2 . Certified / Trained Adults – Must be present at all times AND submit copies of certifications / training cards with this form . Lifeguards MUST have their certifications and photo identification on their person while they are lifeguarding .
First-aid certified adult |
Exp Date |
CPR certified adult |
Exp Date |
Outdoor Skills trained adult |
Course Date |
Other certifications ( Lifeguard , Archery , Watercraft , Low Ropes Challenge Course or Outdoor trainings attended prior to 2008 ) |
Adult |
Course Name |
Exp Date |
Adult |
Course Name |
Exp Date |
3 . Attach Required Items – please submit the following item when sending in User Agreement and final payment .
� Trip Roster - Attach a roster listing all girls and adults . Note : Remember all adults need to be registered members and have completed the volunteer application process .
4 . Equipment / Pool Rental / Instructor Request
� Check this box if you are requesting any additional equipment or swimming pool rental . Please complete the site specific Equipment Reservation Form and submit with this Campsite Reservation Form .
Credit or Debit Card Information
Check / Money Order ( Make checks payable to GSWPA ) Cookie Dough / Nut Bucks $____________
Charge My : Visa MasterCard AMEX Discover $____________ Card number : ______________________________________________ Exp . date : ___________________ 3-digit code : ___________________ Signature : _________________________________________________ Print Name : ________________________________________________ www . gswpa . org