.Y. the.

Frost Valley YMCA

School Programs Agreement 2000 Frost Valley Road Claryville. NY 12725 Pho"e: 8451985·2291 Fax: 8451985·0056

Contract Number: 017558 Group Name: Pelham Middle School Group Representallve: Tom Roksvold (This penon recei'·C.f all hlritun com""mlcation and if rc.fponslble lor disperslng;/ to ALL Grlll'p penonnellnvolvcd I" tl,e camp proGram.)

Billing Address: 28 Franklin PI

Contract Date: January 16, 2018 Grade Level:

Group Phone: 914-738·8190 Group Fax:

troksvold@pelhamschools.org Pelham. NY 10803 (Group ReprescII/a/lve's E-",al/ Address)

School Administrator:

Total Estimated Participants 3 Day Prime Season-Adult: 3 Day Prime Season-Student: Total Estimated Participants:

Arrival: Mon Oct 15, 2018 I I :00 am

First Meal: Lunch Last Meal: Lunch

Billing Contact:

LQ,atiQn

Beds In Hayden: Beds in Hussey:

26 227 253 Beds In Hydc Watson:

32 74 40 40 40 20 20 20

Beds in Krcsgc: Beds in Quirk: Beds in Scoll Lodge: Bcds in Snow: Bcds in Wolff:

Notes:

Departure: Wed Oct 17,201801:00 pm Total Days: 3 Total Nights: 2

Pelham Middle School, hereinafter the "Group," shaU be entitled to use the facilities at Frost VaUey YMCA during the period stated

above and subject to the terms of this Agreement. The Group is responsible for maintaining its own insurance coverage. At least 14

days prior to arrival, the Group must provide a certificate of Insurance naming Frost VaUey additlonaUy Insured with

indi<atlng the foUowing coverages:

I. Commercial General Liability coverage (including contractual indemnity below) with per OCCUlTence limits no less that 52,000,000; no less than S 1,000,000 personal and advertising injury per occurence; no less than SI 00,000 fire damage liability; and $5,000 medical expense.

2. Worker Compensation must have limits of 5 I 00,000 each accident; 5500,000 policy limits; $100,000 employee caneeUation clause-30 days notice.

3. Frost VaUey YMCA must be named as additional insured on the General Liability certificatc and as Certificate Holder on the Workers Conpensation certificate.

Any New York City Public School shaU send a letter of self insurance from the New York City Department of Education in place of

the Certificate oflnsuranee.

Please send this insurance document under separate cover to: Frost VaUey YMCA, 2000 Frost VaUey Road, ClaryVille, NY 12725.

Attention: Reservations.

Frost VaUey YMCA reserves the right to cancel this Agreement ifan insurance certificate is not provided at least fourteen (14) days

prior to the Group's arrival and the Group will forfeit its deposit.

The Group understands that the risk of injury is inherent to outdoor physical activities such as those conducted at Frost VaUey YMCA

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are hereby (I) waives all claims against Frost Valley YMCA, their employees and agents ("Indemnified Parties") arising out of the

Group's usc of Frost Valley YMCA, excluding those claims caused by the negligence of one of the Indemnified Parties, and (2) agrees

to indemnify and hold harmless each of the Indemnified Parties against any and all claims, losses or liabilities, penalties, damages,

judgments, suits, costs and lor expenses, including withoullimilalion, reasonable allomeys' fees, court COSIS, any deduclible or

incrcased insurance prcmiums Frost Vallcy may be rcquired 10 pay on accounl of Ihe Group's, of such usc and olher OUI of pockel

expenses arising oUI of or relaling in any way 10 Ihe Group's use of Frosl Valley YMCA, excepl cases in which Ihe Indemnified Parties have been judged negligen!.

