2022-05-25 Shooting Sports –Registration

Informed Consent, Release Agreement, and Authorization


Activity: 2022 Annual Shooting Sports Camp Out
Date: 25 - 27 March 2022


From 25 to 27 March 2022, Troop 51 will be going on a trip to the Izaak Walton League (IWL) located at 4719 Reels Mill Road, Frederick, MD 21701. The IWL is a nation-wide conservation advocacy organization focused on the continued sustainability of our nation’s natural resources. The Frederick Chapter also holds seminars to interested groups, like Troop 51, in the proper care and use of long guns and archery equipment. Credentialed members from the IWL will begin and lead the training event we are planning from Saturday morning until noon Sunday.


We will depart on 25 March no later than 530pm from the upper parking lot at Floris United Methodist Church. We plan to arrive at the IWL no later than 6:30pm. Activities on the trip will include Rifle and Shotgun shooting as well as archery, tent camping, the potential for short hikes and outdoor cooking. The focus of the program will be on the proper care and use of 22-gauge rifles, shotguns and archery equipment. Due to the fluid situation surrounding COVID, transportation will be on your own (or as arranged between families) and driving by private car. If this policy changes, a notification will be sent.


All participants (Scouts and adults) should bring the 10 essentials, daypacks, a tent, mess kit, masks, hand sanitizer, and dress appropriately for the weather (always plan for rain). Depending on the size of attendance, we’ll organize into Patrols to help maintain social distancing. Scouts and adults are asked to wear a mask, maintain social distance, and follow other guidance to be provided by the Troop. Use of Scout’s electronic devices during the event for a Scouting purpose MUST be approved by the Scoutmaster. Cell coverage is weak or spotty. A current (within the last 12 months) BSA health exam and medical record (Part B) must be on file for all participants. All adults attending must have completed BSA Youth Protection Training (YPT).


We need to make a firm commitment to the Izaak Walton League as soon as possible so we strongly encourage everyone if you are planning to attend to please register by 22 January 2022. The IWL will purchase ammunition by the end of February and as such if you are unable to attend, we can offer a full refund up to 20 February 2022. We will not be able to offer refunds from 21 February on.


Fees include $150 for ammunition and the standard $5 per meal for five meals for a total of $175. A full commitment is to complete the on-line information with payment. We expect to conclude with activities by noon on Sunday 27 March.


Emergency Contact Numbers during trip: Mark Christoffersen: [571-685-3395], Peter Young: [703-851-0161]

Section 1 - Main Participant

Section 2 - Additional Participants

In addition to the main participant

Section 3 - Additional Contact Information

Section 4 - Medical Information

Section 5 - Consent

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.

Section 6 - Payment

$ 0.00