2018 Troop 171 PSlip [Shelf Road Climbing Campout] (Responses)
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TimestampRequired FormsReleaseNOTES
Special Climbing Consent
Signing AdultMedical Information
Name Not on List Above
EmailCell NumberSpecial Food NeedsScout NameScout/Adult Patrol
Telephone Number
StatusVehicleSeat BeltsSeats TOSeats HOME
Driving [TO Campout (FRIDAY 5:30 PM at Annex)]
Driving [FROM Campout (Sunday, 10:00 AM on site)]
Climbing Level/AbilityClimbing MBActivity Interest
Driving [TO Campout (SATURDAY 8:00 AM)]
Adult TrainingEmail Address
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533235
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10/2/2018 15:20:54
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
Agree
We need to haul all of our own water, this is a dry campsite.
Yes - Climbing releaseDavid Kreutzern/aKreutzer, Daviddavid.,kreutzer@coag.gov(303) 437-9320No restrictions1Kreutzer, David
Adult - Scoutmaster Staff
(303) 437-9320
Scoutmaster Staff
2009 Toy Taco, Red555YES, I Can DriveYES, I Can Drive
"Done a Bunch", TYPE: Real Rock!
Nope - Climb for fun only
Help on Advancement, Help with Climbing
Youth Protection Training (required) [BSA on-line], Advanced or Wilderness First Aid, CPR, Severe Weather Training [BSA on-line], Climbing Certification - BSA
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10/3/2018 8:55:17
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
AgreeYes - Climbing releaseBryan OplingerBryan Oplingerbryanoplinger@gmail.com(303) 847-1037No restrictions2Bryan Oplinger
Adult - Scoutmaster Staff
(303) 847-1037
Scoutmaster Staff
2018 Chevy Colorado/Lava
511NO, I Cannot DriveONLY if neededNovice (some climbing)
Advancement ONLY, Climbing AND Advancement, Help on Advancement
Youth Protection Training (required) [BSA on-line], Standard First Aid, CPR
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10/3/2018 10:51:38
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
AgreeYes - Climbing releaseMike Johnson
I take 3 mg of warfarin each day to prevent blood clots.
Mike Johnson
michael_c_johnson@yahoo.com
(720) 474-8790Vegetarian3Mike Johnson
Adult - Scoutmaster Staff
(720) 474-8790
Scoutmaster Staff
2001 Audi A4 dark blue444YES, I Can DriveYES, I Can Drive
"Done a Bunch", TYPE: Rock Gym, TYPE: Real Rock!
Climbing AND Advancement, Help on Advancement, Help with Climbing
Youth Protection Training (required) [BSA on-line], Standard First Aid, Advanced or Wilderness First Aid, Climbing Certification - BSA
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10/7/2018 12:46:44
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
Agree
Marta and I will go to Shelf Road on Wednesday to secure the site.
Yes - Climbing releaseJeff NoneBradley, Jeffjeffbradley@mac.com(303) 304-11044Bradley, Jeff
Adult - Scoutmaster Staff
(303) 304-1104
Scoutmaster Staff
2011 Nissan Frontier Black
525NO, I Cannot DriveYES, I Can DriveNovice (some climbing)
Nope - Climb for fun only
Help on Advancement
Youth Protection Training (required) [BSA on-line], Advanced or Wilderness First Aid, CPR
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10/7/2018 12:46:44
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
Agree
Marta and I will go to Shelf Road on Wednesday to secure the site.
Yes - Climbing releaseJeff NoneTurnbull, Martajeffbradley@mac.com(303) 304-11045Turnbull, Marta
Adult - Scoutmaster Staff
(303) 304-1104SM Stfnot drivenot drivenot driveNO, I Cannot DriveNO, I Cannot Drive
Nope - Climb for fun only
Help on Advancement
Youth Protection Training (required) [BSA on-line], Advanced or Wilderness First Aid, CPR
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10/2/2018 14:07:47
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
AgreeYes - Climbing releaseRobert AntonsonRobert Antonsonpowderpig@q.com(303) 884-7813Food Allergy - peanuts6Antonson, RobieAdult - Parent(303) 884-7813Parent
2016 Chevy colorado white
522YES, I Can DriveYES, I Can Drivelevel 2 instructorClimbing ONLY
Youth Protection Training (required) [BSA on-line], Advanced or Wilderness First Aid, CPR, Severe Weather Training [BSA on-line], Climbing Certification - BSA
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10/3/2018 10:21:27
Adults: Medical parts A and B, Adults: Registered with BSA
Agree
Will complete YPT prior to trip
Yes - Climbing releaseChris DelanyNoneChris Delanycsdelany@gmail.com(303) 819-3404Dairy Free (Non-allergic)7Delany, ChrisAdult - Parent(303) 819-3404Parent2007 Toyota FJ Cruiser411YES, I Can DriveYES, I Can Drive
"Done a Bunch", TYPE: Real Rock!
