Trip to Colonial Williamsburg 1

Table of Contents

Purpose of the trip……………………………………………………………………………………………………………...... …….2

Demographic Information……………………………………………………………………………………………………………………....3

Participant Information …………………………………………………………………………………………………………………………..4

Medical Form ………………………………………………………………………………………………………………………………………….5

Leaders information…………………………………………………………………………………………….………………………………….6

Written policies and procedure…………….…………………………………………………………………………………………………7

Itinerary of trip………………………………………………………………………………………………………………………………………..8

Emergency information…………………………………………………………………………………………………………………………11

Emergency protocol plan…………………………………………………………………………………………………….…………………12

Liability waiver and release …………………………………………………………………………………………………….……………15

Equipment/ clothing list…………………………………………………………………………………………………………………………16

Accident Report Form…………………………………………………………………………………………………………………………..17

Purpose of the Trip

The purpose of this trip is to enrich older adults’ lives with learning the history of the State of Virginia in which they live. The participants gain knowledge of how Virginia once was. They will learn about the several jobs and art during the colonial era. The will also see art that is from the time period.

Demographic Information

This trip will have older adult participants from Henrico, Virginia.This trip will include people from a golden age club at the local parks and recreation center. There are about 25 people going on this trip. There will be both males and females on this trip. These people will not have disabilities. These people will not be experts on history but will be very adapt to learning.

Trip to Williamsburg

Participants name:______

Date of Birth:______Gender:______

Address:______

Phone Number:______Email:______

Person to Contact in Case of Emergency

Name:______Relationship to individual:______

Phone Number:______

Medical History and Insurance Information

Emergency Medical Treatment: In case of an emergency. I give my permission to be taken to the closest hospital to receive treatment. ______

Medicines currently taking: ______

______

Allergies:______

Health Insurance Provider:______

Policy Number:______

Doctor:______Office Phone Number:______

Medical Form for Williamsburg Trip

Name:______Date of Birth ______/______/______

Addressee:______

Phone Number:______Email:______

Primary Care Doctor:______Number:______

Health insurance provider:______

Policy Number:______

Medical History

Have you ever been hospitalized?  YN For What?______

What Medication are you currently taking? ______

______

Have you had any of the following conditions?

Allergies *Stroke Liver Disease

Seizures Heart Attack  Use of hearing aid

Epilepsy Arthritis Asthma

DiabetesFainting Spells Ulcers

Depression/ Anxiety**

*Please list your allergies______

______

** How does your depression/ anxiety affect you? What are your symptoms?______

______

Is there any thing other you want the staff to know? ______

______

Leader Information

Amy Sale- She is a 25 year old college educated individual. This women is newly hired and has only gone on small trips not overnights. This woman is a CTRS and is First Aid, AED, and CPR certified. She has no knowledge of this area. This women is the main leader.

Elise Jones- She is 33 year old college educated individual. This women has lead and gone on many trips for the program and other golden age clubs. This woman is a CTRS and is First Aid, AED, and CPR certified. She has no knowledge of this area.

Erin Johnson- She is a 27 year old college educated individual. This women has never lead a trip but has helped in the past. This woman is First Aid, AED, and CPR certified. This woman has a vast knowledge of this area because she grew up in Williamsburg.

Jack Smith- He is a 40 years old college educated individual. He has his masters in gerontology. He has been on several trips with this golden age club but has never been the main leader. This man is First Aid, AED, and CPR certified. This man has a vast knowledge of this area because he recently went on vacation here with his family.

Policies

Employees can not use cell phones for personal use. The only time employees can use their phones is in a case of emergency.
Employees must carry around participant health form with them at all times in case of emergency
Employees must carry a first aid kit at all times with them
Employees need to engage with the participants and not just the other employees that are on the trip
Employees must know the emergency protocol plan at all time and have a copy with them at all times

Procedures

The group will not go to the next location without the whole group unless an emergency occurs
The group will walk slowly enough so that no one is left behind or worried about keeping up with the group
There will be a leader in the front of the group and a leader in the back of the group when walking to the new destination
We will eat as a group by sitting at the same table or table close to each other
Each person will be responsible to wake up each morning and eat breakfast

Itinerary of Trip to Williamsburg

8:00am- Load the bus and pack all of the participant’s belongs on the bus.

8:30am-Leave from Dorey Recreation Center.

