firmar un prestador de servicios de salud certificado y con licencia: un médico (Doctor en medicina o Doctor en osteopatía), enfermera profesional o asistente médico. Es importante tomar en cuenta que los límites de estatura y peso deben ser estrictamente controlados cuando el evento llevará a la unidad a más de 30 minutos de un vehículo de emergencia, camino accesible, o cuando el programa lo requiera, tal como expediciones, actividades de aventura extrema y proyectos de conservación en áreas remotas. Consulte las Preguntas Frecuentes para cuando estos lineamientos no aplican. La Parte D se requiere que la revisen todos los participantes del programa de aventura extrema en una de las bases nacionales de aventura extrema, así como actividades de aventura extrema en zonas aisladas basadas en la unidad, y que la compartan con el prestador de servicios de salud antes de completar la Parte C. • Rancho Scout Philmont. Los participantes e invitados en las actividades Philmont que se realicen con acceso limitado a las zonas campestres, incluyendo la mayoría de las conferencias y programas familiares en el Centro de Capacitación Philmont, no requerirán llenar la Parte C. Sin embargo, los participantes deberán repasar la Parte D para entender los riesgos potenciales inherentes a los 6,700 pies de elevación en un ambiente seco del Suroeste. Favor de revisar la información de registro específica para la actividad o evento. • Base nacional de aventura extrema Northern Tier. • Base nacional marina de aventura extrema de la Florida. También se requiere el formulario médico PADI si se va a bucear en esta base. • Summit Bechtel Reserve. Risk Factors Based on the vast experience of the medical community, the BSA has identified the following risk factors that may limit your participation in various outdoor adventures. • Excessive body weight • Heart disease • Hypertension (high blood pressure) • Diabetes • Seizures • Lack of appropriate immunizations • Asthma • Allergies/anaphylaxis • Muscular/skeletal injuries • Psychiatric/ psychological and emotional difficulties Factores de riesgo Con base en la gran experiencia de la comunidad médica, BSA ha identificado los siguientes factores de riesgo que podrían limitar su participación en varias aventuras al aire libre. • Peso corporal excesivo • Enfermedad cardiaca • Hipertensión (Presión arterial alta) • Diabetes • Convulsiones • Falta de vacunación adecuada • Asma • Alergias/anafilaxia • Lesiones musculares/ óseas • Trastornos psiquiátricos/ psicológicos y emocionales For more information on medical risk factors, visit Scouting Safely on www.scouting.org. Para obtener más información sobre los factores de riesgo médicos, visite Scouting Safely en www.scouting.org. Prescriptions The taking of prescription medication is the responsibility of the individual taking the medication and/or that individual’s parent or guardian. A leader, after obtaining all the necessary information, can agree to accept the responsibility of making sure a youth takes the necessary medication at the appropriate time, but the BSA does not mandate or necessarily encourage the leader to do so. Also, if state laws are more limiting, they must be followed. Prescripciones Tomar los medicamentos prescritos es responsabilidad del individuo que requiere el medicamento o del padre de familia o tutor del individuo. Un líder, después de haber obtenido toda la información necesaria, puede aceptar la responsabilidad de asegurarse de que un niño tome el medicamento necesario a la hora apropiada, pero BSA no obliga ni necesariamente anima al líder a que lo haga. Asimismo, si las leyes estatales son más limitantes, deben ser cumplidas. Frequently Asked Questions (FAQs) • Philmont Scout Ranch: www.philmontscoutranch.org or 575-376-2281 • Northern Tier National High Adventure Program: www.ntier.org or 218-365-4811 • Florida National High Adventure Sea Base: www.bsaseabase.org or 305-664-5612 • National Scout jamboree: www.bsajamboree.org • Summit Bechtel Reserve: www.summitblog.org or 304-250-6750 For frequently asked questions about this Annual Health and Medical Record, see Scouting Safely online at http://www.scouting.org/scoutsource/HealthandSafety. aspx. Information about the Health Insurance Portability and Accountability Act (HIPAA) may be found at www.hhs.gov/ocr/ privacy/. Preguntas frecuentes • Rancho Scout Philmont: www.philmontscoutranch.org ó 575-376-2281 • Base nacional de aventura extrema Northern Tier: www.ntier.org ó 218-365-4811 • Base nacional marina de aventura extrema de la Florida: www.bsaseabase.org ó 305-664-5612 • Jamboree Scout Nacional: www.bsajamboree.org • Summit Bechtel Reserve: www.summitblog.org ó 304-250-6750 Para consultar las preguntas frecuentes sobre este Registro Médico y de Salud Anual, consulte Scouting Safely en línea en http://www.scouting.org/scoutsource/HealthandSafety.aspx. La información sobre la Ley de responsabilidad y transferibilidad de seguros médicos (HIPAA, por sus siglas en inglés) se encuentra en www.hhs.gov/ocr/privacy/. 680-001 2012 Printing Rev. 9/2012 Parte A Nombre completo Fecha de nacimiento Alergias Teléfono en caso de emergencia Part A Full name:_________________________________DOB:________________ Allergies:___________________ Emergency contact No.:______________ Annual Health and Medical Record Registro Médico y de Salud Anual Part A/Parte A High-adventure base participants: Participantes en la base de aventura extrema: Expedition/crew No. Expedición/grupo no.:_______________________________ or staff position o puesto fijo: ______________________________________ GENERAL INFORMATION/INFORMACIÓN GENERAL Name ____________________________________________________ Date of birth ___________________________________ Age ____________ Nombre Fecha de nacimiento (MM/DD/Year) - (MM/DD/Año) Edad Male Masculino Female Femenino Address ______________________________________________________________________________________________ Grade completed (youth only)______________________ Domicilio Grado escolar completado (sólo niños) City __________________________________________________________ State______________ Zip ______________________ Phone No. _______________________________ Ciudad Estado Código postal No. telefónico Unit leader ____________________________________________________ Council name/No. ___________________________________________ Unit No. ___________________ Líder de la unidad Nombre y no. del concilio No. de unidad Social Security No. (optional; may be required by medical facilities for treatment)___________________________________ Religious preference ________________________ No. de Seguro Social (opcional; puede ser solicitado por las instalaciones médicas para brindar tratamiento) Preferencia religiosa Health/accident insurance company ____________________________________________________________ Policy No. ________________________________________________ Compañía de seguro médico/accidental No. de póliza ATTACH A PHOTOCOPY OF BOTH SIDES OF INSURANCE CARD. IF YOU DO NOT HAVE MEDICAL INSURANCE, ENTER “NONE” ABOVE. ANEXAR UNA FOTOCOPIA DE AMBOS LADOS DE LA TARJETA DEL SEGURO. SI USTED NO TIENE SEGURO MÉDICO, ESCRIBA “NINGUNO.” In case of emergency, notify/En caso de emergencia, notificar a: Name _________________________________________________________________________________ Relationship ____________________________________________________ Nombre Parentesco Address _______________________________________________________________________________________________________________________________________________ Domicilio Home phone _________________________________________ Business phone _____________________________________ Mobile phone _______________________________ Teléfono de casa Teléfono de oficina Teléfono móvil Alternate contact name _____________________________________________________________________ Alternate’s phone ___________________________________________ Nombre de contacto alterno Teléfono del contacto alterno HEALTH HISTORY/HISTORIAL MÉDICO Please fill in the bubbles as indicated below: Por favor rellene los círculos tal como se indica a continuación: Do you currently have, or have you ever been treated for any of the following? Incorrect: ¿Tiene actualmente, o ha tenido alguna vez los siguientes? Yes/Sí No/No Incorrecto Condition/Padecimiento Asthma Asma Diabetes Diabetes Correct: Correcto Explain/Explique Last attack: (MM/YY) Último ataque: (MM/AA) % Last HbA1c: (Percentage) Última HbA1c: (Porcentaje) Hypertension (high blood pressure) Hipertensión (presión alta) Heart disease/heart attack/chest pain/heart murmur Enfermedad del corazón/infarto/dolores de pecho/soplo cardíaco Stroke/TIA Apoplejía/Accidente isquémico transitorio Lung/respiratory disease Enfermedades pulmonares/respiratorias Ear/sinus problems Problemas del oído/senos paranasales Muscular/skeletal condition Condiciones musculares/óseas Menstrual problems (women only) Problemas menstruales (sólo mujeres) Psychiatric/psychological and emotional difficulties Dificultades psiquiátricas/psicológicas y emocionales Behavioral/neurological disorders Trastornos de conducta/neurológicos Bleeding disorders Enfermedades hemorrágicas Fainting spells Desmayos Thyroid disease Enfermedades de la tiroides Kidney disease Enfermedades del riñón Sickle cell disease Anemia falciforme Seizures Last seizure: (MM/YY) Convulsiones Última convulsión: (MM/AA) Sleep disorders (e.g., sleep apnea) Trastornos del sueño (por ejemplo, síndrome de apnea-hipopnea durante el sueño) Use CPAP: Usa CPAP Yes Sí No No Abdominal/digestive problems Problemas abdominales/digestivos Surgery Cirugía Last surgery: (MM/YY) Última cirugía: (MM/AA) Serious injury Lesión grave Excessive fatigue or shortness of breath with exercise Fatiga en exceso o dificultad para respirar al hacer ejercicio Other Otro Page 1 of 2 PART A (continued on next page) HEALTH HISTORY/HISTORIAL MÉDICO Please fill in the bubbles as indicated: Are you allergic to or do you have any adverse reaction to any of the following? Por favor rellene los círculos tal como se indica: ¿Es alérgico a, o le causa alguna reacción adversa cualquiera de los siguientes? Yes/Sí Correct: IncorrectoCorrecto Explain Allergies or Reaction to No/No Incorrect: Alergias o Reacciones a Explique Medication Medicamentos Food, plants, or insect bites Alimentos, plantas o picaduras de insectos The following immunizations are recommended by the BSA. Tetanus immunization is required and must have been received within the last 10 years. For each item, indicate if you have been immunized, the date of the immunization (MM/YY), if you have had the disease, and the date (MM/YY). BSA recomienda las siguientes vacunas. La vacuna contra el Tétanos es obligatoria y debe haberla recibido en los últimos 10 años. Por cada punto, indique si ha sido vacunado, la fecha en que la recibió (MM/AA), si ha padecido la enfermedad, y la fecha (MM/AA). Immunized? Immunizations ¿Vacunado? Yes/Sí Date (MM/YY) Fecha (MM/AA) Vacunas No/No Had Disease? Date (MM/YY) ¿La ha padecido? Yes/Sí Fecha (MM/AA) No/No Tetanus Tétano Pertussis Part A Full name: __________________________________________________________ DOB: ____________________ Parte A Nombre completo Fecha de nacimiento Tos ferina Diphtheria Difteria Measles Sarampión Mumps Paperas Rubella Rubéola Polio Polio Chicken pox Varicela Hepatitis A Hepatitis A Hepatitis B Hepatitis B Meningitis Meningitis Influenza Influenza Other (i.e., HIB) Otra (por ejemplo, HIB) Exemption to immunizations claimed (form required). Exención de vacunas solicitada (formulario obligatorio). MEDICATIONS List all medications currently used. (If additional space is needed, please photocopy this part of the health form.) Inhalers and EpiPen information must be included, even if they are for occasional or emergency use only. MEDICAMENTOS Enumere todos los medicamentos que usa en la actualidad. (Si requiere espacio adicional, favor de sacar una fotocopia de esta parte del formulario.) Se debe incluir información sobre inhaladores y EpiPen, incluso si son sólo para uso ocasional o en caso de emergencia. Medication Medicamento__________________________________________ Strength Frequency Dosis _____________________ Frecuencia _________________ Medication Medicamento__________________________________________ Strength Frequency Dosis _____________________ Frecuencia _________________ No medications Sin medicamentos Additional medications (sheet attached) Medicamentos adicionales (hoja anexa) Medication Medicamento__________________________________________ Strength Frequency Dosis _____________________ Frecuencia _________________ Approximate date started Approximate date started Approximate date started Reason for medication Reason for medication Reason for medication ______________________________________________________ ______________________________________________________ ______________________________________________________ Medication Medication Medication Fecha aproximada de inicio______________________________ Razón del medicamento_________________________________ Medicamento__________________________________________ Strength Frequency Dosis _____________________ Frecuencia _________________ Fecha aproximada de inicio______________________________ Razón del medicamento_________________________________ Medicamento__________________________________________ Strength Frequency Dosis _____________________ Frecuencia _________________ Fecha aproximada de inicio______________________________ Razón del medicamento_________________________________ Medicamento__________________________________________ Strength Frequency Dosis _____________________ Frecuencia _________________ Approximate date started Approximate date started Approximate date started Reason for medication Reason for medication Reason for medication ______________________________________________________ ______________________________________________________ ______________________________________________________ Fecha aproximada de inicio______________________________ Razón del medicamento_________________________________ Fecha aproximada de inicio______________________________ Razón del medicamento_________________________________ Fecha aproximada de inicio______________________________ Razón del medicamento_________________________________ Administration of the above medications is approved by (if required by your state):__________________________________________________________/________________________________________________________ La administración de los medicamentos arriba Parent/guardian signature and/or mencionados está aprobada por (si lo requiere su estado) Firma del padre o tutor y/o MD/DO, NP, or PA signature Firma del Dr., Enfermera profesional, Asistente médico 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. Asegurarse de traer los medicamentos en cantidades suficientes y en los envases originales. Asegurarse de que NO ESTÉN CADUCADOS, incluyendo inhaladores y EpiPens. NO DEBE DEJAR DE tomar cualquier medicamento de mantenimiento a menos que se lo indique su médico. Page 2 of 2 680-001 2012 Printing Rev. 9/2012 High-adventure base participants: Participantes en la base de aventura extrema: Part B Full name: __________________________________________________________ DOB: ____________________ Parte B Nombre completo Fecha de nacimiento Part B/Parte B Expedition/crew No./Expedición/grupo no.: _______________________________ or staff position/o puesto fijo: ____________________________________________ Informed Consent and Release Agreement NOTIFICACIÓN DE CONSENTIMIENTO 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 also understand that participation in these activities is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. Entiendo que la participación en actividades Scouting implica un cierto grado de riesgo y que pueden ser física, mental y emocionalmente agotadoras. Asimismo, entiendo que la participación en dichas actividades es completamente voluntaria y requiere que los participantes se acaten a las reglas y estándares de conducta pertinentes. In case of an emergency involving me or my child, I understand that every effort will be made to contact the individual listed as the emergency contact person. 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. En caso de que yo, o mi hijo, nos veamos involucrados en un caso de emergencia, entiendo que se hará todo lo posible para contactar al individuo mencionado como persona a contactar en caso de emergencia. En caso de que dicha persona no pueda ser localizada, por este medio otorgo permiso al proveedor de servicios médicos seleccionado por el líder adulto a cargo para asegurar que se proporcione el tratamiento adecuado, incluyendo hospitalización, anestesia, cirugía o inyecciones de medicamentos para mí o mi hijo. Los proveedores médicos están autorizados a compartir información médica protegida con el adulto a cargo, el personal médico del campamento, la administración del campamento, o cualquier médico o proveedor de servicios médicos involucrado en la administración de atención médica al participante. La Información médica protegida/Información médica confidencial (PHI/CHI, por sus siglas en inglés) bajo los Estándares de privacidad de información médica individualmente identificable, 45 C.F.R. §§160.103, 164.501, etc., y siguientes como se enmiendan de vez en cuando, incluye resultados de reconocimientos médicos, resultados de pruebas y tratamiento proporcionado para propósitos de evaluación médica del participante, seguimiento y comunicación con los padres o tutor del participante, y determinación de la habilidad del participante de continuar con las actividades del programa. I have carefully considered the risk involved and give consent for myself and/or my child to participate in these activities. I approve the sharing of the information on this form with BSA volunteers and professionals who need to know of medical situations that might require special consideration for the safe conducting of Scouting activities. 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. He considerado cuidadosamente el riesgo implicado y he dado el consentimiento para mí mismo o mi hijo de participar en dichas actividades. Apruebo que se comparta la información contenida en este formulario con los voluntarios y profesionales de BSA que necesiten tener conocimiento de condiciones médicas que puedan requerir consideración especial para la realización de actividades Scouting de manera segura. Eximo a Boy Scouts of America, al concilio local, a los coordinadores de la actividad y a todos los empleados, voluntarios, grupos involucrados u otras organizaciones asociadas con la actividad, de cualquier y toda reclamación o responsabilidad que surja a raíz de esta participación. Without restrictions./Sin restricciones. With special considerations or restrictions (list)/Con condiciones especiales o restricciones (lista): ________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________ I hereby assign and grant to the local council and the Boy Scouts of America 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. Por este conducto asigno y otorgo al concilio local y a Boy Scouts of America el derecho y permiso para usar y publicar las fotografías/películas/ videocintas/representaciones electrónicas y grabaciones de sonido de mí o mi hijo realizadas en todas las actividades Scouting, y por este medio exonero a Boy Scouts of America, al concilio local, a los coordinadores de la actividad y a todos los empleados, voluntarios, grupos involucrados u otras organizaciones asociadas con la actividad, de cualquier y toda responsabilidad por dicho uso y publicación. I hereby 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 Boy Scouts of America, and I specifically waive any right to any compensation I may have for any of the foregoing. Por este conducto autorizo la reproducción, venta, derechos reservados, exhibición, transmisión, almacenamiento electrónico y distribución de dichas fotografías/películas/ videocintas/representaciones electrónicas y grabaciones de sonido sin limitación a discreción de Boy Scouts of America, y específicamente renuncio a cualquier derecho de compensación alguna que pueda tener por cualquiera de lo anterior. Yes/Sí No/No Page 1 of 2 PART B (continued on next page) ADULTS AUTHORIZED TO TAKE YOUTH TO AND FROM EVENTS: You must designate at least one adult. Please include a telephone number. ADULTOS AUTORIZADOS PARA TRANSPORTAR AL NIÑO HACIA Y DESDE LOS EVENTOS: Debe designar por lo menos a un adulto. Por favor incluya un número telefónico. 1. Name/Nombre___________________________________________________________________________Telephone/Teléfono _________________________ 2. Name/Nombre___________________________________________________________________________Telephone/Teléfono_________________________ 3. Name/Nombre___________________________________________________________________________Telephone/Teléfono_________________________ Adults NOT authorized to take youth to and from events/Adultos NO autorizados para transportar al niño hacia y desde los eventos: 1. Name/Nombre ___________________________________________________________________________Telephone/Teléfono_________________________ 2. Name/Nombre ___________________________________________________________________________Telephone/Teléfono_________________________ Part B Full name: __________________________________________________________ DOB: ____________________ Parte B Nombre completo Fecha de nacimiento 3. Name/Nombre___________________________________________________________________________Telephone/Teléfono_________________________ 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. Entiendo que, si cualquier información que he/hemos proporcionado es errónea, puede limitar o eliminar la oportunidad de participación en cualquier evento o actividad. 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 risk advisories explained in Part D, 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 healthcare provider. If the participant is under the age of 18, a parent or guardian’s signature is required. Si participo en Philmont, el Centro de Capacitación Philmont, Northern Tier, la Base Marina de la Florida o Summit Bechtel Reserve: También he leído y entiendo las advertencias de riesgo explicadas en la Parte D, incluyendo los requisitos y restricciones de estatura y peso, y entiendo que al participante no se le permitirá intervenir en programas de aventura extrema si dichos requisitos no se cumplen. El participante tiene permiso de intervenir en todas las actividades de aventura extrema descritas, excepto aquellas específicamente señaladas por mí o el proveedor de servicios médicos. Si el participante es menor de 18 años, se requiere la firma de el padre/ madre o tutor. Participant’s name/Nombre del participante______________________________________________________________________________________________ Date/Fecha Participant’s signature/Firma del participante Parent/guardian’s signature/Firma del padre o tutor (if participant is under the age of 18/si el participante es menor de 18 años) Second parent/guardian signature/Firma del otro padre o tutor (if required; for example, CA/si se requiere; por ejemplo en CA) Date/Fecha Date/Fecha This Annual Health and Medical Record is valid for 12 calendar months. Este Registro Médico y de Salud Anual tiene vigencia por 12 meses calendario. Page 2 of 2 680-001 2012 Printing Rev. 9/2012 Part C/Parte C Pre-participation Physical Examen físico previo a la participación High-adventure base participants: Participantes en la base de aventura extrema: Expedition/crew No. Expedición/grupo no.:_______________________________ or staff position o puesto fijo: ______________________________________ TO THE EXAMINING HEALTH CARE PROVIDER PARA EL PROVEEDOR DE SERVICIOS DE SALUD QUE REALICE EL RECONOCIMIENTO (Médicos certificados y (Certified and licensed physicians [MD, DO], nurse practitioners, and physician assistants) You are being asked to certify that this individual has no contraindication for participation in a Scouting experience as described in Part D. For individuals who will be attending a high-adventure program, either unitbased or at one of the national high-adventure bases, please refer to Part D for additional information. Height (inches) Estatura (pulgadas) Weight (pounds) Peso (libras) Part C Full name: __________________________________________________________ DOB: ____________________ Parte C Nombre completo Fecha de nacimiento Blood pressure Presión arterial Pulso If you exceed the maximum weight for height as explained on the next page and your planned high-adventure activity will take you more than 30 minutes away from an emergency vehicle/accessible roadway, you will not be allowed to participate. At the discretion of the medical advisers of the event and/or camp, participation of an individual exceeding the maximum weight for height may be allowed if the body fat percentage measured by the health care provider is determined to be 20 percent or less for a female or 15 percent or less for a male. (Philmont requires a hydrostatic weighing or DXA test to be used for this determination.) Please call the event leader and/or camp if you have any questions. Enforcing the height/weight guidelines is strongly encouraged for all other events. Examiner: Please fill in the information. Examinador: Favor de completar la información. Normal Porcentaje de grasa corporal (opcional) Yes/Sí No/No Si usted excede el peso máximo para su estatura tal como se explica en la siguiente página y su actividad de aventura extrema planeada le llevará a más de 30 minutos de distancia de una vía con acceso para un vehículo de emergencia, usted no podrá participar. A juicio de los consejeros médicos del evento o campamento, la participación de un individuo que exceda el peso máximo para su estatura puede permitirse si el porcentaje de grasa corporal medida por el proveedor de servicios de salud determina que es 20 por ciento o menos para una mujer o 15 por ciento o menos para un hombre. (Philmont requiere que se use una prueba de peso hidrostático o de densitometría ósea para determinarlo). Por favor llame al líder del evento o del campamento si tiene preguntas. El cumplimiento de los lineamientos de estatura y peso se recomienda encarecidamente para todos los demás eventos. Range of Mobility Rango de movilidad Eyes Knees (both) Ears Ankles (both) Nose Spine Ojos Cumple con los límites de estatura/peso Percent body fat (optional) Por favor rellene los círculos tal como se indica: Explique cualquier anomalía Meets height/ weight limits Máximo peso para la estatura Please fill in the bubbles as indicated: Abnormal Explain Any Abnormalities Anormal Maximum weight for height Pulse Normal licenciados, enfermeras profesionales y asistentes médicos) Se les está solicitando que certifiquen que este individuo no tiene contraindicación para participar en una experiencia Scouting tal como se describe en la Parte D. Para individuos que estarán participando en un programa de aventura extrema, ya sea en la unidad o en una de las bases nacionales de aventura extrema, por favor consulte la Parte D para información adicional. Incorrect: Correct: IncorrectoCorrecto Normal Normal Abnormal Explain Any Abnormalities Anormal Explique cualquier anomalía Rodillas (ambas) Oídos Tobillos (ambos) Nariz Espina Throat Garganta Lungs Pulmones Neurological Other Yes Otro Neurológico Sí Heart Personal or family history of heart disease Abdomen Medical equipment (i.e., CPAP, oxygen) Genitalia/hernia Contacts Skin Dentures Emotional adjustment Braces Corazón No Explain Explique Historial personal o familiar de enfermedad cardíaca Abdomen Equipo médico (por ejemplo, CPAP, oxígeno) Genitales/hernia Lentes de contacto Piel Dentaduras Tratamientos de ortodoncia Ajuste emocional Tuberculosis (TB) skin test (if required by your state for BSA camp staff): Negative/Negativo Prueba de Tuberculosis (TB) (si lo requiere su estado para personal del campamento BSA) Allergies/Alergias: No No/No� Positive/Positivo Yes/Sí (explain to what agent, type of reaction, treatment/explique a qué agente, tipo de reacción, tratamiento): ___________________________________________________________________________________________________________________________________ Medical restrictions to participate/Restricciones médicas para participar: No/No Yes/Sí (explain/explique): ___________________________________________________________________________________________________________________________________ Page 1 of 2 PART C (continued on next page) EXAMINER’S CERTIFICATION CERTIFICACIÓN DEL EXAMINADOR