Trip # Assigned: ___________
May 22, 2003
Leader Name: _Ralph Blumenthal_________
Destination: Cinnamon Bay, St. John USVI
APPLICATION TO LEAD AN AMC MAJOR EXCURSION
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If possible, please fill this form out electronically so that it can be distributed by email.
Please type in any font other than italics so we can easily identify your responses. Type
on or over lines and directly into the appropriate sections of tables. When responding to
Yes/No questions, please delete the answer you do not want, leaving only the prefered answer.
Please save and forward your electronic document in the following format:
Leader’s Last Name, Trip destination-Trip Activity (if applicable), Trip Start date.
For example: Zukroff New Zealand Hiking 12.26.03.doc
If you are filling out a hard copy, please attach additional pages if you find there is not enough
space to answer thoroughly.
I. TRIP PROPOSED
A) Trip Title: _Snorkeling, Hiking and Unwinding in St. John, U.S.V.I_______________
B) Type of Trip: Camping with day trips for snorkeling and hiking__________________
C) Date: Start February 11, 2004 End February 25, 2004 Length of Trip 15 days, 14 nights
D) Participants: (not counting leaders) Minimum # _18________ Maximum # _34_______
E) Brief outline of trip and trip activities. You may write or type below or attach as a separate
sheet. A complete itinerary with all available contact information must be provided before
departure.
Two weeks of camping in either tents or cottages at Cinnamon Bay Campground in the
Virgin Islands National Park on St. John. Daily trips to explore the island will include
swimming, snorkeling, hiking, and learning about the history, flora, and fauna. An
optional day trip to the British Virgin Islands is also planned.
F) Permits: Does the trip require special permits (required on all U.S. federal lands)? No
If yes, please explain what permits will be needed and how/when they will be acquired.
G) Equipment: Does the trip require special technical equipment? No
If yes, what equipment is needed and will any of it be provided by the trip?
H) Educational Aspect: What are the specific education, conservation, or recreation components
of this trip?
A significant activity will be snorkeling and observing and learning about the many kinds
of fish, coral, and other creatures that inhabit the reefs. Local Ranger walks, talks and
slide shows will be included.
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Appendix – Application to Lead an AMC Major Excursion
I) Outfitters: Will this trip require an outfitter?
No
Why or why not? _I have been to St. John many times and other AMC trips have not
found it necessary.
Who are they? _________________________________________________________________
What is their safety record? _______________________________________________________
Do they have liability insurance? __________________________________________________
Can they provide a certificate of insurance listing AMC as an additional party insured? Yes No
How do they handle emergencies? _________________________________________________
II. LEADER INFORMATION
A) Contact Information
Leader: Ralph B. Blumenthal
Co-Leader: Clifford N. Gerenz
Address: 41 Stoney Brook Road
Address: 57 Taggart Way
Holmdel, NJ, 07733-1122
Saddle Brook, NJ 07662
Home Phone: 732-264-8482
Home Phone: 201-791-0293
Work Phone:
Work Phone:
Email: rblumenthal@comcast.net
Email: cgerenz@msn.com
B) First Aid Training – To lead a Major Excursion, you must have current CPR and Wilderness
First Aid (WFA) or its equivalent at the time of your trip.
Leader
Course
Exp. Date
■ CPR
11/04
■ WFA
11/04
AWFA
Other
Other cert.:
Copy Attached
Yes No
Yes No
Yes No
Yes No
Co-Leader
Course
Exp. Date Copy Attached
■ CPR
Yes No
3/04
■ WFA
Yes No
2/05
AWFA
Yes No
Other
Yes No
Other cert.:
If copies of CPR and WFA or equivalent are not attached, please detail your specific plan to
obtain this certification.
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Appendix – Application to Lead an AMC Major Excursion
C) Leader Experience and Training
New Leaders: If you are a new leader or co-leader, you must have submitted the form
“Application to Become a Major Excursions Leader.” Please attach a copy of that from.
Application for RBB is attached.
Experienced Major Excursions Leaders: Please list below the last three trips you have led for the
AMC including destination, type of trip (backpacking, skiing, etc.), dates, and number of
participants. Feel free to list additional trips you have led, particularly if they demonstrate
experience related to the trip you are proposing.
1.
2.
3.
D) Scouting: Have you or your co-leader led this trip before or traveled in the area? Yes If
yes, please describe:
I have been to St. John 7 times including 5 times with the AMC. In February 2003 I was
the back-up leader for the Rays.
E) Special Experience: What special skills or experience are required to lead this trip and how
do you or your co-leader bring these skills and experience?
I have extensive swimming and snorkeling experience and have previously completed
Boy Scout/Red Cross lifesaving training. I am very familiar with St. John.
F) Couples: If leader and co-leader are a couple or have some other close personal relationship,
what are your back up plans if one if you cannot go and the other must stay behind as well?
Or if you are in the field and both of you must return?
G) Medical History: Both leader and co-leader need to have a recent copy of the AMC
Confidential Medical Form on file at 5 Joy St. This form can be obtained online at
http://snebulos.mit.edu/orgs/amc/ or call Heidi Reilly at 617-523-0655 x356 to receive a hard
copy by mail.
