Form Capf 54 - Civil Air Patrol High Adventure Activity Request

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CIVIL AIR PATROL HIGH ADVENTURE ACTIVITY REQUEST
CAP UNIT INFORMATION
Sponsoring CAP Unit:
Activity Director/Project Officer:
Daytime Phone:
E-mail:
ACTIVITY INFORMATION
Type of Activity
Rappelling
Obstacle/Confidence Course
Canoeing/Kayaking
Ropes Course
Indoor Skydiving
Paintball/ Simunitions
Water Survival
Firearms Training
Other –Please describe:
***Note that flying in ultra-lights, para-sailing, parachuting, and similar activities are expressly
by CAP.
PROHIBITED
Primary Date(s) of Activity:
Alternate Date(s) of Activity / Rain Dates:
Location(s) of Activity:
Estimated Number of Cadets Participating:
HOST AGENCY
Activity Host / Outside Organization:
Point of Contact:
PoC’s Title:
Daytime Phone:
E-mail:
Is this a military unit or law enforcement agency?
What are the host organization’s and/or instructors’ qualifications, certifications, accreditations, etc.? If the host organization
is not a commercial business or a military or law enforcement unit, have the instructor’s credentials been validated? Please
attach a copy of current certification(s).
What published safety protocols will the host organization be following?
ADULT SUPERVISION
How many CPPT-approved senior members will be on-scene?
Senior Member Chaperones’ Name
CAPID
Years of Experience for this HAA
SAFETY CONSIDERATIONS
Does this activity depend on good weather? If so, please identify your minimum weather conditions.
Is this activity open to all cadets or are there any medical or fitness requirements? Please describe.
Are cadets required to bring special equipment? Please describe.
Will the CAP senior staff be bringing any special equipment? Please describe.
What is the group’s plan in the event of a medical emergency?
How will parents be briefed of the activity’s plans? Please attach your Letter to Parents and/or parents’ briefing slides.
Will the staff have completed CAPFs 31 on file, on site, signed by parent or guardian for each cadet?
CAPF 54, Jun 11 (Corrected Copy) (Continued on reverse) (Continue any item in Remarks on reverse)
OPR/ROUTING: CP

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