9:10am- Arrive at Colonial Williamsburg Regional Visitors Center

9:15am – Redeem online tickets for multi- day admissions

9:30am- Ride the bus to the Colonial Williams Art Museums

9:40am- Arrive at The Dewitt Wallace Decorative Art Museum

9:45am-10:15amFree time in the TheDewit Wallace Decorative Art Museum

10:30am- 11:15am African American Artist Tour

11:30am- 12:45pm Lunch at the museum café at The Dewit Wallace Decorative Art Museum

12:45pm- 12:50 pm Bathroom breaks and regrouping after lunch

1:00pm-1:30pm- Decorative Arts Highlights Tour

1:30pm-2:00pm- Free time in the Abby Aldrich Rockefeller Folk Art Museum

2:00pm-3:00pm- Behind Closed Drawers Program

3:00pm-3:30pmFree time in the Public Hospital

3:30pm-4:15pm Focus on Southern Paintings

4:15pm- 5:00pmFree time in the Dewit Wallace Decorative Art Museum, The Abby Aldrich Rockefeller Folk Art Museum, or the Public Hospital. Each staff member can take a group with them.

5:00pm Take bus to the Revolutionary City

5:15pm-6:30pm Dinner at Huzzah! BBQ Grille

6:45pm-8:05pm “When Day Breaks” Movie in the Kimball Theatre Screening Room

8:10pm Take the bus back to the van

8:20pm Take the van to The Governor’s Inn

8:30pm Check in to The Governor’s Inn

8:30pm-7:00am Sleeping and other quiet actives in hotel room

7:00am –Wake up and get ready for the day

8am- 9:15 am Breakfast at the Governor’s Inn

9:15 am take the bus to the Revolutionary City

9:30am -10:00am Orientation Walk that starts at The Greenhow Lumber House

10:00am-11:00am Time to explore The Colonial Garden

11:00am- 12:00pm Time to explore Gunsmith and Foundry

12:00pm-1:00pm Time to explore the Bruton Parish Church

1:00pm- 2:10pm Lunch at the Raleigh Tavern Bakery

2:15pm- 2:45pm Dancing During the War

3:00pm-3:45pmTime to explore the Apothecary

3:45pm-4:30pm Time to explore the Milliner

4:30pm-4:45pm Look at the animals behind Westburn’s Tavern

4:45pm- 5:45pm Explore Duke of Gloucester Street

5:45pm-7:15pm Dinner at Shields Tavern

7:15pm- 8:30pm Cry Witch at the Capital General Court

8:30pm- Take the bus back to The Governor’s Inn

8:45pm-7:00am Sleeping and other quite activities in hotel room

7:00am- Wake up and get ready for the day

8:00am- 9:15am Breakfast at The Governor’s Inn

9:15am-Take the bus to The Revolutionary City

9:30am-10:30am Freedom’s Paradox at the Randolph House

10:45am-11:45am Music at the Sith at the Mary Sith House

11:45am- 12:30pm Lunch at the Raleigh Tavern Bakery

12:30pm- 1:30pmpmExplore the Wigmaker

1:30pm- 2:30pm Explore the Bindery

2:30pm-3:00pm Explore the Cooper

3:00pm-3:30pm Explore the Bindery

3:30pm-4:00pm Explore the Wheel wright

4:00pm-4:30pm Explore the Basket Maker

4:30pm- Ride the bus back to The Governor’s Inn

4:45pm-5:00pm Pack up the van to go back to Henrico

6:00pm- Arrive back in Henrico

Emergency Information

Destination of trip: Colonial Williamsburg Regional Visitors Center (757) 229-1000

Contact at Henrico Parks and Recreation Center: Yvonne Russell (804) 727-8514

Hospital: Riverside Doctors’ Hospital (757) 585-2200

Emergency Protocol Plan

For Some One That Gets Lost

If lost in The Dewitt Wallace Decorative Art Museum, The Abby Aldrich Rockefeller Folk Art Museum, or The Public Hospital:

Let one member of staff take the individuals who are not lost to an agree on meeting place
Let the police/ security guards of the Museums know that someone in your group is lost
Check the place that you walk into and eventually are going to leave out of
Check the bathrooms and water fountains
Divide the museums in to three sections, one for each leader
Let leaders search for lost person in their section until the lost person is found

If lost in The Revolutionary City:

