Explorers Program Form

Must be completed for youth who will participate in our Explorers Program, ages 10-13.
  = Required

Drop-off & Pick-up

All Explorers meetings happen at The Mountaineers Program Center, and most trips leave from there as well.  While we do not arrange transportation for youth to and from the Mountaineers Program Center (or other designated meeting place), we do encourage carpooling. 

Transportation to and from the Mountaineers Seattle Program Center (or other designated meeting place) is at the sole discretion of the parent/guardian of each youth participant.  If a youth carpools with another family, takes public transportation or otherwise transports themselves to/from the meetings or programs, the parent is responsible for making appropriate communication arrangements with the youth.

Explorers monthly meetings begin at 6:30pm and end no later than 8:15pm. Youth who need to leave the meeting early are expected to communicate their plans to Mountaineers staff.  At the end of the meeting, all youth are dismissed to adults picking them up.  Mountaineers staff will stay at The Mountaineers until all youth have left.

Explorers trips begin and end at varied times.  Youth are expected to show up on time at the trip meeting place. At the end of the trip, youth will contact their families and/or the person they are expecting to pick them up approximately one hour prior to return to the meeting place to communicate the estimated time of arrival.  Mountaineers staff will stay at The Mountaineers until all youth have left.

I understand that it is my responsibility as the primary caregiver to ensure that my child is picked up on time, and that if I (or a designated pick-up person) am more than 10 minutes late, and The Mountaineers have not heard from me, program leaders will begin calling emergency contacts, beginning with the primary caregiver.  After 3 hours, if The Mountaineers have not been able to reach any person at any of the contact numbers listed on the participant’s paperwork, The Mountaineers will have no choice but to call CPS to arrange for a place for the child to stay for the night. 

Please initial ONLY ONE option:

 I approve The Mountaineers to release my child with the rest of the youth, and trust my child to return home via transportation that my child and I agree upon.  I DO NOT REQUEST that The Mountaineers monitor who my child leaves meetings and programs with.

 I request that Mountaineers staff or volunteer leaders monitor who my child leaves meetings and programs with.  My child may ride with the following adults ONLY:

     

     

     

     

     

     


Optional Kid Code

Use this ONLY if you are requesting that The Mountaineers monitor who your child leaves meetings and programs with.  To expedite pick-up and skip ID checking, parents may opt to create a password for their child.  Parents with multiple children can use the same password for all children, or can create a unique password for each child. By creating a Kid Code, you authorize The Mountaineers to release your child to anyone who knows your child's Kid Code, without checking ID, and without being listed on the Authorized Pick-up List above.  In the event that a person tries to pick up your child and cannot remember their Kid Code, Mountaineers representatives will ask for ID and will only release the child if that person is on the Authorized Pick-up List.

A Kid Code can be a word, phrase or collection of numbers or letters.

Write your child's Kid Code here   


Drivers for Trips

This section applies to transportation FROM a designated meeting spot TO a trip destination, including transportation to and from campgrounds and recreation sites, and RETURN transportation FROM the trip destination TO the designated meeting spot. This section does not apply to transportation to and from a designated meeting spot or to and from Explorers meetings.

Explorers trips and skills sessions outside of the Program Center happen because of the support of our parent chaperones and volunteer and staff drivers. Your child will often ride with other Explorers parents, volunteers or Mountaineers staff during these trips.

All adults driving youth as part of a Mountaineers program must be at least 21 years old, carry a valid US Drivers License, carry a minimum of $300,000 in auto insurance, and complete a background check.  The Mountaineers will keep copies of drivers licenses, insurance policies and background checks on file.

When transporting youth, all laws must be followed without exception.  This includes speed limits, seat belt laws and not using cell phones unless pulled over in a safe location.

Please select ONLY ONE option by initialing next to your choice:

 I understand that Explorers participants will receive transportation from the designated meeting place to the trip destination(s) and back in the vehicles of staff and volunteers.  I authorize my child to ride with any volunteer or staff member who meets The Mountaineers’ driver prerequisites and agrees to follow Mountaineers Transportation Policies during Explorers trips.

OR

  I understand that Explorers participants will receive transportation from the designated meeting place to the trip destination(s) and back in the vehicles of staff and volunteers.  I authorize my child to ride with any volunteer or staff member who meets The Mountaineers’ driver prerequisites and agrees to follow Mountaineers Transportation Policies during Explorers trips EXCEPT:

My child may NOT ride with these drivers:  

OR

  I  understand that Explorers participants will receive transportation from the designated meeting place to the trip destination(s) and back in the vehicles of staff and volunteers.  I authorize my child to ride with ONLY THE FOLLOWING PEOPLE, and I understand that this restriction may necessitate that I drive if these drivers are not available:

My child may ONLY ride with these drivers:   

CARPOOL

  Yes, I would like my contact information included in a carpool list to be distributed to all Explorers families.

Town/Neighborhood:                     

Notes on Availability:   

Program waiver  

The Mountaineers ACKNOWLEDGEMENT OF RISKS

AND WAIVER AND RELEASE OF LIABILITY

Youth Program Participants

PLEASE READ CAREFULLY THIS ACKNOWLEDGMENT OF RISKS, WAIVER AND RELEASE OF LIABILITY AND SIGN BELOW. The Mountaineers takes pride in our efforts to provide a safe and supervised program, but outdoor adventure by nature is not without risk.  We do not want to diminish your enthusiasm for the experience; we want all participants to know in advance what to expect and what some of the potential risks are by participating in the camp program.  The following describes some but not all of the risks.