Youth Protection Training (required) [BSA on-line], Standard First Aid, Climbing Certification - BSA
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10/3/2018 12:05:33
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
AgreeYes - Climbing releaseLaura GuedelhoeferNoneLaura Guedelhoefer
laura.guedelhoefer@gmail.com
(303) 408-4587No restrictions8Lee, RobbAdult - Parent(303) 408-4587Parent
2012/Toyota/RAV4 Brown/Gold
777YES, I Can DriveYES, I Can Drive
Intermediate, TYPE: Rock Gym, TYPE: Real Rock!
Whatever you need.
Youth Protection Training (required) [BSA on-line], None of the above
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10/8/2018 12:37:12
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
AgreeYes - Climbing release7203606177NAYuchen ChanYcchan71@gmail.com(720) 360-6177No restrictions9Chan, YuchenAdult - Parent(720) 360-6177Parent
2015 Subaru Outback, blue
555YES, I Can DriveYES, I Can Drive"Done a Bunch"
Nope - Climb for fun only
Help with Climbing
Youth Protection Training (required) [BSA on-line], Climbing Certification - BSA
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10/11/2018 9:34:29
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
AgreeMe or Steve will go.Yes - Climbing releaseCandice BrownNoneBrown, Candice
candy.bartholomew@mac.com
(720) 938-0307No restrictions10Brown, CandiceAdult - Parent(720) 938-0307Parent2014 Honda Pilot Grey8not drivenot driveYES, I Can DriveYES, I Can DriveNovice (some climbing)
Nope - Climb for fun only
Help on Advancement, Help with Climbing
Youth Protection Training (required) [BSA on-line], Standard First Aid, Advanced or Wilderness First Aid, CPR, Safe Swim Defense [BSA on-line], Safety-a-Float [BSA on-line]
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10/11/2018 13:24:41
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
AgreeYes - Climbing releaseTodd VogelTodd Vogeltodd.vogel@grainger.com(303) 345-4816No restrictions11Vogel, ToddAdult - Parent(303) 345-4816Parent2006 Honda Pilot555YES, I Can DriveYES, I Can DriveNovice (some climbing)
Youth Protection Training (required) [BSA on-line]
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10/7/2018 22:21:50
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
Agree
Can help drive but won't have a car.
Yes - Climbing releaseCristopher PittsNonePitts, Christopherchristofino@gmail.com(720) 273-1525No restrictions12Pitts, ChristopherAdult - Parent(720) 273-1525Parentnot drivenot driveNO, I Cannot DriveNO, I Cannot DriveHelp with Climbing
Youth Protection Training (required) [BSA on-line], Advanced or Wilderness First Aid, Climbing Certification - BSA
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10/3/2018 13:59:41
Scouts: Medical parts A and B
AgreeYes - Climbing releaseCandice BrownNone
candy.bartholomew@mac.com
No restrictions - limit sugar
13Bartholomew, CasparCrow Patrol(720) 938-0307Scout
"Done a Bunch", TYPE: Rock Gym
Climbing AND Advancement, Cooking, Camping, First Aid - finish 1st & 2nd class requirements
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10/3/2018 19:27:46
Scouts: Medical parts A and B
AgreeYes - Climbing releaseVivienne Palmernoneviviennepalmer@gmail.comNo restrictions14Frye, MicahCrow Patrol(720) 394-3508ScoutNovice (some climbing)Yes on Climbing MB
Climbing AND Advancement
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10/3/2018 20:38:36
Scouts: Medical parts A and B
AgreeYes - Climbing releasePam VogelNonePAMELA VOGELpev@kingsberycpas.comNo restrictions15Vogel, SawyerCrow Patrol(303) 931-0855Scout
Beginner (never climbed)
Nope - Climb for fun only
Climbing ONLY
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10/12/2018 18:11:47
Scouts: Medical parts A and B
AgreeYes - Climbing releaseDolores BerbaumnoneDolodolodolo@hotmail.comNo restrictions16Berbaum, PeterCrow Patrol(303) 842-0029ScoutNovice (some climbing)Yes on Climbing MBClimbing ONLY
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10/14/2018 20:36:08
