Eagle Bluff Chaperone & Snack Form

Eagle Bluff Dates: Sep 19-21, 2011 (Mon-Wed)

Chaperones and snacks needed! We also need a parent who is a licensed nurse or doctor who is willing to chaperone.

(Chaperones need to complete a criminal background check and medical form.)

Chaperones help make sure students are supervised and safe at all times. They teach evening activities and assist with student safety during such classes as Tree Tops High Ropes and Rock Climbing. Chaperones also lead a group of 7 same-gender students, making sure they are safe and supervised in the dorm. We have an information guide for chaperones to help you prepare.


A red asterisk (*) indicates required questions.

  1. Your name:*


  1. Your child's name:*


  1. My child's teacher is *


  1. Your preferred phone:


  1. Your preferred email:


  1. Chaperone or Snack

    I am interested in chaperoning the following dates at Eagle Bluff (preference given to those who can chaperone the entire trip: *
    Monday, Sep 19 through Wednesday, Sep. 21
    Monday, Sep 19, afternnoon & overnight
    Tuesday, Sep 20 all day and overnight through Wednesday, Sep 21
    I am unable to chaperone, but I can contribute a night time snack.


  1. I am
    a licensed nurse.
    a licensed doctor.
    not a licensed nurse and doctor.


  1. Do you have any questions for us?