Height (inches) I certify that I have reviewed the health history and examined this person and find no contraindications for participation in a Scouting experience. This participant (with noted restrictions above): Certifico que he revisado el historial médico, examinado a esta persona y no encuentro contradicciones para su participación en una experiencia Scouting. Este participante (con las restricciones descritas anteriormente): Please fill in the bubbles as indicated: Por favor rellene los círculos tal como se indica: TrueFalse CiertoFalso Part C Full name: __________________________________________________________ DOB: ____________________ Parte C Nombre completo Fecha de nacimiento Incorrect: Correct: IncorrectoCorrecto 60 97-138 139-166 166 61 101-143 144-172 172 62 104-148 149-178 178 63 107-152 153-183 183 64 111-157 158-189 189 Excepción permitida Aceptación máxima 65 114-162 163-195 195 Cumple con los requisitos de estatura/peso 66 118-167 168-201 201 oes not have uncontrolled heart disease, D asthma, or hypertension 67 121-172 173-207 207 68 125-178 179-214 214 69 129-185 186-220 220 70 132-188 189-226 226 71 136-194 195-233 233 72 140-199 200-239 239 No ha tenido una lesión ortopédica, problemas musculoesqueléticos o cirugía ortopédica en los últimos seis meses o posee una carta de autorización por parte de su cirujano ortopédico o médico Maximum Acceptance Meets height/weight requirements Has not had an orthopedic injury, musculoskeletal problems, or orthopedic surgery in the last six months or possesses a letter of clearance from his or her orthopedic surgeon or treating physician Peso recomendado (libras) Allowable Exception No tiene cardiopatía, asma o hipertensión incontrolados Estatura (pulgadas) Recommended Weight (lbs) Has no uncontrolled psychiatric disorders 73 144-205 206-246 246 Has had no seizures in the last year 74 148-210 211-252 252 Does not have poorly controlled diabetes 75 152-216 217-260 260 If less than 18 years of age and planning to scuba dive, does not have diabetes, asthma, or seizures 76 156-222 223-267 267 77 160-228 229-274 274 78 164-234 235-281 281 79 & over 170-240 241-295 295 No tiene trastornos psiquiátricos incontrolados No ha tenido convulsiones en el último año No tiene diabetes mal controlada Si tiene menos de 18 años de edad y piensa realizar buceo, no tiene diabetes, asma o convulsiones I have reviewed Part D for high-adventure activities. He revisado la Parte D para actividades de aventura extrema. Provider printed name Nombre del proveedor ________________________________________________ Address This table is based on the revised Dietary Guidelines for Americans from the U.S. Dept. of Agriculture and the Dept. of Health & Human Services. Esta tabla está basada en los Lineamientos dietéticos para estadounidenses del Departamento de Agricultura de los EE.UU. y del Departamento de Salud y Servicios Humanos. Domicilio ____________________________________________________________ DO NOT WRITE IN THIS BOX NO ESCRIBA EN ESTE RECUADRO City, state, zip Ciudad, estado, código postal _________________________________________ Office phone REVIEW FOR CAMP OR SPECIAL ACTIVITY/REVISIÓN PARA CAMPAMENTO O ACTIVIDAD ESPECIAL Date Reviewed by Revisado por ______________________________________________________________ Teléfono del consultorio _______________________________________________ Fecha ______________________________________________________________ Examiner signature in the box below. Firma del examinador en el recuadro de abajo. Date Fecha ____________________________________________________________________ Further approval required Se requiere aprobación adicional Yes Sí No No Reason Razón_____________________________________________________________________ Approved by Aprobado por______________________________________________________________ Date Fecha ____________________________________________________________________ Click here for more information regarding high-adventure outings or go to www.scouting.org/filestore/HealthSafety/pdf/part_d.pdf. Haga clic aquí para obtener más información sobre las excursiones de aventura extrema o visite www.scouting.org/filestore/HealthSafety/pdf/ part_d.pdf. Page 2 of 2 680-001 2012 Printing Rev. 9/2012 Part D: High-Adventure Notes to Physicians and Parents Parte D: Notas para médicos y padres de familia sobre aventura extrema Participation at any of the BSA’s high-adventure bases or in any unit high-adventure backcountry activities can be physically, mentally, and emotionally demanding. To be better prepared, each participant must complete the following before attending any high-adventure base or participating in any high-adventure backcountry activity: La participación en cualquiera de las bases de aventura extrema de BSA, o en cualquier actividad de aventura extrema en terrenos campestres aislados puede ser física, mental y emocionalmente agotadora. Para estar mejor preparado, cada participante debe completar lo siguiente antes de acudir a cualquier base de aventura extrema o de participar en cualquier actividad de aventura extrema en terrenos campestres aislados: • Fill in parts A and B of the Annual Health and Medical Record. • Share Part D with the examining health-care provider. • Have a physical exam by a certified and licensed healthcare provider/physician (MD, DO), nurse practitioner, or physician assistant, and have part C completed. • Read the following information, which focuses on specific risks at the high-adventure base you will be attending. • Completar las partes A y B del Registro Médico y de Salud Anual. • Compartir la parte D con el proveedor de atención médica que realizará el reconocimiento. • Someterse a un examen físico por un proveedor de atención médica/médico (MD, DO), enfermera profesional o asistente médico certificado y licenciado y que éste complete la parte C. • Leer la siguiente información que se enfoca en riesgos específicos en la base de aventura extrema a la que acudirá. The Trek Experience. Each high-adventure base offers a unique experience that is not risk-free. Knowledgeable staff will instruct all participants in safety measures to be followed. Be prepared to listen to and carefully follow these safety measures and to accept responsibility for the health and safety of yourself and others. Philmont. Each participant must be able to carry a 35- to 50-pound pack while hiking 5 to 12 miles per day in an isolated mountain wilderness ranging from 6,500 to 12,500 feet in elevation. Summer/autumn climatic conditions include temperatures from 30 to 90 degrees, low humidity (10 to 30 percent), and frequent, sometimes severe, afternoon thunderstorms. Activities include horseback riding, rock climbing and rappelling, challenge events, pole climbing, black powder shooting, 12-gauge trap shooting, .30-06 shooting, trail building, mountain biking, and other activities that have potential for injury. Winter climatic conditions can range from -20 to 60 degrees. For the Winter Adventure, each person will walk, ski, or snowshoe along snow-covered trails pulling loaded toboggans or sleds for up to 3 miles, or more on a crosscountry ski trek. Refer to the Philmont Scout Ranch website for specific information. Northern Tier. Each person must be able to carry a 50- to 85-pound pack or canoe from a quarter-mile to 2 miles several times a day on rough, swampy, and rocky portages and paddle 10 to 15 miles per day, often against a headwind. Climatic conditions can range from 30 to 100 degrees in summer/autumn and from -40 to 40 degrees in the winter. For the Okpik Experience, each person will walk, ski, or snowshoe along snow-covered trails or across frozen lakes, pulling loaded toboggans or sleds for up to 3 miles, or more if on a cross-country ski trek. Refer to the Northern Tier website for specific information. Florida Sea Base. Climatic conditions at Florida Sea Base include temperatures ranging from 50 to 95 degrees, high humidity, heat index reaching to 110 degrees, and frequent, sometimes severe, afternoon thunderstorms. Activities include snorkeling, scuba diving, kayaking, canoeing, sailing, hiking, and other activities that have potential for injury. Refer to the Sea Base website for specific information. Experiencia en las caminatas. Cada base de aventura extrema ofrece una experiencia única que implica riesgos. El personal experto dará instrucciones a todos los participantes con respecto a las medidas de seguridad que se deben seguir. Prepárese para escuchar y seguir con atención dichas medidas y a aceptar la responsabilidad por la salud y seguridad de usted y los demás. Philmont. Cada participante debe poder cargar una mochila con un peso de entre 35 y 50 libras en un trayecto de 5 a 12 millas por día en un ambiente montañoso, silvestre y aislado con una elevación entre 6,500 y 12,500 pies. Las condiciones climatológicas del verano/otoño incluyen temperaturas de los 30 a los 90 grados, poca humedad (10 a 30 por ciento) y frecuentes, e incluso severas tormentas eléctricas por la tarde. Las actividades incluyen montar a caballo, escalar en roca, rapel, eventos desafiantes, treparse a un mástil, disparo con pólvora, tiro al vuelo de calibre 12, tiro con cartucho .30-06, senderismo, bicicleta de montaña y otras actividades que tienen posibilidades de causar lesiones. Las condiciones climáticas invernales pueden abarcar de -20 a 60 grados. Para la Aventura invernal, cada persona caminará, esquiará o caminará con raquetas para nieve a lo largo de senderos cubiertos de nieve jalando trineos de carga durante tres millas de distancia o más en un sendero para esquí a campo traviesa. Consulte el sitio web del Rancho Scout Philmont para obtener información específica. Northern Tier. Cada persona debe poder cargar una mochila de 50 a 85 libras o una canoa entre media milla y dos millas varias veces al día en lugares escabrosos, pantanosos y rocosos y remar de 10 a 15 millas por día, con frecuencia con viento de frente. Las condiciones climáticas pueden variar entre los 30 y 100 grados en el verano/otoño y de -40 a 40 grados en el invierno. Para la Experiencia Okpik, cada persona caminará, esquiará o caminará con raquetas para nieve a lo largo de senderos cubiertos de nieve o a través de lagos congelados jalando trineos de carga durante tres millas de distancia o más en un sendero para esquí a campo traviesa. Consulte el sitio web de Northern Tier para obtener información específica. Base Marina de la Florida. Las condiciones climáticas en la Base Marina de la Florida incluyen temperaturas que van desde los 50 hasta los 95 grados, humedad elevada, e índice de calor que alcanza los 110 grados y hay frecuentes e incluso severas, tormentas eléctricas por la tarde. Las actividades incluyen snorkel, buceo, kayak, canotaje, vela, excursión, y otras actividades que pueden causar lesiones. Consulte el sitio web de la Base Marina para obtener información específica. Page 1 of 8 PART D (continued on next page) Risk Advisory. All of the high-adventure bases have excellent health and safety records and strive to minimize risks to participants and advisors by emphasizing appropriate safety precautions. Because most participants are prepared, are conscious of risks, and take safety precautions, they do not experience injuries. If you decide to attend Philmont, Northern Tier, Florida Sea Base, or the Summit Bechtel Reserve, you should be physically fit, have proper clothing and equipment, and be willing to follow instructions, work as a team with your crew, and take responsibility for your own health and safety. Parents, guardians, and participants in any high-adventure program are advised that journeying to and from these bases can involve exposure to accidents, illness, and/or injury. High-adventure staff members have been trained in first aid, CPR, and accident prevention and are prepared to assist the adult advisor in recognizing, reacting to, and responding to accidents, injuries, and illnesses as needed. Each crew is required to have at least one member trained in wilderness first aid and CPR. Medical and search-and-rescue services are provided in response to an accident or emergency. However, response times can be affected by location, terrain, weather, or other emergencies and could be delayed for hours or even days in a wilderness setting. Philmont. Participants and guests for Philmont activities that are conducted with limited access to the backcountry, including most Philmont Training Center conferences and family programs, should review Part D to understand potential health risks inherent at 6,700 feet in elevation in a dry Southwest environment. High elevation; physically demanding high-adventure program in remote mountainous areas; camping while being exposed to occasional severe weather conditions such as lightning, hail, flash floods, and heat; and other potential problems, including injuries from tripping and falling, falls from horses, heat exhaustion, and motor vehicle accidents, can worsen underlying medical conditions. Philmont’s trails are steep and rocky. Wild animals such as bears, rattlesnakes, and mountain lions are native and usually present little danger if proper precautions are taken. Please call Philmont (575-376-2281) if you have any questions. Northern Tier. While participating in Northern Tier’s canoeing and camping wilderness areas, life jackets must be worn at all times when on the water. Crew members travel together at all times. Emergency communications via radio, and in more remote locations by satellite phone, are provided by Northern Tier. Radio communication and/ or emergency evacuation can be hampered by weather, terrain, distance, equipment malfunction, and other factors, and are not a substitute for taking appropriate precautions and having adequate first-aid knowledge and equipment. Please call Northern Tier (218-365-4811) if you have any questions. Florida Sea Base. Several activities are offered, including snorkeling, sailing, camping, kayaking, canoeing, swimming, fishing, and scuba diving. Diving is an exciting and demanding activity. When performed correctly, it is very safe. When established safety procedures are not followed, however, there are extreme dangers. All participants will need to learn from the instructor the important safety rules regarding breathing and equalization while scuba diving. Improper use of scuba equipment can result in serious injury, so participants must be instructed to use the equipment safely under direct supervision of a qualified instructor. Advertencia de riesgo. Todas las bases de aventura extrema tienen excelentes antecedentes de salud y seguridad y se esfuerzan por minimizar los riesgos para los participantes y asesores haciendo hincapié en las precauciones de seguridad adecuadas. Ya que la mayoría de los participantes están preparados, tienen conciencia de los riesgos y toman precauciones de seguridad, no experimentan lesiones. Si usted decide acudir a Philmont, Northern Tier, Base Marina de la Florida o Summit Bechtel Reserve, usted deberá estar en forma física, tener indumentaria y equipo adecuado, y estar dispuesto a seguir instrucciones, trabajar en equipo con su grupo y hacerse responsable de su propia salud y seguridad. Los padres, tutores y participantes de cualquier programa de aventura extrema son notificados de que el recorrido hacia y desde dichas bases puede implicar exposición a accidentes, enfermedades o lesiones. Los miembros del personal de aventura extrema han sido capacitados en primeros auxilios, RCP y prevención de accidentes, y están preparados para ayudar al asesor adulto a reconocer, reaccionar y responder ante accidentes, lesiones y enfermedades según sea necesario. Se requiere que cada grupo tenga por lo menos un miembro capacitado en primeros auxilios en la naturaleza y RCP. Los servicios médicos y de búsqueda y rescate son proporcionados como respuesta ante un accidente o emergencia. Sin embargo, los tiempos de respuesta pueden verse afectados por la ubicación, el terreno, el tiempo, u otras emergencias y puede retrasarse por horas o incluso días en un entorno silvestre. Philmont. Los participantes e invitados de las actividades Philmont que se realicen con acceso limitado a las zonas campestres, incluyendo la mayoría de las conferencias y programas familiares en el Centro de Capacitación Philmont, deberán repasar la Parte D para entender los riesgos potenciales inherentes a los 6,700 pies de elevación en un ambiente seco del Suroeste. La gran altitud; un programa de aventura extrema físicamente exigente en áreas montañosas remotas; acampar mientras se está expuesto a condiciones climatológicas ocasionalmente severas tales como relámpagos, granizo, inundaciones repentinas, y calor; y otros problemas potenciales, incluyendo lesiones a causa de tropezones y caídas, caídas de un caballo, golpe de calor, y accidentes de vehículos a motor, pueden empeorar condiciones médicas subyacentes. Los senderos de Philmont son empinados y pedregosos. Los animales salvajes tales como osos, víboras de cascabel y pumas son nativos de la zona y por lo general presentan poco peligro si se toman las precauciones adecuadas. Por favor, llame a Philmont (575-3762281) si tiene preguntas. Northern Tier. Mientras participe en las áreas silvestres de acampada y canotaje de Northern Tier, debe llevar puesto el chaleco salvavidas en todo momento que se encuentre en el agua. Los miembros del grupo viajan juntos siempre. Las comunicaciones de emergencia vía radio y en lugares más remotos por teléfono satelital, son proporcionadas por Northern Tier. La comunicación por radio y la evacuación de emergencia puede ser obstaculizada por el tiempo, el terreno, la distancia, mal funcionamiento del equipo y otros factores, y no substituyen el tomar las precauciones apropiadas y tener conocimiento y equipo adecuado de primeros auxilios. Por favor, llame a Northern Tier (218-365-4811) si tiene cualquier pregunta. Base Marina de la Florida. Se ofrecen varias actividades incluyendo snorkel, vela, acampada, kayak, canotaje, natación, pesca y buceo. El buceo es una actividad emocionante y exigente. Cuando se realiza de forma correcta, es muy segura. Sin embargo, cuando los procedimientos de seguridad establecidos no se siguen, existen peligros extremos. Todos los participantes necesitan aprender del instructor las reglas de seguridad importantes referentes a la respiración y ecualización mientras se practica el buceo. El uso inadecuado del equipo de buceo puede resultar en lesiones graves, por lo tanto, se les debe instruir a los participantes a utilizar el equipo de manera segura bajo la supervisión directa de un instructor calificado. Page 2 of 8 PART D (continued on next page) To scuba dive safely, participants must not be extremely overweight or in poor physical condition. Diving can be strenuous under certain conditions. Participants’ respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with heart trouble, a current cold or congestion, epilepsy, asthma, or a severe medical problem, or who is under the influence of alcohol or drugs, should not dive. If taking medication, participants should consult a doctor and the instructor before participation in this program. If there is a question about the advisability of participation, contact the family physician first, then call the Sea Base at 305-664-5612. The Sea Base health supervisor reserves the right to make medical decisions regarding the participation of individual at Sea Base. Food. Each base offers food appropriate for the experience. If a participant has a problem with the diet described in the participant guide, please contact the high-adventure base you are considering attending. Medications. Each participant who has a condition requiring medication should bring an appropriate supply for the duration of the trip. Consider bringing duplicate or even triplicate supplies of vital medications. People with allergies that have resulted in severe reactions or anaphylaxis must bring with them an EpiPen that has not expired. Immunizations. Each participant must have received a tetanus immunization within the last 10 years. Recognition will be given to the rights of those Scouts and Scouters who do not have immunizations because of philosophical, political, or religious beliefs. In such a situation, the Immunization Exemption Request form is required. Recommendations Regarding Chronic Illnesses. Each base requires that this information be shared with the parents or guardians and examining physician of every participant. There are no facilities for extended care or treatment; therefore participants who cannot meet these requirements will be sent home at their expense. Staff and/or staff physicians reserve the right to deny the participation of any individual on the basis of a physical examination and/or medical history. Adults or youth who have had any of the following conditions should undergo a thorough evaluation by a physician before considering participation at a BSA highadventure base. Cardiac or Cardiovascular Disease, including: 1. Angina (chest pain caused by blocked blood vessels or coming from the heart) 2. Myocardial infarction (heart attack) 3. Heart surgery or heart catheterization, including angioplasty (balloon dilation) or stents to treat blocked blood vessels 4. Stroke or transient ischemic attacks (TIAs) 5. Claudication (leg pain with exercise, caused by hardening of the arteries) 6. Family history of heart disease or a family member who died unexpectedly before age 50 7.Diabetes 8.Smoking 9. Excessive weight Para bucear de manera segura, los participantes no deben estar extremadamente pasados de peso o tener condición física deficiente. Bucear puede ser extenuante bajo ciertas condiciones. Los sistemas respiratorio y circulatorio de los participantes deben estar en buena condición. Todos los espacios de aire del cuerpo deben ser normales y estar saludables. Una persona con problemas del corazón, un resfriado o congestionamiento, epilepsia, asma o un problema médico severo, o que esté bajo la influencia del alcohol o drogas, no debe bucear. Si se está tomando medicamentos, los participantes deberán consultar a un doctor y al instructor antes de participar en este programa. Si hay alguna pregunta sobre la conveniencia de la participación, contacte al médico familiar primero, luego llame a la Base Marina al 305-664-5612. El supervisor de salud de la Base marina se reserva el derecho de tomar decisiones médicas con respecto a la participación de un individuo en la Base Marina. Comida. Cada base ofrece comida apropiada para la experiencia. Si un participante tiene un problema con la dieta descrita en la guía, favor de comunicarse con la base de aventura extrema que está considerando visitar. Medicamentos. Cada participante que tenga una condición que requiera medicamentos deberá traer consigo la cantidad apropiada para la duración del viaje. Considere traer suministros por duplicado o incluso triplicado de medicamentos vitales. Las personas con alergias que hayan resultado en reacciones severas o anafilaxia deben traer consigo una EpiPen que no haya caducado. Vacunas. Cada participante debe haber recibido una vacuna contra el tétanos en los últimos 10 años. Se les dará reconocimiento a los derechos de aquellos Scouts o Scouters que no tienen vacunas a causa de creencias filosóficas, políticas o religiosas. En dicha situación, se requiere el formulario Solicitud de exención de inmunización. Recomendaciones con respecto a enfermedades crónicas. Cada base requiere que se le comunique esta información a los padres o tutores y médico que realice el examen de cada participante. No hay instalaciones para atención o tratamiento prolongado, por lo tanto, los participantes que no puedan cumplir con dichos requisitos serán enviados a casa y deben asumir los gastos. El personal y los médicos del personal se reservan el derecho de negarle la participación a cualquier individuo con base en el examen físico o historial médico. Los adultos o niños que hayan tenido cualquiera de las siguientes condiciones, deberán someterse a una evaluación por parte de un médico antes de considerar participar en una base de aventura extrema BSA. Enfermedad cardiaca o cardiovascular, incluyendo: 1. Angina (dolor de pecho causado por vasos sanguíneos bloqueados o que vienen del corazón). 2. Infarto al miocardio (ataque al corazón). 3. Cirugía de corazón o cateterismo cardiaco, incluyendo angioplastia (dilatación con balón) o stents para tratar vasos sanguíneos bloqueados. 4. Derrame cerebral o ataques isquémicos transitorios (AIT). 5. Claudicación (dolor de pierna con el ejercicio, causado por el endurecimiento de las arterias). 6. Historial familiar de enfermedad cardiaca o que un miembro de la familia haya muerto inesperadamente antes de los 50 años de edad. 7.Diabetes. 8.Tabaquismo. 9. Exceso de peso. Page 3 of 8 PART D (continued on next page) Participants who have a congenital heart disease or an acquired heart disease such as rheumatic fever, Kawasaki’s disease, or mitral valve prolapse should undergo thorough evaluation by a physician before considering participating at a high-adenture base. The physical exertion at any of the high-adventure bases may precipitate either a heart attack or stroke in susceptible persons. Participants with a history of any of the first seven conditions listed above should have a physician-supervised stress test. More extensive testing (e.g., nuclear stress test) is recommended for participants who have coronary heart disease. Even if the stress test results are normal, the results of testing done at lower elevations, without backpacks, do not guarantee safety. If the test results are abnormal, the individual is advised not to participate. Hypertension (High Blood Pressure). The combination of physical, mental, and emotional stress, increased exertion and/or heat, and altitude appears to cause a significant increase in blood pressure in some individuals. Occasionally, hypertension reaches such a level that it is no longer safe to engage in strenuous activity. Hypertension can increase the risk of having a stroke, heart attack, or angina. Participants should have a blood pressure less than 140/90. Persons with significant hypertension (greater than 140/90) should be treated and controlled before attending any highadventure base, and should continue on medications while participating. The goal of treatment should be to lower the blood pressure to normal levels. Participants already on antihypertensive therapy with normal blood pressure should continue on medications. Individuals taking diuretics to treat hypertension are at increased risk for dehydration related to strenuous physical activity and should be careful to maintain good hydration during the trek. Philmont. Each participant who is 18 years of age or older will have his or her blood pressure checked at Philmont. Those individuals with a blood pressure consistently greater than 160/100 at Philmont may be kept off the trail until their blood pressure decreases. Florida Sea Base. Those taking beta-blocker medication should consider a change of medication before participating in any scuba program. Insulin-Dependent Diabetes Mellitus. Exercise and the type of food eaten affect insulin requirements. Any individual with insulin-dependent diabetes mellitus should be able to monitor personal blood glucose and to know how to adjust insulin doses based on these factors. The person with diabetes also should know how to give a self-injection. Both the person with diabetes and one other person in the group should be able to recognize indications of excessively high blood sugar (hyperglycemia or diabetic ketoacidosis) and excessively low blood sugar (hypoglycemia). The person with diabetes and one other individual should know the appropriate initial responses for these conditions. An insulin-dependent person who has been newly diagnosed (within the last six months) or who has undergone a change in delivery system (e.g., insulin pump) in the last six months is advised not to participate. A person with diabetes who has had frequent hospitalizations for diabetic ketoacidosis or who has had frequent problems with hypoglycemia should not participate until better control of the diabetes has been achieved. Los jóvenes que tengan alguna enfermedad cardiaca congénita o enfermedad cardiaca adquirida como fiebre reumática, enfermedad de Kawasaki o prolapso de la válvula mitral deberán someterse a un examen médico exhaustivo antes de considerar participar en una base de aventura extrema. El esfuerzo físico en cualquiera de las bases de aventura extrema puede precipitar ya sea un ataque al corazón o derrame cerebral en las personas