Youth in Adult Programs Form Must be completed for youth who will participate in any of our adult programs. = Required Introduction Dear Parent, We’re so glad your child is joining our Mountaineers activity. The Mountaineers has been teaching outdoor skills for over 100 years, and we are proud to continue the tradition of incorporating enthusiastic youth into our courses and outings. As you know, the activity your child is enrolled in serves primarily adult participants. As such, it requires a level of maturity and independence on your child’s behalf above what we would expect in an all-youth program or in a family program. We also want to make sure you as a parent understand the policies and procedures we have in place to ensure your child’s safety. When youth are participating in adult-oriented Mountaineers programs, we ensure that at least one adult leader has gone through our youth training and criminal background check, making them a Qualified Youth Leader. We also ensure that regular volunteers who will be working directly with youth receive the necessary training and orientation to create a safe learning environment for the youth. The Qualified Youth Leader(s) working with your child strive to provide a physically and emotionally appropriate environment for your child during the activity. This includes providing appropriate supervision and structuring the program so that youth have the greatest opportunity for success. Please carefully read and sign the sections below. Each of these sections is in place to protect your child and help us provide an appropriately safe program. The Acknowledgment of Risk form specifically outlines special considerations for youth participating in adult-oriented programs, so please read that carefully so you understand our policies and procedures. Please don’t hesitate to contact your activity leader with any questions you have. We look forward to exploring the outdoors with your child. Sincerely, Becca Polglase Director of Education Drop-off & Pick-up 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 and from the meeting location, the parent is responsible for making appropriate communication arrangements with the youth. Course meetings, field trips and activities begin and end at varied times. Youth are expected to show up on time at the activity meeting place. At the end of the event, youth are dismissed with the rest of the students. Mountaineers volunteers will stay at meeting place 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 Adult Supervisors In Mountaineers Adult Programs, youth under the age of 14 must be accompanied by an adult who agrees to take responsibility for providing primary supervision of the youth. Please complete either SECTION A OR SECTION B SECTION A (for youth aged 14+): "I certify that my child enrolled in the Mountaineers Adult Program for which I am submitting this form will be 14 years old or older by the first day of the program.” SECTION B (for youth under 14): I approve the adults listed below to act as supervisors and caretakers for my child while participating in Mountaineers activities. I have informed my child(ren) that the adults listed below will act as their supervisor and caretaker while they participate in Mountaineers activities, and my child agrees to participate under the supervision of these adults. I certify that I have informed the adults listed below of their responsibilities as primary supervisors and caretakers of my child(ren) while participating in Mountaineers activities, and that they have agreed to fulfill these responsibilities. WAIVER The Mountaineers ACKNOWLEDGEMENT OF RISKS AND WAIVER AND RELEASE OF LIABILITY Youth Participating in Adult-Oriented Programming 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 recreation 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. 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. Water activities may include swimming 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 UNDERSTAND THAT MY CHILD WILL BE PARTICIPATING IN A PROGRAM DESIGNED PRIMARILY FOR ADULT LEARNERS, AND THAT THE MAJORITY OF THE OTHER STUDENTS IN THIS PROGRAM WILL BE ADULTS OVER THE AGE OF 18. While The Mountaineers conducts background checks on key volunteers and provides youth training to volunteers instructing youth, The Mountaineers cannot conduct background checks on all volunteers or students. I understand that while The Mountaineers strives to create healthy and respectful learning environments, The Mountaineers ultimately cannot control the conduct of other students, and my child may be exposed environments such as evening campfires where adults of legal age may drink alcohol or smoke, and to language or subject matter that I would consider inappropriate for youth. I understand that The Mountaineers utilizes carpools to get to and from program sites. I understand that if my child participates in carpools, the driver must be on the authorized pick-up list. I understand that The Mountaineers does not provide transportation to and from adult programs, and provides no coverage for students or volunteers while they are in transit to and from programs. The Mountaineers makes no effort to background check or otherwise manage drivers in carpools. Therefore my child’s participation in a carpool is solely at my discretion, and Mountaineers leaders will not release a youth to a driver unless they are listed on my child’s authorized pick-up list. 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 Mountaineers activities. In some instances, Mountaineers Staff or Volunteer Leaders may require medical clearance and/or instructions from a licensed medical professional in order for a youth to participate in the program. Examples include but are not limited to: injuries, surgery, eating disorders, psychological & nervous disorders, developmental disorders, heart conditions, diabetes. This information will be disclosed only to the people who need to have it in order to maintain a safe environment. In some cases, Mountaineers Leaders may, at their discretion, forbid participation on a trip if they feel the circumstances of the trip make it too difficult to safely manage the participant’s medical needs or limitations. 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 DESIGNED FOR ADULT STUDENTS AND 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 a youth participant and appears to be under the influence of drugs or alcohol that the youth will not be released until another person who is not under the influence of drugs or alcohol arrives to pick up the youth. If no person is located, Mountaineers personnel 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.
