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Girl Scouts of Northern Illinois

Permission/Liability Waiver for GSNI Council Event Participants

This form is a waiver and release of liability contract between Girl Scouts of Northern Illinois and the participants. Please read it carefully.

This form must be read and signed by the parent or legal guardian of the participant in order for the participant to take part in the activity/ies listed.

NOTES:

  • Camp Dean/Camp McCormick/Mary Ann Beebe Center reserve the right to deny participation in any of the activities below if facilitators deem the participant is not physically or mentally capable to participate.
  • This is a combined waiver. This does NOT mean your Girl Scout will participate in each of these activities.

Air Rifles Handling a gun and good marksmanship develop positive traits such as patience, discipline, determination, focus, attention to detail, and persistence. Since these skills are key elements of leadership and confidence, we encourage girls to take what they learn from any sport or activity and apply it in their lives, communities, and the world. Girl Scouts are not permitted to use air rifles unless they are 10 years old or older.

Clothing: Participants must follow clothing guidelines: Make sure girls and adults avoid wearing dangling earrings, bracelets, and necklaces that may become entangled in equipment. Tie back long hair. No crocs - all participants must wear closed-toe, closed-heel shoes.

Archery/Nerf Archery/Slingshots: There are a variety of styles and sizes of bows and arrows, but they’re all used for one purpose: to hit a target. Girls will develop skills based on proper procedures and form, handling equipment, getting the right stance, sighting, and observing safety practices. Only Nerf archery is permitted for Daisies, however they may participate in using slingshots as a progression to learning the rules and range commands for archery.

Clothing: Participants should be wearing appropriate clothing:

  • Avoid wearing dangling earrings, bracelets, and necklaces that may become entangled in equipment.
  • No crocs - all participants must wear closed-toe, closed-heel shoes.
  • Tie back long hair.
  • Waterproof sunscreen (SPF of at least 15)
  • Hat and sunglasses

Canoeing/kayaking activities may take place on about any body of water (lake, stream, river) so long as proper equipment, instruction and safety precautions are used. Girl Scouts may canoe/kayak on water that has been rated up to Class III difficulty depending on the age and ability of the participants. Participants must be able to work as a team to lift, carry and paddle the canoe/kayak. Participants are required to wear approved life jacket and safety gear for type of tripped planned. Girl Scout Daisies can only use Canoe's with a parent/guardian. Canoeing and kayaking at GSNI's property is only available at Camp Dean.

Clothing: Participants should be wearing appropriate clothing for the type of trip planned. Basic gear would include:

  • Layered clothing that’s easily changeable depending on temperatures and that protects participant from the sun
  • Appropriate footwear such as boat shoes, closed-toe and nonslip hiking/sport sandals with heel strap or water shoes (no flip-flops)
  • Waterproof sunscreen (SPF of at least 15)
  • Hat and sunglasses

Tomahawk Throwing: A tomahawk is a type of single-handed axe from North America, traditionally resembling a hatchet with a straight handle. Some of the oldest weapons, tools, and hunting methods include axes, tomahawks, knives, and hatchets. Many are still used for traditional purposes in some areas today. *Girls must be 12 years or older to participate. Girls are not permitted to participate in Tomahawk Throwing unless they are 12 or older. 

Clothing: Participants should be wearing appropriate clothing:

  • Avoid wearing dangling earrings, bracelets, and necklaces that may become entangled in equipment.
  • No crocs - all participants must wear closed-toe, closed-heel shoes.
  • Tie back long hair.
  • Waterproof sunscreen (SPF of at least 15)
  • Hat and sunglasses

Crate stacking is essentially a climbing activity. Participants wear helmets and harnesses and are attached to a belay system staffed by trained and qualified individuals. This rope/belay/harness system is used to hold the participants safely as they stack plastic crates (milk crates) upside down, one on top of the other. Participants work toward an individual goal with the help of a helmet-wearing buddy who hands them crates. The participant stacks one crate at a time and then places her/his feet in the handle holes on the crates and climbs to the next one, placing one at a time. They will all eventually fall, but the harness/belay system is in place to catch them and let them down gently.  *All participants must be Junior (4th grade) or older to participate, and must weigh a maximum of 250 pounds. 