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Appendix – Application to Lead an AMC Major Excursion
III. RISK ASSESSMENT
A) Please assess the risks/hazards of your trip. Carefully consider each area of risk and how it
may affect your trip with specific potential hazards. Then, devise a plan to attempt to prevent
each hazard and to respond to it if it becomes necessary.
Areas of Risk
Climate/Terrain:
trail conditions,
weather, etc.
Potential Hazards
Heat stroke, sunburn,
drowning
Prevention/Response
Caution participants to use sun
screen and to bring water on all day
trips. Observe all participants and
use a buddy safe swim procedure.
Foreign Countries:
political concerns,
crime, language
translation
Transportation:
vehicles, drivers,
insurance
NA
Driving accidents
Volunteer drivers will be screened
and given safety instructions.
Collision insurance will be purchased.
Participants:
skill level, health,
group dynamics
Health since participants
may be elderly
Carefully screen medical records and
regularly observe all participants.
Other:
B) Emergency Action Plan
Before you leave for you trip, you will need to provide a list of participants and their emergency
contacts in case something happens to someone in the field as well as an itinerary with phone
numbers (where available) in case something happens at home. In the space below, please
describe your plans for dealing with emergencies. Please use as much detail as possible and
attach additional sheets if necessary.
Emergency Communication (phone contacts, language, documentation)
We will carry all emergency contact information with us.
Evacuation (out of backcountry location, out of foreign country)
Park Services and/or emergency services personnel will be notified in the event of any
emergency.
Medical Care (local medical facilities – location and quality)
St. John has a 24-hour Health Center that has provided excellent care in the past. A full
service hospital is in St. Thomas.
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Appendix – Application to Lead an AMC Major Excursion
IV. COST INFORMATION
Your application to lead a trip will not be accepted if a detailed cost analysis is not attached.
A) Estimated cost per participant with minimum # _$1,800_ with maximum # _$1,690____
Cost per participant to be listed in AMC Outdoors $1,800_including estimated $680
airfare from Boston._See attached spreadsheet for budget._____
B) What deposits are required in advance? _$2,000 has been sent to the Cinnamon Bay
Campground. Rental vehicles may require a deposit. Airline tickets will be arranged
as people sign up._________________________________________
C) What is the latest date for you to cancel and get a full refund? _January 11, 2004 for
Cinnamon Bay. Airline tickets will be purchased in participants name so that they will
become responsible._______________________
D) What are your plans if you do not get the required number of people?
Cancel the trip by 12/1/03. The trip has been popular and several participants have
indicated that they are interested in participating in 2004.
V. PRIVATE TRIPS
Are you currently (up to and including the time frame of this proposed trip) leading trips that are
“private,” i.e. not sponsored by the AMC?
Yes
I lead local walks for the Holmdel Environmental Commission.
VI. AMC OUTDOORS INFORMATION
Detailed instructions on trip listings available at <http://snebulos.mit.edu/orgs/amc/>.
A) Request month for trip to first appear in AMC Outdoors __July 2003________
B) Please provide an electronic copy of both the long (150 words maximum) and short form (50
word maximum) announcements. Note that the word count stops at the phrase “For info.”
*** Caribbean trips use only short form
VII. TRIP PROPOSAL AND APPROVAL PROCESS
Trips cannot come before the Major Excursions Committee for approval unless the forms are
completely filled out and received three weeks prior to MEC meetings for review. Please make
sure you have filled out all appropriate sections of this form completely and included any
necessary attachments.
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First aid certifications
Leader Qualification information
AMC Medical form for both leaders
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Detailed cost information
AMC Outdoors listings
Appendix – Application to Lead an AMC Major Excursion
By turning in this proposal, you are agreeing to the following:
I have read the Major Excursions Leader Handbook and I agree to follow all policies and
procedures of the Major Excursions Committee and the Appalachian Mountain Club in
preparing for and conducting my major excursion.
Thank you for completing this form!
 Copies of first aid certifications and medical forms should be submitted in hard copy only.
These can be faxed (marked attn: Heidi Reilly) to 617-367-8878 or mailed to the Major
Excursions, 5 Joy St. address below.
 Email submissions of this trip proposal form are preferred.
Email should be sent to both of the following two addresses:
T. Walley Williams, Major Excursions Committee Chair at <vze2g9bb@verizon.net>
Heidi Reilly, AMC Travel Programs Coordinator at <hreilly@amcinfo.org>
Or, if you unable to send electronically, please mail a hard copy to the following two addresses:
T. Walley Williams, III
Chair, AMC Major Excursions Committee
71 Orchard St.
Belmont, MA 02478-3509
Major Excursions
Appalachian Mountain Club
5 Joy St.
Boston, MA 02108
Questions? Call T. Walley Williams at the above email or 617-484-1877.
He can put you in touch with an experienced MEC mentor who can help you with trip planning.
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Appendix – Application to Lead an AMC Major Excursion