Let one of the members of the staff take the individuals who are not lost to an agree
Let the police/security of the Revolutionary City know that you have lost someone
Check the bus stop in which you original came to Revolutionary City
Check places with bathrooms and water fountains
Divide The Revolutionary City in to three sections, one for each leader
Let leaders search for lost person in the section until the lost person is found

For someone that gets injured

For injuries that require basic first aid

One leader preforms basic first aid on the participant while the other leaders and participants continue in the planed activity
They will enjoin the group when the basic first aid is complete

For injuries that require driving to the hospital

Quickly and calmly decide who is going to stay with the person who is injured, who is going to get the van, and who is going to stay with the other participants
One person stays with the injured person and talks them to a spot in which they can meet the person with the van. Walking to a different location might be necessary because cars are not allowed on Duke of Gloucester Street.
Two people stay with the group and continue the trip as planed
The person who is injured and the leader who was taking care of them will meet the person who is driving the van
The person who is injured gets placed in the care of the person driving the van
The leader who was waiting for the person getting the van rejoins the group
The injured participant and the van driver go to Riverside Doctors’ Hospital Williamsburg
Directions to the Hospital from Colonial Williamsburg Regional Visitors Center
Colonial Williamsburg Regional Visitor Center (101 Visitor Center Dr, Williamsburg, VA 23185)
HeadwesttowardVisitor Center Dr (0.1mi)
TurnleftontoVisitor Center Dr (308ft)
SlightrightontoColonial National Historic Pkwy (0.2mi)
TurnrightontoN England St (446ft)
TurnrightontoLafayette St (0.8mi)
Continue ontoUS-60 E/York St
Continue to follow US-60 E (1.8mi)
TurnrightontoJacobs Rd
Destination will be on the right

For injuries that require taking an ambulance to the hospital

One person calls 911 and talks to the operator for the information they need
Another person stays with the injured person and monitors them while getting their medical forms to hand to EMT/ paramedics when there come to the seen
Other two people stay with the group and continue the trip as planned.
The person who is the monitor of the injured participant goes in the ambulance to the hospital with the injured participant
The person who is caller of 911 is on standby with their cell phone and waits for the call if the person at the hospital gets discharged. Then this person will go pick up the injured participant and the leader who went with them to the hospital.

Behavioral Issues

If there are behavioral issues give out 3 warnings before taking more serious actions
The first warring a staff member will say
The second warning a staff member will say
The third warning a staff member will say
After given the warnings are given if the participants is still acting up then a group leader will remove the participant and go back to the hotel
This means that the participant and the leader will walk to Colonial Williamsburg Regional Visitors Center to get the Van and drive back to The Governor’s Inn

Liability Waiver and Release

Henrico Parks and Recreation Program

(804) 727-8514

In the event of the trip to Colonial Williamsburg I am in good health and in good condition to participate in this trip. To participate in the trip I have considered the following

I fully understand that (a) I could trip, fall, and get injured at any time during the trip including at the Revolutionary City, the Governor’s Inn, the Dewitt Wallace Decorative Art Museum, the Abby Aldrich Rockefeller Folk Art Museum, or The Public Hospital (b) I could get bitten if I touch any of the animals from the Rare Breeds Program in the Revolutionary City (c)Get overheated or get any heat related sickness due to not drinking enough water and being outside (d) have a medical emergency that would result in me having to go to the hospital

I hereby release, discharge, waive, hold harmless, and agree not to sue Henrico Parks and Recreation Program staff, volunteers, or shareholders from any and all claims from the actives that are taking place during this trip including broken bones, animal bites, scrapes, bruises, headaches, stomach aches, heat related symptoms I will indemnify , save, and hold harmless each of the result of loss, liability, damage of the cost many occur as a result of a claim

______

Printed Name

______/______/______

Signature Date

Equipment/Clothing list

Please bring the following to make our trip successful.

2 complete changes of clothes

Pajamas

Toilets (ex. Tooth brush, tooth paste, shampoo, hair brush, etc.)

Comfort walking shoes

Sunscreen and bug repellent

Sun hat or ball cap (optional)

Reusable water bottle

Small backpack or day bag to carry belongings (optional)

Camera (optional)

Accident Report Form

Time of Accident:______Date of Accident:______

Victim of Accident:______

Caregiver to Victim:______

Nature of Injury:______

______

Care Given:______

______

Describe the Accident: ______

______

Witness: ______

______

Additional Notes: ______

______