Camp Whip Poor Will Adventure Day July 22, :00 a.m. 3:00 p.m.

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1 Camp Whip Poor Will Adventure Day July 22, :00 a.m. 3:00 p.m. We are delighted that you and your camper will be joining us for Adventure Day at Camp Whip Poor Will. Your safety and welfare are always our primary concern. We hope you are as excited about camp as we are. Please read the enclosed information carefully and save it for future reference. Description: Are you ready for a jam-packed day at camp? This event it designed for Girl Scout Juniors through Ambassadors to explore the many adventures of Camp Whip Poor Will. Go canoeing on Four Winds Lake, visit the low challenge course, tackle the climbing wall, take aim at the archery range, hunt for geocaches, cool off at the pool and much more! You can attend as a troop or as an individual with an adult. This packet contains all the forms needed to be completed for Adventure Day. All forms need to be brought to check in: Permission Slip * stays with leader Troop Health Form * stays with leader High Risk Form for each participant Release for Minor (photo release) Arrival Check-in for this event starts at 9:45 a.m. Upon arrival, you will proceed to the check in parking lot where staff members will greet you and help you with checking in. At check-in, you will turn in all of your paperwork (see above). If your child is arriving with someone else, please make sure that all forms are complete. Check-in At check-in, we will provide you with a schedule and collect paperwork. If you check in after 10:00 a.m., you will need to park your car and walk down to the dining hall to check in with staff. Check-out Check-out will be at approximately 3:00 p.m. We ask that you complete and return evaluations before leaving camp. Lunch Lunch is not provided for this activity. You should pack a picnic style lunch with foods that can be easily eaten, such as, sandwiches, fruit, veggies, and a drink. Refrigeration is not available. Staff/Supervision The camp staff will be available to help lead activities. You will be responsible for supervising your campers at all times.

2 Health Care Our goal is to provide a safe, healthy environment. All of our staff is first aid/cpr certified and our camp health care provider (a local doctor) is on call daily. Participants at Camp Butterworth needing additional medical attention or treatment are taken to Mercy Health Center Mason, Bethesda Medical Center at Arrow Springs or Bethesda North Hospital. The adult in charge is responsible for minor first aid and medication distribution. Smoking/Alcohol Policy The use of tobacco products where girls are present is not permitted. There will be no smoking in any camp buildings. There is an established smoking area at camp behind Evergreen that may be used. At no time should smoking take place in front of girls. Alcohol of any kind is prohibited and should not be brought onto the campgrounds. What to Bring Participants should pack all of their items into a backpack or duffel bag to avoid losing items. Each participant needs to bring the following items: Sack lunch Swimming suit Beach towel Play clothes that can get wet and muddy Shower shoes for in the shower house (optional) Sunscreen waterproof with good SPF Baseball cap/bandana Water bottle Insect repellant (non-aerosol) Old tennis shoes that can get wet and muddy Camp Address: Camp Whip Poor Will 3223 Middleborro Rd. Morrow, OH We look forward to seeing you at Camp Whip Poor Will! TH:bd/

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8 Date(s): Photographer/Producer: Assignment: Location: Activity: Photo Release for Minors 12/15 For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby consent and agree to the following: 1. I hereby grant to Girl Scouts of Western Ohio, and others working for Girl Scouts of Western Ohio or on its behalf, and each of its respective licensees, successors and assigns (each a Releasee ), the irrevocable, royalty-free, perpetual, unlimited right and permission to use, distribute, publish, exhibit, digitize, broadcast, display, modify, create derivative works of, reproduce or otherwise exploit my name, picture, likeness and voice (including any video footage of the same) (collectively, Media ), or to refrain from so doing, anywhere in the world, by any persons or entities deemed appropriate by Girl Scouts of Western Ohio, for any purpose (except defamatory) including, without limitation, any use for educational, advertising, non-commercial or commercial purposes in any manner or media whatsoever (whether known or hereafter devised) including, without limitation, on the internet, in print campaigns, in-store and via television. I agree that I have no interest or ownership in any of the Media. 2. I shall have no right of approval, no claim to compensation and no claim (including, without limitation, claims based upon invasion of privacy, defamation or right of publicity) arising out of any use, alteration, blurring, illusionary effect or use in any composite form of my name, picture, likeness and voice. I agree that nothing in this Release will create any obligation on Girl Scouts of Western Ohio to make any use of the Media or the rights granted in this Release. I hereby release and hold harmless Releasees from any claim for injury, compensation or negligence resulting or arising from any activities authorized by this Release and any use of the Media by Girl Scouts of Western Ohio. Name of Minor (please print): Address: City: State: Zip: Daytime Phone Number: ( ) Additional Phone (optional): ( ) Release for minors (those under the age of eighteen): I, the undersigned, being a parent/caregiver of the minor, hereby consent to the foregoing conditions and warrant that I have the authority to give such consent. Name of Caregiver (please print): Signature of Caregiver (Required): Caregiver Address*: (*will not be used for any other purposes or distributed to third parties) Region: Troop#: Service Unit: Please return the completed and signed release to your regional Girl Scout Center

9 Photo Release for Adults 12/15 Date(s): Photographer/Producer: Assignment: Location: Activity: For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby consent and agree to the following: 1. I acknowledge that I am eighteen (18) years of age or older. I hereby grant to Girl Scouts of Western, and others working for Girl Scouts of Western Ohio or on its behalf, and each of its respective licensees, successors and assigns (each a releasee ), the irrevocable, royalty-free, perpetual, unlimited right and permission to use, distribute, publish, exhibit, digitize, broadcast, display, modify, create derivative works of, reproduce or otherwise exploit my name, picture, likeness and voice (including any video footage of the same) (collectively, media ), or to refrain from so doing, anywhere in the world, by any persons or entities deemed appropriate by Girl Scouts of Western Ohio, for any purpose (except defamatory) including, without limitation, any use for educational, advertising, non-commercial or commercial purposes in any manner or media whatsoever (whether known or hereafter devised) including, without limitation, on the internet, in print campaigns, in-store and via television. I agree that I have no interest or ownership in any of the media. 2. I shall have no right of approval, no claim to compensation and no claim (including, without limitation, claims based upon invasion of privacy, defamation or right of publicity) arising out of any use, alteration, blurring, illusionary effect or use in any composite form of my name, picture, likeness and voice. I agree that nothing in this release will create any obligation on Girl Scouts of Western Ohio to make any use of the media or the rights granted in this release. I hereby release and hold harmless releasees from any claim for injury, compensation or negligence resulting or arising from any activities authorized by this release and any use of the media by Girl Scouts of Western Ohio. Signature: Date: Name (please print): Home Address: City: State: Zip: Daytime Phone: ( ) Additional Phone (optional): ( ) (*will not be used for any other purposes or distributed to third parties) Region: Troop#: Service Unit: Please return the completed and signed release to your regional Girl Scout Center