Permission slip for activities and field trips for the FRDS camp held at Martin’s
Tree Farm Activity Center
Age Group: age 4 - going into grade 3
Name of children/child: _________________, ________________
Please read the activities and sign the last page. If there is an activity in which you do not
want your child to participate, please draw a large dark X over the activity and initial.
1. Walks, Water Play, and Outdoor Play
Uniform: Participants should wear closed-toed shoes like sneakers or water shoes, shorts and shirts, or bathing
suits and water shoes. Students will put on sunscreen provided by the parents.
Participants are required to listen to the staff and the camp rules to insure their safety.
Injuries: Participants may suffer bee stings, insect bites, sunburn, or uncontrollable nature or play induced injuries.
Staff: Participants will be with a staff member that has a phone or walkie-talkie. 1 staff for 15 participants.
Additional Information: First aid kits and water will be close by. Trails are marked. Play areas include grass,
stream, playgrounds, and black top area.
2. Gymnastics:
Uniform: Participants should wear closed-toed shoes like sneakers or bare feet, shorts and shirts.
Participants are required to listen to the staff and the camp rules to insure their safety
Injuries: Participants may suffer serious or even catastrophic injuries from participating in gymnastics.
Instruction: A staff member will teach participants safe practices for all of the equipment.
Staff: One staff for every 15 participants.
3. Climbing Wall
Uniform: Participants should wear closed-toed shoes like sneakers or water shoes, shorts and shirts.
Participants are required to listen to the staff and the camp rules to insure their safety
Instruction: A staff member will teach participants safe practices for climbing the wall.
Injuries: Participants may suffer injuries from the climbing wall such as falls, scrapes and foot injuries.
Staff: Participants will be watched by a staff member at the climbing wall. One staff for every 15 participants.
4. Archery
Uniform: Participants should wear closed-toed shoes like sneakers or water shoes, shorts and shirts.
Participants are required to listen to the staff and the camp rules to insure their safety
Injuries: Participants may suffer bee stings, insect bites, sunburn, or uncontrollable nature injuries. Participants
may suffer play induced injuries such as, but not limited to, brush burns from the string.
Instruction: Participants will be taught the correct way to hold a bow and release the arrows.
Staff: One staff for 6 participants.
Other Information: The range is located away from the play area and will be marked by a red flag.
5. Wheels
Information: Wheels include, scooters, skateboards, bikes, tricycles, and skates
Uniform: Participants should wear closed-toed shoes like sneakers or water shoes, shorts and shirts. They must
wear a helmet and other safety equipment brought from home.
Participants may bring their wheels from home or use the limited supply at the camp.
Injuries: Participants may suffer bee stings, insect bites, sunburn, scrapes, falls, or uncontrollable nature or play
induced injuries.
Instruction: None
Staff: One staff for every 15 participants.
6. Field Trips (Most trips will have additional fees for the activity and transportation.)
Uniform: Participants should wear closed-toed shoes like sneakers or water shoes, shorts and shirts.
Participants are required to listen to the staff and the camp rules to insure their safety.
Injuries: Participants may suffer insect bites, stings, sunburn, blisters, or even catastrophic injuries on the field trip
or while being transported.
Transportation: Participants are transported in leaders’ or volunteer’s cars, or buses depending on the size of the
group. When transported by car, children will wear seatbelts. Students will be reminded of safety rules while
traveling in a vehicle.
Other information: Trips that include swimming will have lifeguard/s on duty.
Staff: Participants will be with a staff member that has a phone. 1 staff for 10 participants.
7. Indoor games, crafts, activities
Uniform: Participants should wear closed-toed shoes like sneakers or water shoes, shorts and shirts.
Participants are required to listen to the staff and the camp rules to insure their safety.
Injuries: Participants may suffer from sprains, cuts, abrasions or other play induced injuries.
Staff: 1 staff for 15
8. Suntan lotion
Participants will bring their own suntan lotion and label it with their name. Staff and participants may apply the
suntan lotion to the child. In case the child does not have lotion, the participant may wear suntan lotion provided
by the camp or other campers.
9. Horse Riding Lessons (An additional fee is charged for this activity)
*There will be an addition waiver from the riding stable that needs to be signed.
Uniform: riding helmet (they can be borrowed from the stable), Long pants, boots or shoes with a smooth bottom;
not rubber soled shoes.
Participants are required to listen to the staff, riding instructor, and the rules of the riding stable to insure their
safety.
Injuries: Participants may suffer bee stings, insect bites, sunburn, scrapes, falls, or uncontrollable nature or riding
induced injuries.
Instruction: There will be a riding instructor with every 6 participants. There will also be a camp staff member
present during the lesson.
10. Medications
The camp operator will obtain written authorization from both the parent and the prescriber for prescription and
nonprescription medication. Parents will fill out the DHMH “Medication Administration Authorization Form.”
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Medication must be given from the original container.
Medication must be given according to the prescriptive order.
Medication will be kept in the locked drawer in the office or if it is a self-carry like an epee pen it will be
carried by the potential user in a safe manner prescribed by their doctor.
Medication will be stored according to conditions specified by the manufacturer of the medication. At the
end of the camper’s stay the medication will be returned to the parent/guardian or destroyed by the
office worker or director and documented on the DHMH “Medication Final Disposition Form.”
The participant’s parent/s assumes the risk of injury from participating in these activities. You agree
not to hold any of the following responsible for injuries or accidents resulting from the this camp
program: The Martin Tree Farm, The Martin’s Tree Farm Activity Center, volunteers and the staff, the
Martin Families, Falls Road Dance Studio, and renters of the building.
I have read and agree to the above rules and policies
Signed _______________________________Date _____
Parent/guardian
Reminder-If there is an activity in which you do not want your child to participate, please
draw a large dark X over the activity and initial.