Welcome to L.L.Bean February Break Kids Camp An Amazing Winter Vacation They ll Always Remember

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1 Welcome to L.L.Bean February Break Kids Camp An Amazing Winter Vacation They ll Always Remember Hello Parents, We are so excited that you have chosen to enroll your child in L.L.Bean Outdoor Discovery Schools February Break Kids Camp and are certain your child will remember our fun mix of outdoor skills and play as the highlight of their winter vacation. We ve included some helpful information for your child s first day of camp. Pickup and Drop Off: Please note our pick up and drop off location and time changes. Location: Drop off and pick up is at our Flying Point Paddling Center, 14 Marietta Lane, Freeport. Drop-Off Time: Drop off time is between 8:45 and 9:00 a.m. Please call the camp session line at if your child will be late, is unable to attend or if there are any unexpected changes in plan during the week of camp. Please note: parking is limited at camp; your patience and courtesy is apprecated. Pickup Time: 4 p.m. Parent Sign-Out: You re required to accompany your child and sign them out at pickup. Please fill out the authorized release form, making sure to include any adult who may pick up your child. Campers will not be released to any individual not identified on that form. Medications: At drop off, please give our staff any medications that your child may need. Medication required during the camp, whether prescription or over the counter, must be provided in the original pharmacy containers with labels showing camper s name, the name of the medication, dosage and time intervals of administration. The medication should be in a zip-lock bag labeled with the child s full name. Each day provide only enough of each medication for one day at camp. Camper must have taken at least one dose prior to attending camp. Required Paperwork: In order to give every camper the best possible experience, it is important that we get all of the state required registration and medical paperwork to camp as soon as possible. All paperwork must be in by Friday, February 9, Please or fax all registration materials to odsyouthprograms@llbean.com or What to Bring: It is very important that your child arrives well prepared in order to have a safe and enjoyable experience while they are outside. The weather at our Paddling Center is frequently wetter and colder than the forecast. Please be sure your child has all of the items listed below with them each session and please mark each item with your child s name. Backpack big enough to store all items on the checklist Lunch and numerous snacks for energy Personal prescriptions such as EpiPen or inhaler One one-quart water bottle drinking water will be onsite Polarized sunglasses with lanyard or ski goggles Warm hat, gloves or mittens, preferably waterproof* Insulated waterproof boots Extra pair of synthetic or wool socks Insulated, waterproof jacket and pants plus fleece jacket or wool sweater (appropriate level of insulation for activity) Long underwear tops and bottoms, synthetic or wool Extra change of clothes in case your child s clothes get wet Optional: Waterproof camera, neck gaiter and personal ski helmet for sledding *Synthetic clothing dries quickly and is the best choice for outdoor pursuits. Please do not dress your child in cotton clothing. When wet, cotton rapidly robs heat from the body and takes a long time to dry. We also recommend you dress your child in multiple layers of clothing, allowing them more flexibility to comfortably respond to the weather conditions and their level of exertion. Cancelling or Rescheduling: If you need to cancel or reschedule, we will gladly provide a full refund with at least 14 days notification. We also offer a 50% credit or refund with 7 to 13 days notification; however, there are no refunds with less than seven days notification. Communication: We want your child to have the best experience possible, so please feel free to contact us at any time. If you have any questions prior to the start of camp or need to contact your camper during the session, please call us at If you need to contact your camper during the session, please call Please understand that your child may not be immediately available, as they could be out on an adventure. Rest assured, in the case of an emergency call, we would do our best to get them in contact with you ASAP. Also, please make sure you list the best contact number to reach you during the camp s hours, so we can quickly get in touch with you should the need arise. Warmest regards, Ryan Jaret Kids Camp Supervisor Please keep this page for your reference. Questions? Please call us at

2 L.L.Bean, Inc., Outdoor Discovery Schools Participant Agreement and Liability Release Form In consideration of the services of L.L.Bean, Inc. ( L.L.Bean ), on behalf of myself and my child, I agree as follows: 1. I acknowledge that my child s participation in the L.L.Bean Outdoor Discovery Schools program involves known and unanticipated risks, which could lead to physical injury, paralysis, death or damage to the participants and property. Risks include (but are not limited to): following: dehydration, muscle strains or sprains, bone breaks, abrasions, cuts, blisters, exposure to biting insects and the infectious diseases they may carry, exposure to poisonous plants, drowning, sunburn, frostbite, other heat and/or cold related illnesses, cardiac arrest, being shot by bullets or arrows, eye and ear injuries, and trips and falls. I understand L.L.Bean does not seek to eliminate all the risks of my activities because some are part of adventurous sports. I agree to assume the inherent risks and all other risks in the activities. 2. I acknowledge that instructors cannot pay continuous attention to everyone at all times and cannot be responsible for participants safety at all times. I also understand that L.L.Bean is not responsible for weather, terrain, wildlife or equipment failure and that they may cause or contribute to an injury or property damage. 3. I agree, to the fullest extent allowed by law, to release and discharge L.L.Bean from any and all claims or liabilities arising from or connected with the participation of my child in this program, as well as any and all claims or liabilities arising from or connected with my child s use of any equipment, presence on L.L.Bean s premises, or presence on any property owned by others where Outdoor Discovery Schools activities are conducted. But, any attempt to bring a claim must be brought in the state of Maine and the law of Maine will apply. 4. I understand it is my responsibility to determine if my child is capable of participating in the activities safely. I am aware of the activities and the environment of my child s program. I certify that my child has no medical condition or restriction that prevents my child from safely participating in this program. 5. On behalf of my child, I give L.L.Bean permission to give or secure emergency care or other treatment that may become necessary and agree to pay for such care. I authorize the release of medical information to rescue or medical personnel. 6. I consent to my child being photographed/filmed while participating in this program and for L.L.Bean to use any of such films, photographs and resulting testimonials for any purpose, including training, advertising, catalogs, displays, media publications including newspapers and magazines, and social media without compensation or prior approval. 7. I understand that the above releases apply to me and my child as well as to each of our heirs, insurers, successors and assigns. 8. I understand that I am completely responsible for any and all personal equipment that my child brings on this program, the damage or theft of it, any personal damage it may cause me or others and any damage to other property owned by me or others. I have read, understand, and agree to the above terms and warnings. I consent to the participation of my child and agree for myself and my child to be bound by these terms. Printed name of parent and parent s signature: Date: Approved Participant Agreement Form For Minors: 04/01/2016 1

