Trip # Assigned: ___________
Leader Name: Pam Madigan
Destination: St. John U.S.V.I.
APPLICATION TO LEAD AN AMC MAJOR EXCURSION
If possible, please fill this form out electronically so that it can be distributed by email. 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 so that only the appropriate answer remains.
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 Camping at the National Park St. John U.S.V.I.
B) Type of Trip: Other: Hiking and snorkeling
C) Date: Start 3/19/04 End 3/28/04 Length of Trip 10 days
D) Participants: (not counting leaders) Minimum # 20 Maximum # 30
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.
Daily hikes and/or snorkel trips are planned daily through the National Park waters and grounds.
An optional day trip to the British Virgin Islands will be offered. See attached summary.
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?
3/8/02
H) Educational Aspect: What are the specific education, conservation, or recreation
components of this trip? There will be several planned day hikes through the National Park.
Two of the outings are to be led by Park Rangers. One is the Reef Bay Trail, the other will be
the Leinster Bay Water’s Edge Walk. There will also be evening slide presentations by the
Park Rangers on the flora and fauna on St. John. A visit is planned to the historic Annaberg
Sugar Mill ruins. There will be snorkel trips to a number of areas so trip participants have an
opportunity to see a wide variety of fish and coral.
There is a
I) Outfitters: Will this trip require an outfitter? No
Why or why not? I am very familiar with the destination and have successfully run this trip
without outfitters for multiple years.
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: Pam Madigan
Co-Leader: Chris Rapacki
Address: 12 School Street
Address: Eptech Corp.
Medfield, MA 02052
104 Gaither Dr. Mt. Laurel NJ 08054
Home Phone: 508-359-6789 or 6521
Cell 908-400-5500
Work Phone: 617-457-3358
Work 856-802-6444 x14
Email: Pam.Madigan@hunneman.com
Email: C-Rapacki@eptech.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.
Course
Other cert.:
3/8/02
Leader
Exp. Date
9/25/03
12/03
Copy Attached
Course
Other cert.:
Co-Leader
Exp. Date Copy Attached
If copies of CPR and WFA or equivalent are not attached, please detail your specific plan to
obtain this certification.
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.
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. March 2001 – St. John U.S.V.I.
2. March 2000 – St. John U.S.V.I.
3. 1978-1985 – Leader of trips to St. John U.S.V.I.
4. March 2004 – St. John U.S.V.I.
D) Scouting: Have you or your co-leader led this trip before or traveled in the area? Yes If yes,
please describe:
My first trip to St. John was on an A.M.C. trip in 1970. I was a participant on several A.M.C.
trips until 1979 when I led my first trip to St. John. I have been to St. John over 20 times. Chris
was Co-leader for the March 2003 trip.
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 am a former Water Safety Instructor Certified with extensive experience with swimming and
snorkeling. I have extensive hiking experience and great familiarity 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 Katherine Byers at 617-523-0655 x333 to receive a
hard copy by mail.
III. RISK ASSESSMENT
3/8/02
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
Water safety
Hiking accidents
Foreign Countries: N/A
Political concerns,
crime, language
translation
Transportation:
Collision
Vehicles, drivers,
insurance
Participants:
Skill level, health,
group dynamics
Water safety and hiking
accidents
Prevention/Response
Written & verbal instruction will be
given to participants stating they must
ALWAYS use the buddy swim system.
Leader or co-leader will be present at all
scheduled snorkel trips. Proper footwear
will be recommended for day hikes. Extra
water and sun lotion will be brought on
all planned outings along with a first aid
kit.
Drivers will be used on a voluntary basis
and given written/verbal instruction on
safety procedures. Any driver not
complying will have driving privileges
removed. Insurance at Varlack will be
purchased.
Non swimmers will need to use flotation
devices. Walkie talkies will be used on
all planned day trips for easy access to
emergency services.
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.
3/8/02
Emergency Communication (phone contacts, language, documentation)
Copies of trip participants and their emergency contact information will be distributed to Heidi
Reilly at A.M.C. prior to departure. I will have the information with me during the trip for easy
access as well. Emergencies will be documented and reported immediately to Heidi Reilly and
Walley Williams.
Evacuation (out of backcountry location, out of foreign country)
Walkie talkies and cell phones will be used in case of a true emergency. Park Service or Water
taxi will be used as needed.
Medical Care (local medical facilities – location and quality)
St. John has the Myrah Keating Smith Community Health Center (340-693-8900) on Center
Line Road. My co-leader or I will drive a trip participant there if needed. There is 911 service on
the island. Also, St. Thomas has a full service hospital available by water taxi.
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 (20) $1,439.71 with maximum (30) $1,513.73
Cost per participant to be listed in AMC Outdoors $1,515.00
B) What deposits are required in advance? $2000.00 to Cinnamon Bay, $300.00 to Varlack
Ventures and $1200 to American Airlines.
C) What is the latest date for you to cancel and get a full refund? January 18th 2004.
D) What are your plans if you do not get the required number of people?
Leaders agree to pay up to 50% of their costs if necessary. Trip will be cancelled by 1/2/04 if
registrations will not cover half of leader’s costs.
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? No
VI. AMC OUTDOORS INFORMATION
Detailed instructions on trip listings available at <http://snebulos.mit.edu/orgs/amc/>.
3/8/02
A) Request month for trip to first appear in AMC Outdoors __ July 2004________
Date to be pulled _____April 2004____________
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.” D
*** 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.



First aid certifications
Leader Qualification information
AMC Medical form for both leaders

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Detailed cost information
AMC Outdoors listings
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: Katherine Byers) to 617-523-0722 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>
Katherine Byers, AMC Outdoor Leadership Coordinator at <kbyers@amcinfo.org>
Or, if you unable to send electronically, please mail a hard copy to the following two addresses:
T. Walley Williams, III
3/8/02
Major Excursions
Chair, AMC Major Excursions Committee
71 Orchard St.
Belmont, MA 02478-3509
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.
3/8/02