The Group agrees 10 provide adequale adult supervision of sludenls al all limes during the usc of FrOSI Valley YMCA, including

sludenl "free lime" before and aner meals, and in every building. The Group acknowledges that Frost Valley requires a minimum

of one (1) adult supervisor for each eight (8) students up to and Including the 6th grade and onc (1) adult supervisor for each

10 students attending grades 7th and above. The Group agrees 10 comply wilh Ihis rule. Quiel hours are 10:00 pm to 7:00 am and

are slrictly enforced. Frost Valley YMCA Staff are not responsible for discipline of the Group participants. Should a situalion arise

belween studenls including such things as fighling or then, Frosl Volley YMCA reserves the right 10 have studenl participants senl

home. Frosl Valley YMCA Program Coordinalors have malerials explaining Ihe required studenl behavior and examples of "Behavior

Conlracls" Ihal have been used wilh success. These malerials shall be furnished upon request.

The Group shall be responsible for Ihe cleanliness of buildings and cabins occupied by il and all such facilities shall be left in a

"broom clean" condilion. The Group aUlhorizes Frosl Valley YMCA 10 inspecI buildings before and arter use for cleanliness and

damages. In Ihe event of damage, caused by Ihe Group, Ihe Group shall be responsible for Ihe cost of repairs, including but nOllimiled

10 Ihe following: fire eXlinguisher discharge - $50.00 each; graffiti - $10.00 per square inch; broken windows or screens - varies wilh

size; beyond normal cleaning - $25.00 per slaffhour required.

The Group underslands thaI Frosl Valley YMCA facililies may be shared wilh other groups. Certain programs may remain separale

and conlact wilh other groups will be minimized, bUI dining may be shared. Studenls and adult supervisors are not permilled in or near

Ihe lodging of olher groups.

The Group must provide its own vehicle to transport participanls to a medical facility in the event of a minor medical emergency.

The Group participanls shall have full use of contracted facililies and aUlhorized program supplies as planned wilh Ihe Frosl Valley

YMCA Program Coordinator. The usc of all facilitics is subjccllo scheduling and supervision by Frost Valley YMCA slafT. Smoking

is nol permilled in any Frost Valley YMCA buildings or cabins, or while allending programs. A speed limit of 15 miles per hour on

Frost Volley YMCA property is enforced. Parking musl be done only in designated parking areas. Frost Valley YMCA assumes no

responsibility for property brought onto Frost Valley YMCA premises. Frost Valley YMCA will mail, at the owner's expense, any losl

and found ilems upon the request of the Group. Frost Valley YMCA does nol permit swimming or wading in any body ofwaler

localed on property.

It is the policy of Frost Valley YMCA that groups or individuals using our facilities cannot bring or consume alcohol or controlled

substances on Frosl Valley YMCA premises. The Group sholl comply wilh this policy. Law enforcement officials will be contacted to

escort any individual under or suspecled to be under the influence of alcohol or controlled substances off Frost Valley YMCA

premises.

Outdoor campfires are to be built with permission of Frost Valley YMCA Staff in designated and established fire circles only. All fires

arc to be allended conslantly by the Group. The Group will be responsible for any damages or injuries resulting from a failure to

utilize established fire circles, leaving the fire unallended, or unauthorized campfires.

Pets are not permilled on Frost Valley YMCA premises at any time. Collecting of plants, animals, or other natural materials must first

be cleared through a Frost Valley YMCA Director. Frost Valley YMCA or other authorized personnel, shall have the right at any time

10 prohibit any activity of the Group, which Frost Valley YMCA determines or considers to be hazardous to the safety of life or

property or is contrary to Frost Valley YMCA's stated mission and goals.

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ADDITIONAL SERVICES

Frost Valley YMCA has two Level 2 eledrlc vehicle charging stations for registered guests. Reservations (call 845-985-2291 CIt

200) are highly encouraged to ensure availability. Please note this service Is NOT available at East Valley Ranch or the Frost

Volley Farm

Please complete the following sections for busing, linens, nursing services, and optional evening programs. (See additional

sheet for prices for the additional services.)

Busing - For a fee busing can be provided to and from Frost Valley YMCA. Please see attached sheet for more infonnation.

Please note that Frost Valley Is unable to order buses unless we receive a completed contract and a deposit.

1 Yes, we would like Frost Valley YMCA to arrange busing ___ No, we do not need busing.

-L Academy ___ Tonche

LInens

__ Yes, we would like Frost Valley YMCA to provide linens. V No, we do not need linens.

_ 2 sheets, I pillow, I pillow case, and I blanket ___ I blanket and I pillow.