3 L.L.Bean Kids Camp Registration Form Please or fax registration materials to: Fax: Questions? Call For camp use only: Name Week(s) Attending: Paperwork complete? Yes No Reviewer s Name: Paperwork Missing: Recorded in Roster: Resolved: Initials: All weeks updated in Ryan s Roster: Date: Initials: Recorded in Roster: Resolved: Initials: To Parent(s)/Guardian(s): 1) In order for your camper to attend, please complete all attached forms and keep copies for your records. 2) or fax the signed forms to us at the address below as soon as possible. All paperwork must be in two weeks before your child arrives at camp. 3) Parent(s)/Guardian(s) are solely responsible for ensuring the accuracy of the information contained within these forms and for keeping such information current. Dates of camp attendance (please list all nonconsecutive multiday attendance dates): from to from to Camper Name: Birth date: Age at camp: Gender: Male Female Custodial Parent/Guardian: Home address: address: Second Parent/Guardian or Emergency Contact: Home address: address: If not available in an emergency, notify: Name of camper s healthcare provider: Insurance Information Is this participant covered by family medical/hospital insurance? Yes No If so, indicate carrier or plan name: Group # Policy # Phone number (often found on back of card): Alternate Pick-up Person I hereby authorize the following person(s) to pick up my child from the L.L.Bean Youth Camps and activities: Name: Relationship: (please print) Name: Relationship: (please print) 2

4 L.L.Bean Medical & Health History Form Camper Name: Allergies (please include medications, foods, insect stings, hay fever, asthma, dander, etc.): Camper has known allergies Yes No If yes, please list and describe below. Restrictions (including special diet, activities): Camper has known restrictions Yes No If yes, please list and describe below. General Health History: Check Yes or No for each statement. Please explain Yes answers below, adding any information you think would be helpful for us to know. We may contact you for additional information if necessary. Has camper had or does camper have Use this space to explain Yes answers 1) A recent infectious disease? Yes No 2) A recent injury? Yes No 3) Asthma/wheezing/shortness of breath? Yes No 4) Diabetes? Yes No 5) Seizures? Yes No 6) Headaches? Yes No 7) Glasses or contact lenses? Yes No 8) Fainting or dizziness? Yes No 9) Passed out or experienced chest pain during exercise? Yes No 10) Back/joint problems? Yes No Are there any emotional or behavioral issues that we need to know about to ensure your child has a safe and successful experience at camp? Yes No If yes, please explain: Special Placement Requests: If you have anyone who you d like your child to be paired with during this camp, please list their name below. Please note: Our staff will try hard to honor these requests, but they are not guaranteed because of required state laws governing staff to student ratios. What have we forgotten to ask? In the space below, please provide any additional information about the camper that you think is important or that may affect the camper s ability to fully participate in camp programs. Attach additional information if needed. 3

5 Camper Medications Camper Name: Does your child take any medications on a regular basis? Yes No If yes, please list: Will your child need to take any of these medications while attending camp? Yes (Please see note* below) No (Signature not required.) * Medication required during the camper s day at camp, whether prescription or over the counter, must be provided in the original pharmacy containers with labels showing camper s name, the name of the medication, dosage and time intervals of administration. The medication should be in a zip-lock bag labeled with the child s full name. Each day, provide only enough of each medication for one day at camp. Camper must have taken at least one dose prior to attending camp. Name of medication to be taken during the camp day, and, if a prescription medication, prescribing health care provider s name and phone number. Prescriber Date started Reason for medication Dosage time Amount or dose How administered Potential side effects I understand that camp staff is not trained in administering medication. With full knowledge of this, I hereby give permission for the administration of the medication specified above by camp staff. The healthcare provider prescribing this medication may be contacted in the event that complications arise or clarifying information is needed. I release and hold harmless L.L.Bean, Inc., from any and all claims arising out of or related to the administration of the medication. Signature of Parent/Guardian Date: (Signature required only if you are sending medication) Name (please print): Relationship to camper: Camper Immunization History Please have your doctor fax or us your child s immunization records or any other documentation for their medical history to: (207) or odsyouthprograms@llbean.com. Exemption from Immunization Requirements I request that my child, ( my child ) be exempted on religious grounds, or on the basis of strong moral or ethical conviction similar to a religious belief, from all immunization requirements established by L.L.Bean for attendance at L.L.Bean Youth Camps and activities. To the best of my knowledge and belief, my child is in good health and free from all communicable and contagious diseases. If, at any time within 24 hours prior to my child s scheduled attendance at the camp, my child manifests any conditions where there appears to be reasonable grounds for suspecting the presence of a communicable or contagious illness, my child will not attend camp until such signs are no longer present. If, at any time during attendance at the camp, my child manifests any condition where there appears to be reasonable grounds for suspecting the presence of communicable or contagious diseases, I agree that my child will comply with L.L.Bean s quarantine or isolation procedures and will withdraw from the camp program. I have read and understand the above terms and agree to be bound by them. Signature of Parent/Guardian Date: (No signature is required, if you are providing immunization records) Name (please print): Address: 4