susceptibles. Los participantes con antecedentes de cualquiera de las primeras siete condiciones enumeradas anteriormente deberán someterse a una prueba de esfuerzo supervisada por un médico. Se recomiendan pruebas más exhaustivas (por ejemplo, prueba de esfuerzo con radioisótopos) para los participantes que tengan una enfermedad coronaria. Incluso si los resultados de la prueba de esfuerzo son normales, los resultados de la prueba realizada en elevaciones bajas, sin mochilas, no garantiza la seguridad. Si los resultados de la prueba son anormales, se le aconseja al individuo no participar. Hipertensión (Presión arterial alta). La combinación de estrés físico, mental y emocional, el aumento de esfuerzo y de calor, y la altura, aparentemente causan un incremento significativo en la presión arterial en algunos individuos. En ocasiones, la hipertensión alcanza tal nivel que no es seguro participar en una actividad vigorosa. La hipertensión puede incrementar el riesgo de tener un derrame cerebral, ataque al corazón o angina. Los participantes deben tener una presión arterial normal menor de 140/90. Las personas con una hipertensión importante (mayor a 140/90) deberán estar bajo tratamiento y su condición debe estar controlada antes de que acudan a cualquier base de aventura extrema, y deberán continuar con sus medicamentos mientras participen. El objetivo del tratamiento debe ser disminuir la presión arterial a niveles normales. Aquellos que ya se encuentren bajo tratamiento antihipertensivo y que tengan una presión arterial normal deberán continuar con su tratamiento. Los individuos que tomen diuréticos para tratar la hipertensión corren un mayor riesgo de deshidratación relacionada con actividad física desgastante y deberán tener cuidado de mantener una muy buena hidratación durante la excursión. Philmont. A cada participante que tenga 18 años de edad o más se le tomará la presión en Philmont. Aquellos individuos con presión arterial consistentemente mayor a 160/100 en Philmont serán apartados del sendero hasta que la presión arterial disminuya. Base Marina de la Florida. Quienes toman medicamentos beta bloqueadores deberían considerar cambiar de medicamento antes de participar en cualquier programa de buceo. Diabetes Mellitus dependiente de insulina. El ejercicio y el tipo de alimentos que se consumen afectan la necesidad de insulina. Cualquier persona que padezca diabetes mellitus dependiente de insulina deberá ser capaz de autocontrolar su nivel de glucosa en la sangre y saber cómo ajustar las dosis de insulina con base en estos factores. Las personas con diabetes también deben saber cómo inyectarse. Tanto la persona con diabetes y otra más en el grupo debe saber reconocer los síntomas de niveles excesivamente altos de azúcar (hiperglucemia o cetoacidosis diabética) y los de niveles excesivamente bajos de azúcar en la sangre (hipoglicemia). La persona con diabetes y otra persona más deberán saber las respuestas iniciales apropiadas para dichas condiciones. Una persona dependiente de insulina que haya sido diagnosticada recientemente (en los últimos 6 meses) o que se haya sometido a un cambio en el sistema de dosificación (por ejemplo, una bomba para insulina) en el mismo periodo no deberá intentar participar. Una persona que haya sido hospitalizada frecuentemente debido a cetoacidosis diabética o que haya tenido problemas frecuentes de hipoglicemia, no deberá participar hasta que se obtenga un mejor control de la diabetes. Page 4 of 8 PART D (continued on next page) Philmont. It is recommended that the person with diabetes and one other individual carry insulin on the trek (in case of accident) and that a third vial be kept at the Health Lodge for backup. Bring insulin in a small insulated container. Bring enough testing equipment and supplies for the entire trip and trek. Extras are usually needed. If an individual has been hospitalized for diabetes-related illnesses within the past year, the individual must obtain permission to participate by contacting the Philmont Health Lodge at 575-376-2281. Philmont. Se recomienda que la persona con diabetes y otra persona más lleve consigo insulina en el recorrido (en caso de un accidente) y que una tercera ampolleta sea guardada en el pabellón médico como reserva. Lleve la insulina en un pequeño recipiente aislante. Lleve suficientes suministros de prueba para el viaje y el recorrido. Normalmente se requieren adicionales. Si un individuo ha sido hospitalizado por enfermedades relacionadas con la diabetes en el último año, el individuo debe obtener permiso para participar llamando al Pabellón médico de Philmont al 575-376-2281. Florida Sea Base. Persons with diabetes who are 18 years of age or older who wish to scuba dive should be assessed by a physician familiar with both hyperbaric issues related to diabetes and medications used for the control and treatment of diabetes. Persons 18 years old or older who are determined to be candidates for scuba diving must submit four hemoglobin A1c (HbA1c) tests, each with HbA1c values less than 7, taken within the previous 12 months. Any test within the past 12 months with an HbA1c value greater than 7 disqualifies a person from scuba diving as part of a BSA activity. Persons less than 18 years of age with Type 1 diabetes will not be allowed to scuba dive. Persons under the age of 18 who control their diabetes with exercise and diet (no medications) and can provide three sequential hemoglobin tests with HbA1c values less than 6 may be approved to scuba dive. Base Marina de la Florida. Las personas con diabetes que tengan 18 años de edad o más que deseen bucear, deberán ser evaluados por un médico familiar tanto en temas hiperbáricos relacionados con la diabetes, como medicamentos utilizados para el control y tratamiento de la diabetes. Las personas de 18 años de edad o más que sean determinadas como candidatos para bucear, deben remitir cuatro pruebas de hemoglobina A1c (HbA1c), cada una con valores HbA1c menores a 7, tomadas dentro de los 12 meses anteriores. Cualquier prueba dentro de los últimos 12 meses con un valor HbA1c mayor a 7 descalifica a dicha persona de bucear como parte de una actividad BSA. Seizures (Epilepsy). A seizure disorder or epilepsy does not exclude an individual from participating at a high-adventure base. However, the seizure disorder should be wellcontrolled by medications. A minimum one year seizure-free period is considered to be adequate control. Exceptions to this guideline may be considered on an individual basis, and will be based on the specific type of seizure and the likely risks to the individual and to other members of the crew. Florida Sea Base. Any seizure activity within the past five years, regardless of control and/or medication, disqualifies an individual from participation in any scuba program. A person with a history of seizure activity who has been asymptomatic AND medication-free for five years, as evidenced by a physician, will be allowed to dive. Asthma. Asthma should be well-controlled before participating at any high-adventure base. Well-controlled asthma means: 1) the use of a rescue inhaler (e.g., albuterol) less than once daily; 2) no need for nighttime treatment with a rescue inhaler (e.g., albuterol). Well-controlled asthma may include the use of long-acting bronchodilators, inhaled steroids, or oral medications such as Singulair. You must meet these guidelines in order to participate. You may not be allowed to participate if: 1) you have exercise asthma not controlled by medications; or 2) you have been hospitalized or have gone to the emergency room to treat asthma in the past six months; or 3) you have needed treatment with intravenous, intramuscular, or oral steroids (prednisone) in the past six months. You must bring an ample supply of your medications and a spare rescue inhaler that are not expired. At least one other member of the crew should know how to recognize signs of worsening asthma or an asthma attack, and should know how to use the rescue inhaler. Any person who has needed treatment for asthma in the past three years must carry a rescue inhaler on the trek. If you do not bring a rescue inhaler, you must buy one before you will be allowed to participate. Las personas menores de 18 años de edad con diabetes Tipo 1 no podrán bucear. Las personas menores de 18 años que controlan su diabetes con ejercicio y dieta (no medicamentos) y que puedan proporcionar tres pruebas secuenciales de hemoglobina con valores HbA1c menores a 6, pueden ser aprobadas para bucear. Convulsiones (Epilepsia). Las convulsiones o epilepsia no excluyen a un individuo de participar en una base de aventura extrema. Sin embargo, la enfermedad debe estar bien controlada con medicamentos. Se considera como bajo control cuando existe un periodo mínimo de un año sin convulsiones. Se pueden considerar excepciones a estos lineamientos según cada caso individual y se basará en el tipo específico de convulsión y la posibilidad de riesgo para el individuo y a los otros miembros del grupo. Base Marina de la Florida. Cualquier convulsión dentro de los últimos cinco años, sin importar el control o el medicamento, descalifica a un individuo de participar en cualquier programa de buceo. Una persona con antecedentes de convulsiones que ha estado sin síntomas Y sin medicamentos por cinco años, según lo acredite un médico, podrá bucear. Asma. El asma deberá estar bien controlada antes de participar en cualquier base de aventura extrema. Un asma bien controlada significa: 1) el uso de un inhalador de rescate (por ejemplo, albuterol) menos de una vez al día; 2) no tener la necesidad de tratamiento durante la noche con un inhalador de rescate (por ejemplo, albuterol). El asma bien controlada puede incluir el uso de broncodilatadores de larga duración, esteroides inhalados o medicamentos orales como Singulair. Usted debe cumplir con los siguientes lineamientos a fin de participar. No se le permitirá participar si: 1) tiene asma por ejercicio que no se previene con medicamento; ó 2) ha sido hospitalizado o ha acudido a urgencias para tratamiento contra el asma en los últimos seis meses; ó 3) ha necesitado tratamiento con esteroides intravenosos, intramusculares u orales (prednisona) en los últimos seis meses. Debe llevar consigo suficientes suministros del medicamento e inhaladores de rescate de repuesto que no hayan caducado. Por lo menos otro miembro del grupo debe saber cómo reconocer las señales de empeoramiento de asma o un ataque de asma y deberá saber cómo utilizar el inhalador de rescate. Cualquier persona que haya necesitado tratamiento para el asma en los últimos tres años, debe llevar consigo un inhalador de rescate durante el recorrido. Si no trae uno, debe comprarlo antes de que se le permita participar. Page 5 of 8 PART D (continued on next page) Florida Sea Base. Persons being treated for asthma (including reactive airway disease) are disqualified from BSA scuba programs. Persons with a history of asthma who have been asymptomatic and have not used medications to control asthma for five years or more may be allowed to scuba dive as part of a BSA activity upon submission of evidence from their treating physician. Persons with a history of asthma who have been asymptomatic and have not used medication to control asthma for less than five years may be allowed to scuba dive as part of a BSA activity upon submission of a methacholine challenge test showing the asthma to be resolved. Base Marina de la Florida. Las personas que reciben tratamiento para el asma (incluyendo enfermedad reactiva de las vías respiratorias) son descalificadas de los programas de buceo BSA. Las personas con antecedentes de asma que no han tenido síntomas y que no han usado medicamentos para el control del asma durante cinco años o más, pueden bucear como parte de una actividad BSA una vez que remitan evidencia de su médico. Las personas con antecedentes de asma que no han tenido síntomas y que no han usado medicamentos para el control del asma durante menos de cinco años, pueden bucear como parte de una actividad BSA una vez que remitan una prueba de metacolina que muestre que el asma ha sido resuelta. Allergy or Anaphylaxis. Persons who have had an anaphylactic reaction from any cause must contact the high-adventure base before arrival. If you are allowed to participate, you will be required to have appropriate treatment with you. You and at least one other member of your crew must know how to give the treatment. If you do not bring appropriate treatment with you, you will be required to buy it before you will be allowed to participate. Alergia o anafilaxia. Las personas que han tenido una reacción anafiláctica por cualquier causa, deben contactar a la base de aventura extrema antes de llegar. Si a usted le han permitido participar, se le requerirá que tenga el tratamiento adecuado con usted. Usted y por lo menos otro miembro de su grupo debe saber cómo administrar el tratamiento. Si usted no trae consigo el tratamiento apropiado, se le requerirá que lo compre antes de que se le permita participar. Recent Musculoskeletal Injuries and Orthopedic Surgery. Every participant will put a great deal of strain on feet, ankles, and knees due to negotiating steep, rocky trails with a backpack; paddling and portaging heavy gear over irregular terrain; or climbing into and out of a boat. Therefore, individuals with significant musculoskeletal problems (including back problems) or orthopedic surgery/injuries within the last 6 months must have a letter of clearance from their orthopedic surgeon or treating physician to be considered for approval to participate. Permission is not guaranteed. A person with a cast on any extremity may participate only if approved by the high-adventure base. Ingrown toenails are a common problem and must be treated 30 days prior to arrival. Lesiones musculoesqueléticas recientes y cirugía ortopédica recientes. Cada participante ejercerá una gran cantidad de presión en los pies, tobillos y rodillas a causa del efecto de andar por un terreno empinado y senderos escabrosos cargando una mochila; remando y cargando equipo pesado sobre terreno irregular; o al subirse y salir de una embarcación. Por lo tanto, los individuos con problemas musculoesqueléticos (incluyendo problemas de la espalda) o lesiones/cirugías ortopédicas en los últimos seis meses, deben