Informed Consent, Release Agreement, and Authorization

 

Activity: Scout-tober Fall Festival (Camp Snyder)
Dates: October 24-26, 2025

 

Calling all Scouts! Get ready for a fun weekend at our Scout-tober Fall Festival. This special Council-wide event will make your Fall unforgettable!

Archery: Test your aim and focus on the archery range. Whether you’re a beginner or a seasoned archer, this activity might create some bullseye moments!

STEM Activities: Immerse yourself in the world of science, technology, engineering, and mathematics (STEM) with our hands-on activities that offer the chance to learn, create, and explore while having a blast!

Don’t miss out on this Scout-tober Fall Festival! The perfect chance to invite friends and family to a Scout event and have a good time outdoors.

Human foosball tournament: Can our team of 6-8 scouts be the scout-tober fest champion?

GAGA Ball Tournament: Is one of our Scouts a master gaga ball player? There will be an opportunity to win an awesome prize!

Returning for 2025, Zombie Run! and costume contest!

Activities Planned:
Friday (10/24):
-5.30pm to 5.45pm – Gather at Floris Church and depart
-7pm – Reach camp site, set-up camp (Scouts should eat dinner ahead of time or bring a packed meal)
-10pm – Lights Out

Saturday (10/25):
-8am – Breakfast and Cleanup
-9am to 5pm- participate in various events.
-5.30pm – Dinner Prep
-6.30pm -Dinner and Cleanup
-8pm – Campfire
-10pm – Lights Out

Sunday (10/26):
-7am to 8am – Breakfast and Breakdown Camp (fruits, power bars)
-9am – Tentative Departure. ETR to Floris Elementary School 10am

 

Total cost is $50 for scouts and $45* for adults, which includes grub, campsite fee, and Troop subsidy.

(*There will be no fees payable by ASMs)

Transportation will by private car and adults or drivers may be needed depending on attendance. Camp Snyder is located at 6100 Antioch Road, Haymarket, VA 20169, approximately 30-45 minutes away. Additional information can be found here: https://www.gotosnyder.org/

 

A current (within the last 12 months) BSA health & medical record (Parts A & B) is required for all participants–both Scouts and Adults. Bring paper form(s) with you to check-in and they will be returned at the end of the campout. All adults attending must be registered with BSA and have completed BSA Youth Protection Training (YPT) in the past two years.

 

Please register by 21st Oct so that routes, itinerary, meal and other plans can be finalized. Emergency Contact Number during trip: Kevin Learned, 703-851-7624

I understand that participation in Scouting activities involves the risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Information about those activities may be obtained from the venue, activity coordinators, or local council. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and the standards of conduct. I understand that COVID-19 is also a risk, particularly when gathering in groups; have received Troop guidance pertaining to gathering safely and agree to comply; and acknowledge that “Safe” is NOT the same as “Risk-Free.”

I have carefully considered the risk involved and hereby give my informed consent for my child to participate in all activities offered in the program. I further authorize the sharing of the information with any BSA volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Scouting activities.

With appreciation of the dangers and risks associated with programs and activities including preparations for and transportation to and from the activity, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program or activity.

In case of an emergency involving my child, I understand that efforts will be made to contact me. In the event I cannot be reached, permission is hereby given to the medical provider to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose protected health information to the adult in charge and/or any physician or health care provider involved in providing medical care to the participant. Protected Health Information/Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities.

Troop 51 cannot continually monitor compliance of program participants or any limitations imposed upon them by parents or medical providers. However, so that leaders can be as familiar as possible with any limitations, list any restrictions imposed on a child participant in connection with programs or activities below and counsel your child to comply with those restrictions.