Request edit access
Pontoon Activity Permission 

This form must be completed by a parent/guardian & returned prior to your child’s participation in the activity described below:

Activity: Pontoon Boating    

Location:  Osborne Landing, 9680 Osborne Turnpike, Richmond, VA 23231

Date:    July 18, 2025                 Cost: Free

Time: 10-12pm   

Description: We will enjoy a leisurely ride on the James River together! 

Supplies/Requirements: bottled water, sunblock, bathing suit under clothes in case you get wet, flip flops

**Please note, we do not allow aerosol sunscreen to be applied ON the boat. The spray eats away and destroys the seating on the boat. You can apply it before the trip!

1.The new Beyond Boundaries boat will be able to take out a maximum of 10 participants. 

2. Please fill out the REQUIRED Waiver below: 

BB Waiver: https://waiver.smartwaiver.com/w/sri91r7czafvfhdsdscac4/web/

3. You can meet us near the accessible dock, not the one near the Lily Pad restaurant!

See provided MAP below.

Sign in to Google to save your progress. Learn more
Email *
Location:  Osborne Landing, 9680 Osborne Turnpike, Richmond, VA 23231
View Map Below
BB Representative: Alek Wiggins, (804) 839-4661  
Parent's/Guardian's First and Last Names *
My Child's First and Last Names *
Name of my child's school *

My child has my permission to participate in the pontoon boating activity listed above.

 *

My child has my permission to participate in the pontoon boating activity with the following restrictions: (If your child has no restrictions, please put "None".)


 *

G2W-VA has permission to photograph my child.

 *

Transportation:  Parents are responsible for getting their child to and from the event.

 *
Emergency Contact Name *
Emergency Contact Phone Number *
By typing my name below, I acknowledge that I, the parent/guardian, have completed the Beyond Boundaries Waiver in order for my child to participate in this activity: https://waiver.smartwaiver.com/w/sri91r7czafvfhdsdscac4/web/
 *
By typing my name below,, I am acknowledging that I, the parent/guardian, am aware of the risks:

Acknowledgement of Risks:

I understand that participation in the activity involves a certain degree of risk. I have carefully considered the risk involved and have given consent for myself or my child to participate in the activity. I understand that participation in the activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release the Girls2Women-Virginia association, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.

In case of an emergency involving my child, I understand every effort will be made to contact me.  In the event I cannot be reached, I hereby give my permission to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child.  Medical providers are authorized to disclose to the adult in charge examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities.

 *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of girls2women-va.org.

Does this form look suspicious? Report

Google Forms