tener una carta de autorización por parte de su cirujano ortopedista o médico tratante para que sea considerado para aprobación para participar. El permiso no se garantiza. Una persona con un yeso en cualquier extremidad puede participar sólo si lo aprueba la base de aventura extrema. Las uñas encarnadas son un problema común y deben tratarse un mes antes del evento. Psychological and Emotional Difficulties. A psychological disorder does not necessarily exclude an individual from participation. Parents and advisers should be aware that no high-adventure experience is designed to assist participants in overcoming psychological or emotional problems. Experience demonstrates that these problems frequently become magnified, not lessened, when a participant is subjected to the physical and mental challenges of a remote wilderness setting. Any condition should be well-controlled without the services of a mental health practitioner. Under no circumstance should medication be stopped immediately prior to participation, and medication should be continued throughout the entire high-adventure experience. Participants requiring medication must bring an appropriate supply for the duration of the trip. Weight Limits. Weight limit guidelines are used because overweight individuals are at a greater risk for heart disease, high blood pressure, stroke, altitude illness, sleep problems, and injury. Those who fall within the limits are more likely to have an enjoyable trek and avoid incurring health risks. These guidelines are to be in use for all Scouting high-adventure bases and high-adventure backcountry activities. Philmont. Each participant in a Philmont trek must not exceed the maximum acceptable limit in the weight chart shown below. The right-hand column shows the maximum acceptable weight for a person’s height in order to participate in a Philmont trek. Trastornos psicológicos y emocionales. Los trastornos psicológicos no necesariamente excluyen a una persona de la participación. Los padres y consejeros deben estar conscientes de que ninguna experiencia de aventura extrema está diseñada para ayudar a contrarrestar problemas psicológicos o emocionales. La experiencia demuestra que estos problemas generalmente aumentan, no disminuyen cuando un participante se somete a los desafíos físicos y mentales de un ambiente remoto y silvestre. Cualquier condición debe estar bien controlada sin los servicios de un profesional del cuidado de la salud mental. Bajo ninguna circunstancia se debe suspender el medicamento inmediatamente antes de participar, y el medicamento deberá continuarse durante la totalidad de la experiencia de aventura extrema. Los participantes que necesiten medicamento deben llevar la cantidad adecuada para la duración del viaje. Límites de peso. Las reglas de límite de peso son utilizadas ya que los individuos con exceso de peso corren mayor riesgo de ataque al corazón, presión arterial elevada, derrame cerebral, enfermedades de altitud, trastornos del sueño y lesiones. Quienes están dentro de los límites tienen más posibilidades de tener una excursión placentera y evitar incurrir en riesgos de salud. Estos lineamientos deben utilizarse en todas las bases Scouting de aventura extrema y actividades de aventura extrema en terrenos aislados. Philmont. Cada participante en una excursión en Philmont no debe exceder el límite máximo aceptable en la tabla de peso que se muestra a continuación. La columna a la derecha muestra el peso máximo aceptable para la estatura de una persona a fin de poder participar en una excursión en Philmont. Page 6 of 8 PART D (continued on next page) Participants 21 years and older who exceed the maximum acceptable weight limit for their height at the Philmont medical recheck WILL NOT be permitted to backpack or hike at Philmont. They will be sent home. For example, a person 70 inches tall cannot weigh more than 226 pounds. All heights and weights will be measured in stocking feet. Los participantes de 21 años de edad o más que excedan el límite de aceptación máxima de peso correspondiente a su altura en la revisión médica en Philmont, NO podrán excursionar o ir de expedición con mochila en Philmont. Serán enviados a casa. Por ejemplo, una persona de 70 pulgadas de estatura no puede pesar más de 226 libras. Todas las estaturas y pesos serán medidos con calcetines puestos. For participants under 21 years of age who exceed the maximum acceptable weight for height, the Philmont physicians will use their best professional judgment in determining participation in a Philmont trek. Philmont will consider up to 20 pounds over the maximum acceptable as stated on the chart; however exceptions are not made automatically, and discussion in advance with Philmont is required regarding any exception to the weight limit for persons under 21 years of age. Philmont’s telephone number is 575-3762281. Para los participantes menores de 21 años que excedan el límite de aceptación máxima de peso correspondiente a su altura, los médicos de Philmont utilizarán su mejor juicio profesional para determinar la participación en un recorrido en Philmont. Philmont considerará hasta 20 libras sobre la aceptación máxima tal como se establece en la tabla; sin embargo, las excepciones no se realizan automáticamente, y se requiere un análisis por adelantado con Philmont con respecto a cualquier excepción al límite de peso para personas menores de 21 años de edad. El teléfono de Philmont es 575-376-2281. Under no circumstances will any individual weighing more than 295 pounds be permitted to participate in backcountry programs. This requirement is necessary due to rescue equipment restrictions and for the safety of search-and-rescue personnel. Bajo ninguna circunstancia se le permitirá a ningún individuo que pese más de 295 libras participar en los programas en las áreas campestres. Este requisito es necesario debido a las restricciones del equipo de rescate y por la seguridad del personal de búsqueda y rescate. The maximum weight for any participant in a Cavalcade Trek and for horse rides is 200 pounds. El peso máximo para cualquier participante en el Sendero Cavalcade y para montar a caballo es 200 libras. Participants and guests in Philmont activities, including most Philmont Training Center conference and family programs, who will participate in limited backcountry access during their visit must not exceed the maximum acceptable limit in the weight chart. Los participantes e invitados de las actividades Philmont, incluyendo la mayoría de las conferencias y programas familiares del Centro de Capacitación Philmont que participarán en zonas campestres con acceso limitado durante su visita, no deben exceder el límite máximo aceptable en la tabla de peso. Northern Tier. Each participant in a Northern Tier expedition should not exceed the maximum acceptable weight for height in the table shown on the Annual Health and Medical Record form. Those who fall within the recommended weight limits are much more likely to have an enjoyable trek and avoid incurring injuries and health risks. Extra weight puts strain on the back, joints, and feet. The portage trails can be very muddy, slippery, and rocky, and present a potential for tripping and falling. We also strongly recommend that no participant be less than 100 pounds in weight. Extremely small participants will have a very difficult time carrying canoes and heavy packs. Canoes’ loads are another important reason to limit participant weight. Northern Tier assigns three people to a canoe. The total participant load per canoe must not exceed 600 pounds, or an average of 200 pounds per participant. Northern Tier does not permit individuals exceeding 295 pounds to participate in high-adventure programs. Florida Sea Base. Any participant or advisor who exceeds the maximum weight limits on the weight chart may want to reconsider participation in a Sea Base highadventure program. Anyone who exceeds these limits is at extreme risk for health problems. Participants who fall within the guidelines are more likely to have an enjoyable program and avoid incurring health risks. The absolute weight limit for our programs is 295 pounds. Northern Tier. Cada participante en una expedición en Northern Tier no deberá exceder el peso máximo aceptable correspondiente a su estatura según la tabla que se muestra en el Registro Médico y de Seguridad Anual. Aquellos que entran en los límites de peso recomendables tienen mayor posibilidad de tener un trayecto agradable y evitar incurrir en lesiones y riesgos de salud. El exceso de peso causa estragos en la espalda, articulaciones y pies. Los senderos para trasladar embarcaciones pueden ser fangosos, resbalosos y pedregosos, y presentar riesgos de tropezones y caídas. Asimismo, recomendamos encarecidamente que no haya participantes que pesen menos de 100 libras. Los participantes extremadamente pequeños tendrán dificultad para cargar canoas y mochilas pesadas. Las cargas de las canoas son otra razón importante para limitar el peso. Northern Tier asigna tres personas por canoa. La carga total de los participantes por canoa no debe exceder 600 libras, o un promedio de 200 libras por participante. Northern Tier no permite a los individuos que excedan 295 libras que participen en programas de aventura extrema. Base Marina de la Florida. Cualquier participante o consejero que exceda los límites máximos de peso en la tabla quizá quiera reconsiderar su participación en el programa de aventura extrema en una Base Marina. Cualquiera que exceda dichos límites está en riesgo grave de tener problemas de salud. Los participantes que entran en los lineamientos tienen más posibilidades de disfrutar del programa y evitar incurrir en riesgos de la salud. El peso límite absoluto para nuestros programas es 295 libras. Page 7 of 8 PART D (continued on next page) Summit Bechtel Reserve. The Summit Bechtel Reserve offers many types of activities that can be physically demanding, including rock climbing, mountain biking, white-water rafting, zip-line canopy tours, and more. Due to the mountainous terrain and remote location, there are safety precautions that must be followed. Check the Summit’s website for more specific information: https:// summit.scouting.org/en/Pages/default.aspx. Please contact the Summit Bechtel Reserve at 304-250-6750 if you have any questions. Height (inches) Summit Bechtel Reserve. Este lugar ofrece muchos tipos de actividades que pueden ser físicamente exigentes, incluyendo escalada en roca, ciclismo de montaña, descenso en ríos, recorridos en tirolesa y mucho más. Debido a los terrenos montañosos y ubicación remota, se deben seguir precauciones de seguridad. Consulte el sitio web de Summit para obtener información más específica: https://summit.scouting.org/en/ Pages/default.aspx. Favor de contactar a Summit Bechtel Reserve al 304-250-6750 si tiene más preguntas. Recommended Weight (lbs) Allowable Exception Maximum Acceptance Estatura (pulgadas) Recommended Weight (lbs) Peso recomendado (libras) Allowable Exception Maximum Acceptance Aceptación máxima 60 97-138 139-166 61 101-143 144-172 166 71 136-194 195-233 233 172 72 140-199 200-239 62 104-148 239 149-178 178 73 144-205 206-246 63 246 107-152 153-183 183 74 148-210 211-252 252 64 111-157 158-189 189 75 152-216 217-260 260 65 114-162 163-195 195 76 156-222 223-267 267 66 118-167 168-201 201 77 160-228 229-274 274 67 121-172 173-207 207 78 164-234 235-281 281 68 125-178 179-214 214 69 129-185 186-220 220 79 & over 79 y más 170-240 241-295 295 70 132-188 189-226 226 Estatura (pulgadas) Peso recomendado (libras) Excepción permitida Height (inches) Excepción permitida Aceptación máxima This table is based on the revised Dietary Guidelines for Americans from the U.S. Dept. of Agriculture and the Dept. of Health & Human Services. Esta tabla está basada en la revisión de las Directrices dietéticas para estadounidenses del Departamento de Agricultura y del Departamento de Salud y Servicios Humanos de los EE.UU. Page 8 of 8 680-001 2012 Printing Rev. 9/2012 MEDICAL STATEMENT Participant Record (Confidential Information) Please read carefully before signing. This is a statement in which you are informed of some potential risks involved in scuba diving and of the conduct required of you during the scuba training program. Your signature on this statement is required for you to participate in the scuba training program offered by_____________________________________________________and Instructor _______________________________________________located in the Facility city of_______________________, state/province of _______________. Read this statement prior to signing it. You must complete this Medical Statement, which includes the medical questionnaire section, to enroll in the scuba training program. If you are a minor, you must have this Statement signed by a parent or guardian. Diving is an exciting and demanding activity. When performed correctly, applying correct techniques, it is relatively safe. When established safety procedures are not followed, however, there are increased risks. To scuba dive safely, you should not be extremely overweight or out of condition. Diving can be strenuous under certain conditions. Your respiratory and circulatory systems must be in good health. All body air spaces must be normal and healthy. A person with coronary disease, a current cold or congestion, epilepsy, a severe medical problem or who is under the influence of alcohol or drugs should not dive. If you have asthma, heart disease, other chronic medical conditions or you are taking medications on a regular basis, you should consult your doctor and the instructor before participating in this program, and on a regular basis thereafter upon completion. You will also learn from the instructor the important safety rules regarding breathing and equalization while scuba diving. Improper use of scuba equipment can result in serious injury. You must be thoroughly instructed in its use under direct supervision of a qualified instructor to use it safely. If you have any additional questions regarding this Medical Statement or the Medical Questionnaire section, review them with your instructor before signing. Divers Medical Questionnaire To the Participant: The purpose of this Medical Questionnaire is to find out if you should be examined by your doctor before participating in recreational diver training. A positive response to a question does not necessarily disqualify you from diving. A positive response means that there is a preexisting condition that may affect your safety while diving and you must seek the advice of your physician prior to engaging in dive activities. Please answer the following questions on your past or present medical history with a YES or NO. If you are not sure, answer YES. If any of these items apply to you, we must request that you consult with a physician prior to participating in scuba diving. Your instructor will supply you with an RSTC Medical Statement and Guidelines for Recreational Scuba Diver’s Physical Examination to take to your physician. _____ Could you be pregnant, or are you attempting to become pregnant? _____ Dysentery or dehydration requiring medical intervention? _____ Are you presently taking prescription medications? (with the exception of birth control or anti-malarial) _____ Any dive accidents or decompression sickness? _____ Are you over 45 years of age and can answer YES to one or more of the following? • currently smoke a pipe, cigars or cigarettes • have a high cholesterol level • have a family history of heart attack or stroke • are currently receiving medical care • high blood pressure • diabetes mellitus, even if controlled by diet alone Have you ever had or do you currently have… _____ Asthma, or wheezing with breathing, or wheezing with exercise? _____ Frequent or severe attacks of hayfever or allergy? _____ Frequent colds, sinusitis or bronchitis? _____ Any form of lung disease? _____ Pneumothorax (collapsed lung)? _____ Other chest disease or chest surgery? _____ Behavioral health, mental or psychological problems (Panic attack, fear of closed or open spaces)? _____ Epilepsy, seizures, convulsions or take medications to prevent them? _____ Recurring complicated migraine headaches or take medications to prevent them? _____ Blackouts or fainting (full/partial loss of consciousness)? _____ Frequent or severe suffering from motion sickness (seasick, carsick, etc.)