Youth in Adult Programs Form Must be completed for youth who will participate in any of our adult programs. = Required Introduction Dear Parent, We’re so glad your child is joining our Mountaineers activity. The Mountaineers has been teaching outdoor skills for over 100 years, and we are proud to continue the tradition of incorporating enthusiastic youth into our courses and outings. As you know, the activity your child is enrolled in serves primarily adult participants. As such, it requires a level of maturity and independence on your child’s behalf above what we would expect in an all-youth program or in a family program. We also want to make sure you as a parent understand the policies and procedures we have in place to ensure your child’s safety. When youth are participating in adult-oriented Mountaineers programs, we ensure that at least one adult leader has gone through our youth training and criminal background check, making them a Qualified Youth Leader. We also ensure that regular volunteers who will be working directly with youth receive the necessary training and orientation to create a safe learning environment for the youth. The Qualified Youth Leader(s) working with your child strive to provide a physically and emotionally appropriate environment for your child during the activity. This includes providing appropriate supervision and structuring the program so that youth have the greatest opportunity for success. Please carefully read and sign the sections below. Each of these sections is in place to protect your child and help us provide an appropriately safe program. The Acknowledgment of Risk form specifically outlines special considerations for youth participating in adult-oriented programs, so please read that carefully so you understand our policies and procedures. Please don’t hesitate to contact your activity leader with any questions you have. We look forward to exploring the outdoors with your child. Sincerely, Becca Polglase Director of Education Drop-off & Pick-up 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 and from the meeting location, the parent is responsible for making appropriate communication arrangements with the youth. Course meetings, field trips and activities begin and end at varied times. Youth are expected to show up on time at the activity meeting place. At the end of the event, youth are dismissed with the rest of the students. Mountaineers volunteers will stay at meeting place 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 Adult Supervisors In Mountaineers Adult Programs, youth under the age of 14 must be accompanied by an adult who agrees to take responsibility for providing primary supervision of the youth. Please complete either SECTION A OR SECTION B SECTION A (for youth aged 14+): "I certify that my child enrolled in the Mountaineers Adult Program for which I am submitting this form will be 14 years old or older by the first day of the program.” SECTION B (for youth under 14): I approve the adults listed below to act as supervisors and caretakers for my child while participating in Mountaineers activities. I have informed my child(ren) that the adults listed below will act as their supervisor and caretaker while they participate in Mountaineers activities, and my child agrees to participate under the supervision of these adults. I certify that I have informed the adults listed below of their responsibilities as primary supervisors and caretakers of my child(ren) while participating in Mountaineers activities, and that they have agreed to fulfill these responsibilities. WAIVER The Mountaineers ACKNOWLEDGEMENT OF RISKS AND WAIVER AND RELEASE OF LIABILITY Youth Participating in Adult-Oriented Programming 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 recreation 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. 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. Water activities may include swimming 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 UNDERSTAND THAT MY CHILD WILL BE PARTICIPATING IN A PROGRAM DESIGNED PRIMARILY FOR ADULT LEARNERS, AND THAT THE MAJORITY OF THE OTHER STUDENTS IN THIS PROGRAM WILL BE ADULTS OVER THE AGE OF 18. While The Mountaineers conducts background checks on key volunteers and provides youth training to volunteers instructing youth, The Mountaineers cannot conduct background checks on all volunteers or students. I understand that while The Mountaineers strives to create healthy and respectful learning environments, The Mountaineers ultimately cannot control the conduct of other students, and my child may be exposed environments such as evening campfires where adults of legal age may drink alcohol or smoke, and to language or subject matter that I would consider inappropriate for youth. I understand that The Mountaineers utilizes carpools to get to and from program sites. I understand that if my child participates in carpools, the driver must be on the authorized pick-up list. I understand that The Mountaineers does not provide transportation to and from adult programs, and provides no coverage for students or volunteers while they are in transit to and from programs. The Mountaineers makes no effort to background check or otherwise manage drivers in carpools. Therefore my child’s participation in a carpool is solely at my discretion, and Mountaineers leaders will not release a youth to a driver unless they are listed on my child’s authorized pick-up list. 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 Mountaineers activities. In some instances, Mountaineers Staff or Volunteer Leaders may require medical clearance and/or instructions from a licensed medical professional in order for a youth to participate in the program. Examples include but are not limited to: injuries, surgery, eating disorders, psychological & nervous disorders, developmental disorders, heart conditions, diabetes. This information will be disclosed only to the people who need to have it in order to maintain a safe environment. In some cases, Mountaineers Leaders may, at their discretion, forbid participation on a trip if they feel the circumstances of the trip make it too difficult to safely manage the participant’s medical needs or limitations. 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 DESIGNED FOR ADULT STUDENTS AND 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 a youth participant and appears to be under the influence of drugs or alcohol that the youth will not be released until another person who is not under the influence of drugs or alcohol arrives to pick up the youth. If no person is located, Mountaineers personnel 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.