people prayer praise 2016 Youth Camp July 4 th -8 th, 2016 Corner Stone Conference Center 7545 Highway 29 North Browns Summit, NC 27214

Transcription

1 peple prayer praise 2016 Yuth Camp July 4 th -8 th, 2016 Crner Stne Cnference Center 7545 Highway 29 Nrth Brwns Summit, NC 27214

2 Dear Parents and Campers, Camp is right arund the crner, July 4 th 8 th, 2016 at CORNER STONE CONFERENCE CENTER. Check in time n the 4 th is 2:00pm-4:00pm. Our first evening is scheduled s please be prmpt!! If yur child is six years f age r lder, make plans nw fr him/her t attend. (Children yunger than six years f age MUST be accmpanied by an adult/parent/guardian at all times.) In this packet, yu will be asked t designate wh may pick up yur child. On the last day f camp, July 8 th, all campers will be check ut thrugh their Cunselr r Camp Directrs by 11:00am. This prcedure helps us t ensure that all children are released t the crrect persns. We are als asking camper t leave all games, tys, and audi/vide devices at hme (ipads, ipds, cell phnes, etc.). There are tw reasns fr this; first, we shuld nt want any valued pssessins lst at camp, and secnd, we d nt want ur campers distracted frm the purpse f the camp. Abslutely NO CELL PHONES will be allwed fr campers/yuth. All campers persnal belngings will be inspected at check in. Anything deemed unnecessary will be withheld and returned at the end f the week. Pranks f any kind are prhibited. Failure t fllw the N Prank guidelines may result in dismissal frm camp. The price f camp ($120.00) is nn-refundable. The Brwn Summit Yuth Camp, where camp will take place, is set in a natural envirnment. If yur child is allergic t the sun, r is severely allergic t dust r grass, he/she may nt be able t fully participate in camp activities. Yu may want t cnsult yur child s physician fr advice. Als, any child that is taking medicatins must be able t selfadminister their wn medicatins. If unable t d s there shuld be a respnsible adult t accmpany the child t camp that has been given written permissin t assist that child. (Written nte shuld be placed with the child s flder upn arrival at camp.) As yu pack fr camp, remember that while the days are rather warm, the evenings tend t be cl. We wuld recmmend packing a sweatshirt r warm pajamas. We als have a Dress Cde that all campers and wrkers must abide by. Wmen/Girls/Teens are t wear shirts & skirts/dresses belw the knee and MUST be mdest in nature (i.e. length and size), at all times while utside their cabin/drmitry. N sleeveless dresses/shirts r tank tps. Men/Bys/Teens MUST wear pants and shirt at all times while utside their cabin/drmitry. N tank tps, white tee shirts, r muscle shirts. N clthing with bscene gestures r slgans will be allwed. Wear a belt please! (Refer als t ITEMS list). We are anticipating a great year! Feel free t call Tny Harper if yu have any questins abut the camp. We lk frward t seeing yu and yur children at camp. Tny Harper ( ) Camp Directr CAMPER REGISTRATION 2016 WEST ASHEBORO YOUTH CAMP Name Address City State Zip Age Sex Entered Grade Phne # Emergency # Parent s Name Church Pastr s Signature T-Shirt Size: Circle Size (final date fr shirt size entry is May 31 st ) Adult Reg: Sm Med Lg XL XXL Adult Lng Sleeve: Other Yuth: Sm Med Lg XL XXL Sm Med Lg XL XXL Other Other The cst fr each child/adult is $ nn-refundable. Please make checks payable t: West Ashebr Church f Gd Registratin Due by May 31 st, 2016 Payment is required upn registratin Day f Camp Registratin $ there may nt be a CAMP T-shirt available with late registratin.

3 First Aid and Emergency Medical Treatment I recgnize there may be ccasins where I r my child, if a participant, may be in need f first aid r emergency medical treatment as a result f an accident, illness, r ther health cnditin r injury. I d hereby give permissin fr West Ashebr Church f Gd t seek and secure any needed medical attentin r treatment fr my child r myself, including hspitalizatin, if the need arises. In ding s I agree t pay all fees and cst arising frm this actin t btain medical treatment fr my child r myself. I give permissin t the physician(s) and ther medical persnnel t administer any needed medical treatment, x-rays, injectins, anesthesia, hspitalizatin, I-V s, bld transfusins, medicatins, and surgery and, again, I agree t pay fr the medical treatment fr my child r myself. PARENT OR GUARDIAN SIGNATURE DATE HEALTH HISTORY (check & give apprximate dates and use extra paper if necessary) Diabetes Heart Defect/Disease Cnvulsins Hypertensin Hay Fever Asthma Bleeding/Cltting Disrder Allergies t: Fd (please list, attach nte if necessary) Insect Stings If checked, will yu send EpiPen Sulfa Medicatins Penicillin Other drugs, (attach nte if necessary) Date f last tetanus sht? What treatment is required fr allergy? What treatment is required fr asthema? What treatment is required fr diabetes? Dietary Mdificatins Current medicatins (send with written instructins) Other diseases r details f abve Name and address f Family Physician Physician s phne number (at practice) Date last seen INSURANCE COVERAGE***(Yu CANNOT attend campgrunds withut insurance inf and a Pastr s signature) ******Nte: Make a legible phtcpy f the insurance card, frnt and back, and attach the cpy t this frm. Yu may want t enlarge the cpy t ensure it can be clearly read. (n insurance write: NA) Insurance Cmpany Phne Plicy Number Primary Plicy Hlder s Name Parent r Guardian s Signature Signature Date signed Camp Address: 7545 US Highway 29 Nrth / P.O. Bx 150 Brwns Summit, NC 27214