Clothing: Participants should be wearing appropriate clothing:

  • No short shorts (long pants or shorts that are at the mid-thigh or longer)
  • Hair tied back in low pony tail to accommodate helmet
  • No crocks - all participants must wear closed-toe, closed-heel shoes.
  • Water shoes (provided, if needed)
  • Helmet and harness (provided)

Zipline: Ziplines are gaining popularity across the nation, and GSNI is proud to offer this exciting opportunity to our members at Mary Ann Beebe Center. Soar across the pond and create memories that will last lifetime! To participate in ziplining at Mary Ann Beebe Center, participants must be between the ages of 7-18, weigh between 60-200 pounds, and be no taller than 5'9". The Zipline is geared for youth riders only.

Clothing: Participants must follow clothing guidelines:

  • Wear long pants or biker-type shorts
  • Sturdy closed-toed shoes are a must - no Crocs!
  • Long hair must be tied back
  • Jewelry, especially hoop earrings, heavy pendants and arm bracelets, must not be worn.
  • Protective headgear with a properly fitting safety harness must be worn by girls and adults when on the zipline and are provided by GSNI.

Mobile Rock Wall: Participants wear helmets and harnesses and are attached to a belay system staffed by trained and qualified individuals. The rope/belay/harness system is used to hold the participants safely as they climb the climbing wall or rappel down a tower. Participants work toward an individual goal with the help of the trained and qualified facilitators. The Mobile Rock wall is an auto belay system, and does not require helmets.  Participants must be at least 7 years old and weigh between 40-250 pounds. 

Clothing: Participants should be wearing appropriate clothing:

  • Close-fitting clothing (avoid wearing loose clothing, especially around the head and neck
  • Shoes must tie on and have rubber soles. No open toe or back. No Crocs!
  • Long hair tied back

Permission, Waiver and Release of Liability: I give permission for my daughter/ward (or as an adult I agree) to participate in the activities marked “yes” below.

I acknowledge that there are inherent risks of injury or disability in these program activities. I further acknowledge that my daughter/ward (or myself) must follow the directions and safety rules of the program. I also acknowledge that the program may be cancelled if my daughter/ward (or myself) does not follow safety instructions and policies and/or my daughter/ward's (or my) behavior endangers the group.

I hereby give my daughter/ward, named below, permission to participate in the program activities, as are generally described above. I acknowledge that these activities involve inherent risks, such as falling and being injured. I hereby release, for myself, my daughter/ward, my heirs, executor, administrator, successor and/or assigns, Girl Scouts of Northern Illinois, its officers, employees, volunteers, and board members, from any claim, cause of action, demand or liability arising from or in connection with my daughter/ward’s participation in these activities conducted by the Girl Scouts of Northern Illinois.

Today's Date: October 18, 2025




First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 21 years of age or older
First Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*

I give permission for my daughter to participate in these activities we agree to. I understand that there are inherent risks of injury or disability in this activity. I further understand that my daughter must follow the directions and safety rules of the activity. I have reviewed the GSUSA Zipline, Archery, Sling Shot, Climbing Wall, Crate Stacking, Air Rifle, Tomahawk Throwing, Canoe and Kayaking Safety Activity Checkpoints. I also understand that the activity may be cancelled if my daughter does not follow safety instructions and policies and/or my daughter's behavior endangers herself or the group. The undersigned parent and/or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and is fully responsible and agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian.



By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 21 years of age or older
Parent or Guardian's Information
For girls not currently registered as Girl Scouts: I understand my daughter is not covered by Girl Scouts of the USA Activity Insurance, but she has my permission to participate in this activity.*
No
Yes
Age
GS Level
Participation Date(s
Year
Additional Activity Information, if any:

If they are allowed to participate in 1 or more of the activities below, chose YES. If they are NOT allowed to participate at all, chose NO.

CMC - Camp McCormick, MABC - Mary Ann Beebe Center, CD - Camp Dean


Archery/Slingshots/Nerf Archery (Daisy Girl Scouts can only participate in Nerf Archery and Slingshots)*
No
Yes
Crate stacking (Crate Stacking is only for Girl Scouts in 4th grade and up)*
No
Yes
Mobile Climbing Wall (Daisy Girl Scouts (Grades K-1) are not permitted to use the Mobile Climbing Wall)*
No
Yes
Camp Dean only: Canoeing/Kayaking (Daisy Girl Scouts can only use Canoes with a parent/guardian)*
No
Yes
MABC only: Zipline*
No
Yes
MABC CD CMC : Air Rifles- Must be 10 years old and up*
No
Yes
Camp Dean, Camp McCormick, MABC: Tomahawk Throwing* Must be 12 years old*
No
Yes
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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