? _____ Inability to perform moderate exercise (example: walk 1.6 km/one mile within 12 mins.)? _____ Head injury with loss of consciousness in the past five years? _____ Recurrent back problems? _____ Back or spinal surgery? _____ Diabetes? _____ Back, arm or leg problems following surgery, injury or fracture? _____ High blood pressure or take medicine to control blood pressure? _____ Heart disease? _____ Heart attack? _____ Angina, heart surgery or blood vessel surgery? _____ Sinus surgery? _____ Ear disease or surgery, hearing loss or problems with balance? _____ Recurrent ear problems? _____ Bleeding or other blood disorders? _____ Hernia? _____ Ulcers or ulcer surgery ? _____ A colostomy or ileostomy? _____ Recreational drug use or treatment for, or alcoholism in the past five years? The information I have provided about my medical history is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition. _______________________________________ _________________ Signature _______________________________________ _________________ Date Signature of Parent or Guardian PRODUCT NO. 10063 (Rev. 06/07) Ver. 2.01 Page 1 of 6 Date © PADI 1989, 1990, 1998, 2001, 2007 © Recreational Scuba Training Council, Inc. 1989, 1990, 1998, 2001, 2007 STUDENT Please print legibly. Name__________________________________________________________________________ First Initial Last Birth Date ________________ Age ________ Day/Month/Year Mailing Address __________________________________________________________________________________________________________ City________________________________________________________________ State/Province/Region ________________________________ Country ____________________________________________________________ Home Phone ( )________________________________________ Email _____________________________________________________ Zip/Postal Code _____________________________________ Business Phone ( )______________________________________ FAX_______________________________________________________ Name and address of your family physician Physician __________________________________________________ Clinic/Hospital ______________________________________________ Address________________________________________________________________________________________________________________ Date of last physical examination ________________ Name of examiner____________________________________________ Clinic/Hospital_______________________________________________ Address ________________________________________________________________________________________________________________ Phone ( )___________________________________ Were you ever required to have a physical for diving? Yes Email ________________________________________________________________ No If so, when?________________________________________________ PHYSICIAN This person applying for training or is presently certified to engage in scuba (self-contained underwater breathing apparatus) diving. Your opinion of the applicant’s medical fitness for scuba diving is requested. There are guidelines attached for your information and reference. Physician’s Impression I find no medical conditions that I consider incompatible with diving. I am unable to recommend this individual for diving. Remarks ___________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ __________________________________________________________________________ Date ___________________________ Physician’s Signature or Legal Representative of Medical Practitioner Day/Month/Year Physician_____________________________________________ Clinic/Hospital_________________________________________ Address____________________________________________________________________________________________________ Phone ( )___________________________________ Email ________________________________________________________________ Page 2 of 6 Guidelines for Recreational Scuba Diver’s Physical Examination Instructions to the Physician: Recreational SCUBA (Self-Contained Underwater Breathing Apparatus) can provide recreational divers with an enjoyable sport safer than many other activities. The risk of diving is increased by certain physical conditions, which the relationship to diving may not be readily obvious. Thus, it is important to screen divers for such conditions. The RECREATIONAL SCUBA DIVER’S PHYSICAL EXAMINATION focuses on conditions that may put a diver at increased risk for decompression sickness, pulmonary overinflation syndrome with subsequent arterial gas embolization and other conditions such as loss of consciousness, which could lead to drowning. Additionally, the diver must be able to withstand some degree of cold stress, the physiological effects of immersion and the optical effects of water and have sufficient physical and mental reserves to deal with possible emergencies. The history, review of systems and physical examination should include as a minimum the points listed below. The list of conditions that might adversely affect the diver is not all-inclusive, but contains the most commonly encountered medical problems. The brief introductions should serve as an alert to the nature of the risk posed by each medical problem. The potential diver and his or her physician must weigh the pleasures to be had by diving against an increased risk of death or injury due to the individual’s medical condition. As with any recreational activity, there are no data for diving enabling the calculation of an accurate mathematical probability of injury. Experience and physiological principles only permit a qualitative assessment of relative risk. For the purposes of this document, Severe Risk implies that an individual is believed to be at substantially elevated risk of decompression sickness, pulmonary or otic barotrauma or altered consciousness with subsequent drowning, compared with the general population. The consultants involved in drafting this document would generally discourage a student with such medical problems from diving. Relative Risk refers to a moderate increase in risk, which in some instances may be acceptable. To make a decision as to whether diving is contraindicated for this category of medical problems, physicians must base their judgement on an assessment of the individual patient. Some medical problems which may preclude diving are temporary in nature or responsive to treatment, allowing the student to dive safely after they have resolved. Diagnostic studies and specialty consultations should be obtained as indicated to determine the diver’s status. A list of references is included to aid in clarifying issues that arise. Physicians and other medical professionals of the Divers Alert Network (DAN) associated with Duke University Health System are available for consultation by phone +1 919 684 2948 during normal business hours. For emergency calls, 24 hours 7 days a week, call +1 919 684 8111 or +1 919 684 4DAN (collect). Related organizations exist in other parts of the world – DAN Europe in Italy +39 039 605 7858, DAN S.E.A.P. in Australia +61 3 9886 9166 and Divers Emergency Service (DES) in Australia +61 8 8212 9242, DAN Japan +81 33590 6501 and DAN Southern Africa +27 11 242 0380. There are also a number of informative websites offering similar advice. NEUROLOGICAL Neurological abnormalities affecting a diver’s ability to perform exercise should be assessed according to the degree of compromise. Some diving physicians feel that conditions in which there can be a waxing and waning of neurological symptoms and signs, such as migraine or demyelinating disease, contraindicate diving because an exacerbation or attack of the preexisting disease (e.g.: a migraine with aura) may be difficult to distinguish from neurological decompression sickness. A history of head injury resulting in unconsciousness should be evaluated for risk of seizure. Relative Risk Conditions • Complicated Migraine Headaches whose symptoms or severity impair motor or cognitive function, neurologic manifestations • History of Head Injury with sequelae other than seizure • Herniated Nucleus Pulposus • Intracranial Tumor or Aneurysm • Peripheral Neuropathy • Multiple Sclerosis • Trigeminal Neuralgia • History of spinal cord or brain injury Temporary Risk Condition History of cerebral gas embolism without residual where pulmonary air trapping has been excluded and for which there is a satisfactory explanation and some reason to believe that the probability of recurrence is low. Severe Risk Conditions Any abnormalities where there is a significant probability of unconsciousness, hence putting the diver at increased risk of drowning. Divers with spinal cord or brain abnormalities where perfusion is impaired may be at increased risk of decompression sickness. Some conditions are as follows: • History of seizures other than childhood febrile seizures • History of Transient Ischemic Attack (TIA) or Cerebrovascular Accident (CVA) • History of Serious (Central Nervous System, Cerebral or Inner Ear) Decompression Sickness with residual deficits CARDIOVASCULAR SYSTEMS Relative Risk Conditions The diagnoses listed below potentially render the diver unable to meet the exertional performance requirements likely to be encountered in recreational diving. These conditions may lead the diver to experience cardiac ischemia and its consequences. Formalized stress testing is encouraged if there is any doubt regarding physical performance capability. The suggested minimum criteria for stress testing in such cases is at least 13 METS.* Failure to meet the exercise criteria would be of significant concern. Conditioning and retesting may make later qualification possible. Immersion in water causes a redistribution of blood from the periphery into the central compartment, an effect that is greatest in cold water. The marked increase in cardiac preload during immersion can precipitate pulmonary edema in patients with impaired left ventricular function or significant valvular disease. The effects of immersion can mostly be gauged by an assessment of the diver’s performance while swimming on the surface. A large proportion of scuba diving deaths in North America are due to coronary artery disease. Before being approved to scuba dive, individuals older than 40 years are recommended to undergo risk assessment for coronary artery disease. Formal exercise testing may be needed to assess the risk. * METS is a term used to describe the metabolic cost. The MET at rest is one, two METS is two times the resting level, three METS is three times the resting level, and so on. The resting energy cost (net oxygen requirement) is thus standardized. (Exercise Physiology; Clark, Prentice Hall, 1975.) Page 3 of 6 Relative Risk Conditions • Obesity • History of Coronary Artery Bypass Grafting (CABG) • Percutaneous Balloon Angioplasty (PCTA) or Coronary Artery Disease (CAD) • History of Myocardial Infarction • Congestive Heart Failure • Hypertension • History of dysrythmias requiring medication for suppression • Valvular Regurgitation • History of Immersion Pulmonary Edema Restrictive Disease* • Interstitial lung disease: May increase the risk of pneumothorax * Spirometry should be normal before and after exercise Active Reactive Airway Disease, Active Asthma, Exercise Induced Bronchospasm, Chronic Obstructive Pulmonary Disease or history of same with abnormal PFTs or a positive exercise challenge are concerns for diving. Pacemakers The pathologic process that necessitated should be addressed regarding the diver’s fitness to dive. In those instances where the problem necessitating pacing does not preclude diving, will the diver be able to meet the performance criteria? * NOTE: Pacemakers must be certified by the manufacturer as able to withstand the pressure changes involved in recreational diving. Severe Risks PULMONARY Any process or lesion that impedes airflow from the lungs places the diver at risk for pulmonary overinflation with alveolar rupture and the possibility of cerebral air embolization. Many interstitial diseases predispose to spontaneous pneumothorax: Asthma (reactive airway disease), Chronic Obstructive Pulmonary Disease (COPD), cystic or cavitating lung diseases may all cause air trapping. The 1996 Undersea and Hyperbaric Medical Society (UHMS) consensus on diving and asthma indicates that for the risk of pulmonary barotrauma and decompression illness to be acceptably low, the asthmatic diver should be asymptomatic and have normal spirometry before and after an exercise test. Inhalation challenge tests (e.g.: using histamine, hypertonic saline or methacholine) are not sufficiently standardized to be interpreted in the context of scuba diving. A pneumothorax that occurs or reoccurs while diving may be catastrophic. As the diver ascends, air trapped in the cavity expands and could produce a tension pneumothorax. In addition to the risk of pulmonary barotrauma, respiratory disease due to either structural disorders of the lung or chest wall or neuromuscular disease may impair exercise performance. Structural disorders of the chest or abdominal wall (e.g.: prune belly), or neuromuscular disorders, may impair cough, which could be life threatening if water is aspirated. Respiratory limitation due to disease is compounded by the combined effects of immersion (causing a restrictive deficit) and the increase in gas density, which increases in proportion to the ambient pressure (causing increased airway resistance). Formal exercise testing may be helpful. • History of Asthma or Reactive Airway Disease (RAD)* • History of Exercise Induced Bronchospasm (EIB)* • History of solid, cystic or cavitating lesion* • Pneumothorax secondary to: -Thoracic Surgery -Trauma or Pleural Penetration* -Previous Overinflation Injury* • History of spontaneous pneumothorax. Individuals who have experienced spontaneous pneumothorax should avoid diving, even after a surgical procedure designed to prevent recurrence (such as pleurodesis). Surgical procedures either do not correct the underlying lung abnormality (e.g.: pleurodesis, apical pleurectomy) or may not totally correct it (e.g.: resection of blebs or bullae). • Impaired exercise performance due to respiratory disease. Venous emboli, commonly produced during decompression, may cross major intracardiac right-to-left shunts and enter the cerebral or spinal cord circulations causing neurological decompression illness. Hypertrophic cardiomyopathy and valvular stenosis may lead to the sudden onset of unconsciousness during exercise. Relative Risk Conditions Severe Risk Conditions GASTROINTESTINAL Temporary Risks As with other organ systems and disease states, a process which chronically debilitates the diver may impair exercise performance. Additionally, dive activities may take place in areas remote from medical care. The possibility of acute recurrences of disability or lethal symptoms must be considered. Temporary Risk Conditions • Peptic Ulcer Disease associated with pyloric obstruction or severe reflux • Unrepaired hernias of the abdominal wall large enough to contain bowel within the hernia sac could incarcerate. Relative Risk Conditions • Inflammatory Bowel Disease • Functional Bowel Disorders Severe Risks Altered anatomical relationships secondary to surgery or malformations that lead to gas trapping may cause serious problems. Gas trapped in a hollow viscous expands as the divers surfaces and can lead to rupture or, in the case of the upper GI tract, emesis. Emesis underwater may lead to drowning. Severe Risk Conditions • Gastric outlet obstruction of a degree sufficient to produce recurrent vomiting • Chronic or recurrent small bowel obstruction • Severe gastroesophageal reflux • Achalasia • Paraesophageal Hernia ORTHOPAEDIC Relative impairment of mobility, particularly in a boat or ashore with equipment weighing up to 18 kgs/40 pounds must be assessed. Orthopaedic conditions of a degree sufficient to impair exercise performance may increase the risk. Relative Risk Conditions • Amputation • Scoliosis must also assess impact on respiratory function and exercise performance. • Aseptic Necrosis possible risk of progression due to effects of decompression (evaluate the underlying medical Page 4 of 6 cause of decompression may accelerate/escalate the progression). Temporary Risk Conditions • Back pain HEMATOLOGICAL Abnormalities resulting in altered rheological properties may theoretically increase the risk of decompression sickness. Bleeding disorders could worsen the effects of otic or sinus barotrauma, and exacerbate the injury associated with inner ear or spinal cord decompression sickness. Spontaneous bleeding into the joints (e.g.: in hemophilia) may be difficult to distinguish from decompression illness. personal fears Claustrophobia and agoraphobia Active psychosis History of untreated panic disorder Drug or alcohol abuse OTOLARYNGOLOGICAL Equalisation of pressure must take place during ascent and descent between ambient water pressure and the external auditory canal, middle ear and paranasal sinuses. Failure of this to occur results at least in pain and in the worst case rupture of the occluded space with disabling and possible lethal consequences. The inner ear is fluid filled and therefore noncompressible. The flexible interfaces between the middle and inner ear, the round and oval windows are, however, subject to pressure changes. Previously ruptured but healed round or oval window membranes are at increased risk of rupture due to failure to equalise pressure or due to marked overpressurisation during vigorous or explosive Valsalva manoeuvres. Relative Risk Conditions • • • • • • • • Sickle Cell Disease Polycythemia Vera Leukemia Hemophilia/Impaired Coagulation METABOLIC AND ENDOCRINOLOGICAL With the exception of diabetes mellitus, states of altered hormonal or metabolic function should be assessed according to their impact on the individual’s ability to tolerate the moderate exercise requirement and environmental stress of sport diving. Obesity may predispose the individual to decompression sickness, can impair exercise tolerance and is a risk factor for coronary artery disease. The larynx and pharynx must be free of an obstruction to airflow. The laryngeal and epiglotic structure must function normally to prevent aspiration. Mandibular and maxillary function must be capable of allowing the patient to hold a scuba mouthpiece. Individuals who have had mid-face fractures may be prone to barotrauma and rupture of the air filled cavities involved. Relative Risk Conditions Relative Risk Conditions • Hormonal Excess or Deficiency • Obesity • Renal Insufficiency • • • • • • • • • Severe Risk Conditions The potentially rapid change in level of consciousness associated with hypoglycemia in diabetics on insulin therapy or certain oral hypoglycemic medications can result in drowning. Diving is therefore generally contraindicated, unless associated with a specialized program that addresses these issues. [See “Guidelines for Recreational Diving with Diabetes” at www/wrstc.com and www.diversalertnetwork.org.] Pregnancy: The effect of venous emboli formed during decompression on the fetus has not been thoroughly investigated. Diving is therefore not recommended during any stage of pregnancy or for women actively seeking to become pregnant. BEHAVIORAL HEALTH Behavioral: The diver’s mental capacity and emotional make-up are important to safe diving. The student diver must have sufficient learning abilities to grasp information presented to him by his instructors, be able to safely plan and execute his own dives and react to changes around him in the underwater environment. The student’s motivation to learn and his ability to deal with potentially dangerous situations are also crucial to safe scuba diving. Relative Risk Conditions • • • • Developmental delay History of drug or alcohol abuse History of previous psychotic episodes Use of psychotropic medications Severe Risk Conditions • Inappropriate motivation to dive – solely to please spouse, partner or family member, to prove oneself in the face of • • • • • • • Recurrent otitis externa Significant obstruction of external auditory canal History of significant cold injury to pinna Eustachian tube dysfunction Recurrent otitis media or sinusitis History of TM perforation History of tympanoplasty History of mastoidectomy Significant conductive or sensorineural hearing impairment Facial nerve paralysis not associated with barotrauma Full prosthedontic devices History of mid-face fracture Unhealed oral surgery sites History of head and/or neck therapeutic radiation History of temperomandibular joint dysfunction History of round window rupture Severe Risk Conditions • • • • • • • • • • • • • Monomeric TM Open TM perforation Tube myringotomy History of stapedectomy History of ossicular chain surgery History of inner ear surgery Facial nerve paralysis secondary to barotrauma Inner ear disease other than presbycusis Uncorrected upper airway obstruction Laryngectomy or status post partial laryngectomy Tracheostomy Uncorrected laryngocele History of vestibular decompression sickness Page 5 of 6 BIBLIOGRAPHY/REFERENCE 1. Bennett, P. & Elliott, D (eds.)(1993). The Physiology and Medicine of Diving. 4th Ed., W.B. Saunders Company Ltd., London, England. 2. Bove, A., & Davis, J. (1990). Diving Medicine. 2nd Edition, W.B. Saunders Company, Philadelphia, PA. 3. Davis, J., & Bove, A. (1986). “Medical Examination of Sport Scuba Divers, Medical Seminars, Inc.,” San Antonio, TX 4. Dembert, M. & Keith, J. (1986). “Evaluating the Potential Pediatric Scuba Diver.” AJDC, Vol. 140, November. 5. Edmonds, C., Lowry, C., & Pennefether, J. (1992) .3rd ed., Diving and Subaquatic Medicine. Butterworth & Heineman Ltd., Oxford, England. 6. 7. 8. Neuman, T. & Bove, A. (1994). “Asthma and Diving.” Ann. Allergy, Vol. 73, October, O’Conner & Kelsen. 9. Shilling, C. & Carlston, D. & Mathias, R. (eds) (1984). The Physician’s Guide to Diving Medicine. Plennum Press, New York, NY. 10. Undersea and Hyperbaric Medical Society (UHMS) www.UHMS.org 11. Divers Alert Network (DAN) United States, 6 West Colony Place, Durham, NC www.DiversAlertNetwork.org 12. Divers Alert Network Europe, P.O. Box 64026 Roseto, Italy, telephone non-emergency line: weekdays office hours +39-085-8930333, emergency line 24 hours: +39-039-605-7858 Elliott, D. (Ed) (1994). “Medical Assessment of Fitness to Dive.” Proceedings of an International Conference at the Edinburgh Conference Centre, Biomedical Seminars, Surry, England. “Fitness to Dive,” Proceedings of the 34th Underwater & Hyperbaric Medical Society Workshop (1987) UHMS Publication Number 70(WS-FD) Bethesda, MD. 13. Divers Alert Network S.E.A.P., P. O. Box 384, Ashburton, Australia, telephone 61-3-9886-9166 14. Divers Emergency Service, Australia, www.rah.sa.gov.au/hyperbaric, telephone 61-8-8212-9242 15. South Pacific Underwater Medicine Society (SPUMS), P.O. Box 190, Red Hill South, Victoria, Australia, www.spums.org.au 16. European Underwater and Baromedical Society, www.eubs.org ENDORSERS Paul A. Thombs, M.D., Medical Director Hyperbaric Medical Center St. Luke’s Hospital, Denver, CO, USA Peter Bennett, Ph.D., D.Sc. Professor, Anesthesiology Duke University Medical Center Durham, NC, USA [email protected] Richard E. Moon, M.D., F.A.C.P., F.C.C.P. Departments of Anesthesiology and Pulmonary Medicine Duke University Medical Center Durham, NC, USA Roy A. Myers, M.D. MIEMS Baltimore, MD, USA William Clem, M.D., Hyperbaric Consultant Division Presbyterian/St. Luke’s Medical Center Denver, CO, USA John M. Alexander, M.D. Northridge Hospital Los Angeles, CA, USA Des Gorman, B.Sc., M.B.Ch.B., F.A.C.O.M., F.A.F.O.M., Ph.D. Professor of Medicine University of Auckland, Auckland, NZ [email protected] Alf O. Brubakk, M.D., Ph.D. Norwegian University of Science and Technology Trondheim, Norway [email protected] Alessandro Marroni, M.D. Director, DAN Europe Roseto, Italy Hugh Greer, M.D. Santa Barbara, CA, USA [email protected] Christopher J. Acott, M.B.B.S., Dip. D.H.M., F.A.N.Z.C.A. Physician in Charge, Diving Medicine Royal Adelaide Hospital Adelaide, SA 5000, Australia Chris Edge, M.A., Ph.D., M.B.B.S., A.F.O.M. Nuffield Department of Anaesthetics Radcliffe Infirmary Oxford, United Kingdom [email protected] Richard Vann, Ph.D. Duke University Medical Center Durham, NC, USA Keith Van Meter, M.D., F.A.C.E.P. Assistant Clinical Professor of Surgery Tulane University School of Medicine New Orleans, LA, USA Robert W. Goldmann, M.D. St. Luke’s Hospital Milwaukee, WI, USA Paul G. Linaweaver, M.D., F.A.C.P. Santa Barbara Medical Clinic Undersea Medical Specialist Santa Barbara, CA, USA James Vorosmarti, M.D. 6 Orchard Way South Rockville, MD, USA Tom S. Neuman, M.D., F.A.C.P., F.A.C.P.M. Associate Director, Emergency Medical Services Professor of Medicine and Surgery University of California at San Diego San Diego, CA, USA Yoshihiro Mano, M.D. Professor Tokyo Medical and Dental University Tokyo, Japan [email protected] Page 6 of 6 Simon Mitchell, MB.ChB., DipDHM, Ph.D. Wesley Centre for Hyperbaric Medicine Medical Director Sandford Jackson Bldg., 30 Chasely Street Auchenflower, QLD 4066 Australia [email protected] Jan Risberg, M.D., Ph.D. NUI, Norway Karen B.Van Hoesen, M.D. Associate Clinical Professor UCSD Diving Medicine Center University of California at San Diego San Diego, CA, USA Edmond Kay, M.D., F.A.A.F.P. Dive Physician & Asst. Clinical Prof. of Family Medicine University of Washington Seattle, WA, USA [email protected] Christopher W. Dueker, TWS, M.D. Atherton, CA, USA [email protected] Charles E. Lehner, Ph.D. Department of Surgical Sciences University of Wisconsin Madison, WI, USA [email protected] Undersea & Hyperbaric Medical Society 10531 Metropolitan Avenue Kensington, MD 20895, USA Diver’s Alert Network (DAN) 6 West Colony Place Durham, NC 27705 San Gabriel Valley Council - Boy Scouts of America Catalina Classic Cruises Will be departing/returning from The Catalina Express Terminal located by the Queen Mary Port of Long Beach Queen Mary 1046 Queens Highway, Long Beach, CA PARKING FEES: $15 daily per 24 hours and any part of 24 hours after the first day. PAYABLE IN CASH ONLY ATM AVAILABLE AT TERMINAL Sunday Departure from Long Beach: 2:30 pm, 1:30 pm Check in Saturday Departure from Two Harbor: 10:45 am Monday Travel: Unit contact will receive an email with departure time when council is notify that you need Monday travel. Directions: Take the 710 FWY South. Stay in the right lane; follow the signs to Queen Mary which will lead you to the Catalina Express Terminal in the Queen Mary parking area. You will be met by staff.