4 WEST ASHEBORO CHURCH OF GOD PERMISSION WAIVER FORM 2016 (PLEASE DO NOT LEAVE ANY BLANK LINES. MUST SIGN AT BOTTOM.) Participant s Name Address City State Zip Cde Hme Phne Age Birth Date Mther s Name Mther s Wrk Phne Cell Phne Father s Name Father s Wrk Phne Cell Phne Other emergency cntact phne number and relatinship: It is my understanding that participating in transprtatin, prgrams, recreatinal and ther activities prvided by West Ashebr Church f Gd during 2016 is a privilege. Prir t my participatin r my children s participatin in such transprtatin and activities, I recgnize there are certain risks assciated with the transprtatin and activities, including but nt limited t physical injury due t activity-related accidents, physical injury due t transprtatin-related accidents, illness, r even death. In additin, I recgnize and acknwledge that there may be ther risks inherent in these activities f which I may nt be presently aware and hereby d vluntarily assume any such risks. Release f Liability By signing this Permissin/Waiver frm, I expressly warrant that the child named abve r I (if I am a participant) am capable f withstanding bth the physical and mental demands f the transprtatin and activities. I als expressly assume all risks cncerning my child r my participatin in the activities, whether such risks are knwn r unknwn t me at this time. I further release West Ashebr Church f Gd frm any claim that my child afrementined may have r that I may have against them as a result f injury r illness incurred during the curse f my child r my participatin in the transprtatin and activities. This release f liability shall include (withut limitatin) any claims f negligence r breach f warranty. This release f liability is als intended t cver all claims that members f the child s r my family r estate, heirs, representatives, r assigns may have against West Ashebr Church f Gd. I als further agree t indemnify and hld harmless West Ashebr Church f Gd frm any and all claims arising frm my child s r my participatin in any f the afrementined activities and prgrams, r as a result f injury r illness f my child r myself during such transprtatin and activities. PARENT OR GUARDIAN SIGNATURE DATE

5 PARENT INFORMATION, ALL THE STUFF YOU WANT TO KNOW West Ashebr Church f Gd Yuth Camp Camper Release List My child may be released t the fllwing peple: Drive f Church Van: Parent: Other: My child may NOT be release t the fllwing peple: Please label and bring the fllwing Items: Recmmend travel size tiletries Bedding Clthes Tiletries Other Items Pillw Bys: Pants/Jeans Twels BIBLE Sheets Girls: Skirts/Dresses belw knees Washclths Blanket Underclthes Dedrant Laundry bag Slippers Sweatshirt/Sweater Cmb/Brush Vitamins Scks Shamp Medicatins If I send smene wh is nt listed here t get my child, I need t send a signed nte with that persn and make cntact with Camp Persnnel. Tennis Shes Flip-flps/wet shes fr shwer Swimwear Church attire/casual r dress clthes Tth Paste/Brush Flashlight Insect Repellent Sunscreen BELOW fr YOUTH CAMPERS N Cell Phnes N ipads, Tablets N ipds N Music Bys swimwear will be pants/shirt (n white). We swim ut in the pen N gaming devices etc. We d ask nw that all persns attending the West Ashebr Church f Gd Camp make preparatins t abide by all rules and instructins listed in this applicatin. We want all ur yuth and peple attending t have a gd clean time f fun. While we certainly understand that all f us have different backgrunds and that we are all f different levels f grwth we have said up frnt that this is a hliness yuth camp. The items listed in ur apparel fr bys and girls will als apply t ur adults. Nte: If yu plan t be cnsidered as a leader r a wrker yu shuld knw that yur example f lifestyle shuld be cnsistent with mdesty in hliness. We want ur camp t remain mdest in every area. Items which reveal shulders and legs abve the knee are inapprpriate. Please help us while packing fr yur children and yurself t take these matters int cnsideratin. Here are a cuple f things t remember: Late entries will have a $45.00 late fee. Deadline fr Applicatin entries is May 31 st!!! The cell phne rule is Crner Stne Rule! Our camp directrs will take the phnes up and place in safe keeping until the end f camp. If fr any reasn yu need t cntact yur child during the week f camp, the fllwing leaders will be available 24/7: Br. Matt Gunter ( ) Br. Tny Harper ( ) Br. Frankie Watsn ( )