* Required

Pocono Environmental Education Center

Date of Program: Monday, Sept 13
Location: Pocono Environmental Education Center. 538 Emery Rd, Dingmans Ferry PA, 18328
Departure Time: 7:30 a.m.
Return Time: 7:00 p.m.
Activities: Team building, confidence building, problem-solving, hiking and outdoor education
11th Grade Deans: Vivek Freitas & Jenny Heath

**Cost: The cost of this trip is approximately $100, and will be charged to your account.


  • Please complete this permission slip by September 8.
  • Dress: Students should wear clothes they don’t mind getting dirty, old sneakers or hiking boots (closed-toed shoes are required, and crocs are not suitable for what we do), a reusable water bottle, and a small backpack to carry it.
  • The Program will be held rain or shine. Please keep an eye on the weather in the days leading up to the trip: if it looks like it may be a wet day, students should bring rain gear as well (rain jacket or poncho).
  • Please be sure to review this information regarding ticks.

RCDS Permission Waiver

I acknowledge and agree to the terms outlined below.​​​​

Permission to Participate

My child (the “Student”) may participate in Rye Country Day School’s (“the School’s”) 11th Grade trip to the Pocono Environmental Education Center in Dingmans Ferry, PA (the “Trip”) on September 13, 2021. The Trip will include, among other activities, the Student navigating obstacle courses, orienteering, and hiking. I permit the Student to travel by bus, car, or by whatever means necessary, and to return to the School upon completion of the Trip. I further acknowledge that I am responsible for the Student’s transportation to and from the School. For purposes of this agreement, “I” shall refer to the Student and, where appropriate, the parent(s) or legal guardian of the Student named above who have signed below.

I acknowledge that the Student must strictly adhere to all School and Trip specific rules and instructions during the Trip and also state that, to the best of my knowledge, the Student is in good health and suffers no disability or condition which renders the Student’s participation in the Trip medically inadvisable, or otherwise limits the Student’s ability to engage in the activities on the Trip. I further acknowledge that I must review the information regarding ticks in order for the Student to participate in the Trip. I understand that in the event of a medical emergency, the School will abide by the Medical Information and Consent Form on file with the School.

Assumption of Risk

I understand and agree that the various activities described above and described in the information I received from the School about this Trip, as well as travel generally, present many risks of injury to the Student and of damage to the Student’s property.In particular, I acknowledge the inherent risk and dangers of navigating the obstacle course. These risks may include, but are not limited to:

  • Head, neck or back injuries;
  • Concussions and other brain injuries;
  • Paralysis;
  • Slips and falls;
  • Contact with other students on the Trip;
  • Injury/illness arising out of the condition of the course, such as: equipment malfunctions or improper use, including the failure to keep equipment fastened; over-exertion, falls, and collisions with other persons, structures and objects; falling timber; and moving beyond the boundaries of the course;
  • Shoulder, elbow and wrist injuries; or
  • Interaction with local animals and insects.

I understand and agree that the above list of risks is not exhaustive. I hereby represent that I have reviewed the tentative itinerary and any other information provided to me about the Trip and that I have reviewed information about The Pocono Environmental Education Center at https://www.peec.org/.

Release from Liability

I am aware that all travel and participation in the Trip may be dangerous and may involve many risks of serious injury and even death. I understand that, although School faculty will be present on the Trip, the Student may be unsupervised at times during the Student’s participation in the Trip.I agree that the School does not assume responsibility for spontaneous and unforeseen events that may occur during the Student’s participation in the Trip.In consideration of the School’s permitting the Student to participate in the Trip, I hereby, on behalf of myself, my children, spouse, heirs, agents, executors, administrators, and assigns, release and forever discharge the School, its agents, trustees, officers and employees (the “Released Parties”) for any and all demands, claims, damages, actions and causes of action, pertaining to or arising out of the Student’s participation in the Trip, including but not limited to, claims for negligence, personal injury, breach of contract, or breach of warranty, except in the event of gross negligence or willful misconduct.

Termination of Participation

I understand that the School may terminate the Student’s participation in the Trip at any time, including before departure or during the Trip. Reasons for termination may include, but are not limited to: inappropriate conduct or other behavior by Student deemed detrimental to the best interests of the Trip in the School’s sole discretion; any violation of School rules or the rules set out by supervisors, tour guides, or by any of the places visited on the Trip; health and safety consideration; or emergencies.


I hereby agree to indemnify and hold harmless the Released Parties from any loss or liability whatsoever caused by any act or omission of the Student in connection with the Student’s participation in the Trip.

Construction and Scope of Agreement

The School reserves the right to cancel or modify the Trip before or during its operation for any reason in the sole discretion of the School. It is understood and agreed that if any provision of this agreement is held invalid, the invalidity shall not affect other provisions of this agreement which can be given effect without the invalid provision.To this end, the provisions of this agreement and release are severable.This agreement shall be construed in accordance with and governed by the laws of the State of New York.

I understand that by submitting this form, I am authorizing the School to charge my account.​​​​​​
Electronic Signature: I agree that a) my typing my name and the date and clicking on the "Submit" button constitute a "Signature" to this form that is the equivalent to a hand-written signature, and b) I acknowledge that I have read and agreed to this form.

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