MedIcal Needs

The Group shall be responsible for its own medical supplies and needs. The Group must either bring a qualified health care official or

arrange for Frost Valley YMCA's Nursing Service. If the Group chooses to use Frost Valley YMCA Nursing Service, medical

supplies will be provided by Frost Valley YMCA. The Group must notify Frost Valley YMCA in advance if Nursing Service is

desired. There is an additional charge for use of Nursing Service.

In the event Group wishes to utilize Frost Valley YMCA Nursing Service, a fully executed medical fonn (to be provided by Frost

Valley YMCA) for every Group participant must be received upon arrival at Frost Valley YMCA. The Frost Valley YMCA Nursing

Service will not provide medical services to any Group participant who has not provided a signed medical fonn and the Group

understands that it will be fully responsible for securing all necessary medical autention for that participant at an off-site facility.

Size ofGrollp:

I. From I to 100 2. From IOlto 150 3. From 150 and more

...J Ycs, we would like Nursing Service. ___ No, we do not want Nursing Service.

Evening Speakers

Evening Speakers are subject to availability. Prices subject to change.

I. __ Herpetology with Jack Dimuccio 2. __ Omithology with Bill Robinson 3. __ Square Dance with Joyce Hartsfield 4. __ Square Dance with Sandy Corey Freyer 5. Interactive Native American Culture with Little Hawk 6. -- Catskill Story Teller with Lourie Macintosh 7. = Revolutionary War Soldier with Sheldon Stowe

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Proposed Numbers - The Total Estimated Participants found on Page I is the proposed number of participants for lodging reserved

for the dates listed on this Agreement.

Confirmed Numbers - Please update the Estimated Participant numbers below. These numbers will be considered your Confirmed

Numbers. Please be as accurate as possible. If you do not complete the Confirmed Number section below, your Proposed Numbers

will be used.

YOUTH --,'O-"",\,,-O ___ ADULT _'J",-{~ __

Final Numbers -If you need to change the Confirmed Numbers written in this Agreement, please contact Frost Valley YMCA - in

writing via mail, fax, or email-- before July 17,2018 which Is 90 days prior to your visit. After July 17, 2018 your Confirmed

Numbers will becomc your Final Numbers. Pelham Middle School will be charged for 85% of your Final Numbers or the Actual

attendance number, whichever is higher (e.g., if Final Numbers total 100 and 75 people attend, the invoice will rellect 85 participants.)

TO SECURE YOUR RESERVATION a deposit of$ 9,398.00 is due February 15,2018. Please make deposit check payable to

Frost Valley YMCA and mail together with a signed copy of this Agreement to: Frost Valley YMCA, Attn: Reservations, 2000

Frost Valley Road, Claryville, NY 12725.

The remaining balance Is due within 30 days of date of use. Any amount outstanding after the due date is subject to a monthly

finance fcc of 1.5%.

In case of cancellation by the Group within 90 days of the scheduled trip, the deposit will be forfeited by the Group. If Frost

Valley YMCA is required to cancel this Agreement, a full refund will be made to the Group and Frost Valley YMCA shall

have no further obligation to the Group.

Before returning this Agreement, be slIre you have:

1. Read each page of this Agreement thoroughly 2. Selected and initialed for Bussing, if needed 3. Selected and initialcd for Linens, if needed 4. Selected and initialed for Evening Speakers, if needed 5. Selected and initialed for Frost Valley YMCA Nursing Service, if needed 6. Provided Confirmed Numbers 7. Signed and dated the last page 8. Attached a check, purchase order, or letter of commitment made payable to Frost Valley YMCA for $ 9,398.00 9. Made arrangements to send the Certificate of Insurance at least 14 days prior to Arrival Date

Pricing:

Item Description School - Prime 3-Day-Adult School - Prime 3-Day-Student

Estlmatcd Ouantity 26

227

Unit Price $207.00 $207.00

Extended Price $5,382.00

$46,989.00

We accept this Agreement and will communicate these Terms of Agreement to all group personnel involved in the camp program prior to arri I at camp.

Group School Administrator I Date

YMCA School Programs Director I Date

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