Form 585f - Request For Approval Of Day Or Overnight Activity/trip Requiring Council Permission - Girl Scouts Of Eastern Oklahoma Page 2

ADVERTISEMENT

PLANNED ACTIVITIES (check all that apply):
 Archery
3
 Rafting/White-Water Rafting
2
 Backpacking
3
 Scuba Diving
2
 Boating/Sailing
2
 Segway
3
 Canoeing/Kayaking
2
 Shooting Sports
3
 Challenge Course/Climbing & Rappelling/Ziplining
3
 Skateboarding
3
 Fencing
3
 Snow Skiing, Sledding, Tobogganing, Tubing
3
 Hayrides
4
 Snorkeling
2
 Horseback Riding or Vaulting on Horseback
3
 Spelunking
3
 Indoor Skydiving
3
 Standup Paddleboarding
2
 Indoor Trapoline Parks
3
 Surfing
2
 Overnight with Camping
1
 Swimming
2
 Overnight without Camping
 Tubing/Water Skiing/Wakeboarding
2
 Parades and Other Large Group Gatherings
4
 Windsurfing
2
 Pedal Boating
2
Numbered activities require trained and/or certified personnel. Refer to boxes 1, 2 or 3 and Form #571T.
1. TROOP CAMPER (Required for camping activities)
3. OTHER SPECIALIZED PERSONNEL
Name: ___________________________________________
Name ___________________________________________
SITE ORIENTATION (Required if using council campsite)
Certification Type*________________________________
Name: ___________________________________________
Expiration Date
________________________________
2. WATERFRONT ACTIVITIES (Specify Type)
* Documented experience may replace certification, but a copy
.
 Swimming Pool
 Waterpark
 Lake  River
of the documentation must be provided.
 Other _________________________________________
Personnel provided by:  Facility
 Service Unit
4. COMMUNITY EVENTS
 Troop (Fill in information below):
Name of Event: ____________________________________
Lifeguard Name __________________________________
In detail, describe how the troop plans to participate (i.e. – march
Certification Type & Expiration Date _________________
or ride on a float in a parade, provide a service booth at a town
Canoe Instructor __________________________________
carnival, etc): ________________________________________
Certification Type & Expiration Date _________________
Other (Specify): ___________________________________
Name ___________________________________________
Certification Type & Expiration Date _________________
Refer to Safety Activity Checkpoints for Parades and Other Large
Please list names of adults serving as watchers. The troop is
Group Gatherings which includes a paragraph pertaining to
responsible for watchers:
appropriate plans for parade floats. If renting, leasing or
_______________________
________________________
borrowing a vehicle, Form #589F must be attached to this
_______________________
________________________
request. NOTE: The term “vehicle” refers to trailers or other
towed conveyances as well as to motorized carriers.
Charge Campsite Use Fee of $__________ to:
YOU DO NOT NEED COUNCIL APPROVAL IF THE TROOP
IS ATTENDING THE EVENT AS SPECTATORS.
Account # _________________________________________
 VISA
 MasterCard
 Other ___________________
HAYRIDES
Name on Card ______________________________________
Refer to Safety Activity Checkpoints for Hayrides. The State of
Expiration Date: Month __________ Year __________
Oklahoma does not require a hauled vehicle to be licensed or to
CVV (3-Digit Code on Back of Card) _____ _____ _____
display a safety inspection sticker if it is not used commercially.
Billing Zip Code _______________
Therefore, it is the responsibility of the leader to insure that these
guidelines are being met.
FOR OFFICE USE ONLY
Date
APPROVED __________
DENIED __________
Comments: _________________________________________________________________
Date Received ______________
Use Fee Paid $______________
Receipt #
______________
#585F 06/16

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go
Page of 2