  • Slips and falls during activities at the Program Center and in the mountains can occur as a result of uneven ground, backpacking and hiking on slopes and paths with bumps, sharp sticks and exposed roots, climbing and hiking on loose, wet, snowy or icy terrain.
  • While out of doors, participants may also be exposed to a variety of natural life including, but not limited to, marine life such as crabs, sea urchins, and jelly fish, plant life such as stinging nettles, flying insects such as yellow jackets, wasps and mosquitoes, other animals such as snakes, raccoons, goats and deer.
  • While out of doors, participants may be exposed to hazardous conditions including but not limited to extreme heat, extreme cold,  rain, snow, falling rock, exposed ledges, and steep slopes.
  • Water activities may include swimming, rafting, canoeing, sailing and kayaking.  All water activities have the danger of bodily harm, hypothermia and drowning.
  • Participants may be responsible for helping with food preparation, and may be around outdoor cooking stoves, flammable materials, sharp knives and open fire.

Potential consequences of the activities include, but are not limited to broken bones, muscle tears, sprains, joint problems, or other orthopedic injuries, disabling head or spinal injuries, eye injuries, heart attacks, strokes, and other cardiovascular problems, heat exhaustion or heat stroke, allergic reactions, cuts, infections, burns, dehydration, mental anguish, hypothermia, drowning or other means of death.

Risks may include equipment malfunction or loss of control, collision of obstacles, variation of terrain, or unexpected actions by animals or other people.  I understand that participants may act in a negligent manner that can contribute to injury to themselves or others, such as failing to maintain control, not acting within his or her abilities or not following the rules.

I acknowledge that The Mountaineers or its representatives are not responsible in any way for personal clothing, items or equipment that may be lost, stolen or damaged as a result of my participation in camp activities.

We, youth participant and parent/guardian, understand that it is the responsibility of each participant to participate in the whole program including activities of work, play, values and working together.  We understand and support policies prohibiting participants from possessing or using tobacco products, alcoholic beverages, illegal drugs, marijuana, fireworks, knives and weapons of any kind.  We recognize that participants must follow safety instructions, remain in areas designated by leaders, and refrain from behavior that is harmful to themselves or others.  Failure to adhere to Mountaineers policies will be cause for participant’s dismissal from the program without refund of fees.  We acknowledge that we will be responsible for pick-up and transportation of our participant if dismissed early from the program.

IN CONSIDERATION FOR MY CHILD BEING PERMITTED TO PARTICIPATE IN MOUNTAINEERS ACTIVITIES, I AND MY CHILD HAVE READ AND AGREE TO THE  MOUNTAINEERS EXPLORERS HANDBOOK, INCLUDING THE CODE OF CONDUCT, PARTICIPANT COMMITMENT,  PARENT/SPONSORING ADULT COMMITMENT,  AND THE SECTIONS ABOUT CARPOOLING, TRIP COMMUNICATION AND REGISTRATION, TRIP TRANSPORTATION, ELECTRONICS, WEAPONS, DRUGS, ALCOHOL AND TOBACCO, MEDICATION AND MEDICAL CLEARANCE.  I VOLUNTARILY CHOOSE TO ENROLL MY CHILD IN MOUNTAINEERS EXPLORERS PROGRAM WITH FULL UNDERSTANDING OF THE PROGRAM AS IT IS DESCRIBED IN THE MOUNTAINEERS EXPLORERS HANDBOOK.

IN CONSIDERATION FOR MY CHILD BEING PERMITTED TO PARTICIPATE IN MOUNTAINEERS ACTIVITIES, I HAVE READ OR HAVE HAD READ TO ME THE RISKS OF ACTIVITIES WITH THE MOUNTAINEERS.  I VOLUNTARILY ACCEPT THE RISKS INVOLVED.   I AM AWARE THAT MY CHILD WILL HAVE THE OPPORTUNITY TO PARTICIPATE IN, AND I APPROVE OF HIS/HER PARTICIPATION IN, MOUNTAINEERS ACTIVITIES INVOLVING A DEGREE OF RISK.  I AGREE TO RELEASE ANY CLAIMS THAT I MIGHT HAVE AS AN ADULT FOR ANY LOSS, INJURY OR DAMAGE RELATED TO MY CHILD’S PARTICIPATION, INCLUDING CLAIMS BASED ON NEGLIGENCE. 

I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO PROVIDE FOR MY CHILD’S ACCIDENT AND HEALTH COVERAGE WHILE PARTICIPATING IN ANY MOUNTAINEERS ACTIVITY.  THE MOUNTAINEERS DOES NOT PROVIDE ANY ACCIDENT OR HEALTH COVERAGE FOR ITS PARTICIPANTS.

I give permission for The Mountaineers to use, without limitation or obligation, photographs or other media that may identify or include the image or voice or me or my child to promote or interpret Mountaineers programs for any business purpose, including media coverage.  I waive all claims for any compensation for such use.

I understand that should a person arrive to pick up the child and appears to be under the influence of drugs or alcohol that the child will not be released until another person who is not under the influence of drugs or alcohol arrives to pick up the child.  If no person is located, staff may have no recourse but to contact the police.

I HAVE READ OR HAVE HAD READ TO ME, AND I UNDERSTAND AND AGREE TO THE ABOVE STATEMENTS.  I UNDERSTAND THAT THIS FORM MAY NOT BE ALTERED AND THAT MY CHILD MAY NOT PARTICIPATE WITHOUT THIS FORM SIGNED.  I ACKNOWLEDGE THAT I HAVE SIGNED THIS OF MY OWN FREE WILL, THAT THIS DOCUMENT MAY AFFECT MY LEGAL RIGHTS, AND THAT MY CHILD’S PARTICIPATION IN MOUNTAINEERS ACTIVITIES IS PURELY VOLUNTARY.

Youth Participant Name

        

Parent/Guardian Printed Name

   

   I understand that by initialing this box, I agree to the above statements in their entirety.