Scouts: Medical parts A and B
AgreeYes - Climbing releaseAmy Hayesamyehayes13@gmail.comNo restrictions17Paulsrud, UlyCrow Patrol(303) 817-6354Scout
Beginner (never climbed)
Yes on Climbing MB
Climbing AND Advancement
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10/15/2018 22:40:52
Scouts: Medical parts A and B
AgreeYes - Climbing releaseMichaela Megrdichiankalafoss@yahoo.com
Mostly vegetarian - will send extra protein items
18Megrdichian, ZachCrow Patrol(720) 201-6965ScoutNO, I Cannot DriveNO, I Cannot Drive
Beginner (never climbed)
Nope - Climb for fun only
Advancement, with possible climbing if he's interested once on trip
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10/3/2018 19:26:36
Scouts: Medical parts A and B
AgreeYes - Climbing release7203943508noneVivienne Palmerviviennepalmer@gmail.comNo restrictions19Frye, CaseyFlaming Maple Patrol(720) 394-3508ScoutNovice (some climbing)Yes on Climbing MB
Climbing AND Advancement
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10/7/2018 22:17:53
Scouts: Medical parts A and B
AgreeYes - Climbing releaseChristoper PittsNonePerrine Pavillard-Pittschristofino@gmail.comNo restrictions20Pavillard-Pitts, ElliotFlaming Maple Patrol(303) 847-9664Scout
"Done a Bunch", TYPE: Rock Gym, TYPE: Real Rock!
Nope - Have the badge!
Climbing AND Advancement
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10/15/2018 19:12:42
Scouts: Medical parts A and B
AgreeYes - Climbing releaseEllen FranconiNoneEllen80301@gmAil.comNo restrictions21
Robichaud, Cooper: Maple Patrol
Flaming Maple Patrol(720) 253-6104ScoutNovice (some climbing)Yes on Climbing MB
Climbing AND Advancement
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10/3/2018 12:02:01
Scouts: Medical parts A and B
AgreeYes - Climbing releaseLaura GuedelhoeferPeanut
laura.guedelhoefer@gmail.com
Food Allergy - peanuts22Lee, IanGolden Eagle Patrol(303) 408-4587Scout
Novice (some climbing), TYPE: Rock Gym, TYPE: Real Rock!
Climbing AND Advancement
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10/6/2018 20:15:05
Scouts: Medical parts A and B
AgreeYes - Climbing releaseTamara bodner Tamara bodnertbodner@gmail.com
Gluten Free, Not an allergy
23Bodner, EthanGolden Eagle Patrol(650) 533-3042ScoutNovice (some climbing)Yes on Climbing MB
Climbing AND Advancement
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10/8/2018 12:33:19
Scouts: Medical parts A and B
AgreeYes - Climbing release7203606177hayfeverYuchen ChanYcchan71@gmail.comNo restrictions24Chan, LucasGolden Eagle Patrol(720) 360-6177ScoutNovice (some climbing)Yes on Climbing MB
Climbing AND Advancement
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10/8/2018 20:43:35
Scouts: Medical parts A and B
AgreeYes - Climbing releaseBruce FeistnerGluten, Dairy Freebfeistner@comcast.netGluten Free, Dairy Free25Feistner, IanGolden Eagle Patrol(303) 819-2816Scout
Intermediate, TYPE: Rock Gym
Yes on Climbing MBClimbing ONLY
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10/15/2018 17:26:18
Scouts: Medical parts A and B
AgreeYes - Climbing releaseRayleigh Rasknonerayleigh_rask@yahoo.comGluten FreeRask, SpencerGolden Eagle Patrol(720) 470-9246
CANCELLED
NO, I Cannot DriveNO, I Cannot DriveIntermediateYes on Climbing MB
Climbing AND Advancement
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10/2/2018 13:45:04
Adults: Medical parts A and B, Adults: YPT current, Adults: Registered with BSA
Agree
this is a note to the trip leader.
Yes - Climbing releaseSigned by Scott MillerNo medical infoScott Millerscott.miller@bsa171.orgCANCELNo restrictionsAntonson, TyCANCEL(303) 748-7551
Senior Patrol Leader
2007/Toyota/4Runner/Gray
not drivenot drivenot driveNO, I Cannot DriveNO, I Cannot DriveNovice (some climbing)
Nope - Have the badge!
Help on Advancement
Youth Protection Training (required) [BSA on-line], Advanced or Wilderness First Aid, CPR
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