Safety Checklist:
Our First-Aider is: _____________________________________________________
(Attach a copy of the current CPR/FA Certification Card for your First-Aider and any additional safety certifications
required for your trip based on Safety Checkpoints.)
We will have a First-Aid kit on hand.
We have made/will make alternate plans should weather be an issue.
All adults participating in the trip are familiar with and will abide by the safety information provided in the
Safety-Wise chapter of the Volunteer Essentials Handbook.
If any Safety Activity Checkpoints apply to your trip, list the checkpoints and the additional safety
requirements you will adhere to.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Paperwork Checklist:
I have obtained/will obtain signed Permission for Special Activities forms for each girl participant.
If the trip is longer than 2 nights, I have attached a Trip Itinerary.
Attach a roster of girls attending the overnight trip.
Insurance Checklist:
If the trip is longer than 2 nights, I have obtained/will obtain Plan 2 Liability Insurance.
If the overnight trip has the potential for injury, I have obtained/will obtain Plan 2 Insurance.
Training Checklist:
At least one of the adults on this trip has completed 401 Planning Overnight Trips with Girls within the past
two years.
If we are troop camping, at least one of the adults on this trip has completed 402 Outdoor Basics and 403
Troop Camp Skills or met the competency requirements.
Person Completing Form
_____________________________________________________________________________________________
Name
Position
Date
Approvals
______________________________________
_____________________________________
Service Unit Manager/Date
Volunteer Support Team/Date
Give this completed form to your Service Unit Manager for approval,
who will forward it to the Volunteer Support Team for final review and approval.