(601) Highway 29 Brooklyn, MS 39425

Transcription

1 Date: October 28, 2014 Place: Phone: Website: Chaperons: Red Wolf Staff: Transportation: (601) Highway 29 Brooklyn, MS Red Wolf Wilderness Adventures 1651 Highway 29, Brooklyn, MS Coach Lauren, Coach Bettye, Ms. Scott, Ms. Cicero Jeffrey Coit, Stephanie Lachney, Thea Vallotton Kehoe France School Bus On October 28 th, Kehoe France s 5 th graders will be participating in a team building adventure at the Red Wolf Wilderness Adventures facility. Activities will include team building activities, rock-climbing, and paddle school. This trip is an introduction for the students to the Red Wolf Wilderness Adventures facility, the local area, and activities they will take part in on their 6 th and 7 th grade trips. Release Form: Attached to this handout are health and release forms that need to be completed and returned no later than October If the forms are not completed and returned, the student will not be able to attend the trip. Clothing & Equipment: Students will be spending the day outside. Please dress accordingly. Students can bring a change of clothes, TWO towels, and old sneakers or water shoes in their PE Bags in case they need to change prior to returning home.

2 Departure: Arrival: Departure and Arrival Information 7:30 AM at Kehoe France. Students should be at school by 7:00 AM. 5:00 PM at Kehoe France. Any delays will be communicated via 1-Call NOTE: While the bus should be arriving at Kehoe by 5:00 PM, due to the possibilities of unforeseen traffic conditions, a One Call announcement will be made to all the 5 th grade parents when the bus is approximately 45 minutes away from Kehoe France. Packing Tips: Students should have a PE Bag with a change of clothes, towels and old sneakers or water shoes for time spent on the water, a small bag with activities to pass the time while traveling to and from Red Wolf, and a brown bag lunch. Miscellaneous: All information regarding food allergies, medications, and special dietary needs MUST be noted on the Medical Release form that is due by October 15, Activities: The 5 th grade class will take part in team building exercises, climb our 24 tall climbing wall, and spend time learning to paddle on Red Wolf s pond. While doing these activities, our focus and discussions will be on safety in the outdoors, leadership, teamwork, and personal achievement Emergency Contact: If you need to get in touch with Red Wolf, please call (601) If you can not get in touch with us, please contact Janet Pananos at (504) If you have any further questions or concerns regarding the trip, please contact Jeffrey Coit at Jeff@redwolfwildernessadventures.com

3 Clothing and Equipment Checklist Lunch: To maximize our students time taking part in activities, please send a Brown Bag Lunch with your child. Red Wolf Wilderness Adventures will provide a water bottle and water. Weather Expectations: Red Wolf Wilderness Adventures is located in Wiggins, Mississippi and the temperatures are much like they are here in Metairie. Since our trip will be in late October, it may get cold and we may encounter the possibility of rain. Likewise, it is possible for temperatures to be in the mid 80 s. It is important that we all dress accordingly and are prepared. 1 pair of dry shoes tennis shoes or boots are fine. 1 pair of old shoes or water shoes Rain gear / Wind shell (very important) o o Nylon / Gortex rain suit or a durable heavy poncho is fine. Be sure that it is able to fit over layered clothes. Nylon or Gortex are not only good for keeping your clothing layers dry but also insulate and shield you from wind and rain. o DO NOT bring a small emergency poncho. These are not made to withstand rain for an extended period of time and will fail under heavy rain. Sunglasses with strap (optional) Chapstick or lip balm Personal Items Book (small optional) Camera Please put student name on camera. Insect repellent (students may share) Sunscreen (students may share) Small plastic ziplock style plastic bags to keep personal items dry 1 large black trash bag Medication and detailed instructions to be given to Coach Lauren before boarding the bus.

4 DO NOT BRING: ipods or MP3 Players Cell Phones Knife(s) Snacks GUM Matches, Lighters, or fire starting devices Attached Kehoe France Medical Form Attached RWWA Release Form.

5 Release Form and Assumption of Risk Please Print: Name: Address: Age: Group Name: Phone: Cell: Other Emergency Contact Phone Numbers: I understand that during my participation in the programs at Red Wolf Wilderness Adventures I will be exposed to various inherent risks including, but not limited to, canoeing, kayaking, rock climbing, forces of nature, accidents or illness in remote areas, the hazards of travel in wilderness terrain, and vehicular travel. I acknowledge that some of the activities involve strenuous exercise and entail known and unanticipated risks which in rare instances could result in serious physical or emotional injuries including death. I take full responsibility and assume all related liability for any injury or loss, and release Red Wolf Wilderness Adventures, LLC from all responsibility or liability for any injury or loss while engaging in program activities, or using Red Wolf s equipment or facilities. I and/or my child agree to wear personal flotation devices AT ALL TIMES while on any water based activity and will comply with the instructions and safety rules of the Red Wolf Wilderness Adventures staff SIGNATURE OF PARENT OR GUARDIAN OR ADULT PARTICIPANT: WITNESS: DATE: I UNDERSTAND AND AGREE TO ABIDE BY MY RESTRICTIONS. SIGNATURE OF PARTICIPANT:

6 Medical Authorization Form TO WHOM IT MAY CONCERN: I,, am the parent and legal guardian of (the child ). I hereby authorize Kehoe-France School faculty and staff members to make any medical decisions regarding my child in case of an emergency on, while on a outdoor leadership trip in Mississippi. HEALTH INFORMATION: Describe any conditions that might affect participant s active Allergies, ETC Bee Stings Iodine participation in this program. Penicillin Asthma Other (specify) List any medications participant is taking and the instructions: INSURANCE INFORMATION: Some providers require a front and back copy of your insurance card. (You should attach a copy to this sheet.) Insurance Company Name: Pre-Cert required? Yes/No Mailing Address For Claims: Phone # For Benefit Info: Group Name Group # Policy # Policy Holder Name Relationship to Student WITNESSES: