TAC Leader Manual 2016 - Libbey

Transcription

Troop Adventure
Camp
Leader Manual
Camp Libbey
Troop Adventure Camp  Leader Manual
Girl Scouts of Western Ohio  Camp Libbey
Table of Contents
Purpose of Camp
Girl Scouts of Western Ohio Council Goals, Girl Scout Promise and Law
Important Dates
Planning Checklist
Paying for Camp/Refunds
Camp Libbey Description and Map
Camp Address, Contact Information and Directions to Camp
Leader Orientation
Check-In and Check-Out
Planning With Girls
Caregiver Meeting
Paperwork
Schedule
Activities—Planning and Hints
1
2
3
4
5
6
7
7
8
9
10
11-12
13-15
16
Activity Options
Adventure Challenge Education Programs (A.C.E.)
Arts and Crafts
Nature
Sports
Pool
Other Camp Activities
Me Time/Free Time
Closing Activity and Skits
Rainy Day Activities
Sister Troops/Sharing a Unit
Kapers
Meals and Pack-outs
16
17
18
19
20
21
22
22
22-23
23
24
25-26
Health and Safety
Healthcare Policies
Camp Rules
Camp Policies and Procedures
27-28
29
30-33
Preparing for Camp
Individual Packing List
Troop Packing List
Arrival Day Checklist
34
35
36-38
Forms
Activity Request Form
Pack-out Request Form
T-Shirt/Patch Order Form
Caregiver Permission
Camper Release/High Risk Form
A.C.E. Release Form
Health History Form
Photo Release for Minors
Photo Release for Adults
TAC Registration Roster
39
40-41
42-43
44
45
46-47
48-50
51
52
53-54
ER:bd/1101124-006
Purpose of Camp
When you think of “camp,” what words come to mind? Tents? Swimming? Crafts? Nature? Hikes? Creeking?
Star gazing? Songs? Games? Of course! But what else?
Why Camp?
Camp is a magical place unlike anywhere else in the “real world”—it’s a strange and wonderful place filled
with extraordinary opportunities for girls to become their best selves!
Imagine a place where girls take safe risks, make new friends and learn new things. Girls who attend Girl
Scout camp are in an all-girl environment—an environment where they can be themselves and make their
own decisions. Girls who come to camp are free to try new things outside of the roles they play every day.
No one needs to know that Susie gets straight A’s, Mary’s parents are getting divorced or that Alice is scared
of bugs. At camp, girls get to be themselves and have fun exploring new activities and experiences. By the
end of the week, these girls have formed an unforgettable bond—memories that last them a lifetime.
Learning and Growth
The American Camp Association (ACA), the preeminent association of camps in the world, recently
published Directions - Youth Development Outcomes of the Camp Experience, the largest research study
of camper outcomes ever conducted in the United States. What does the research show?
Caregivers, camp staff and children reported significant growth in
 Self-esteem
 Peer relationships
 Independence
 Adventure and exploration
 Leadership
 Environmental awareness
 Friendship skills
 Values and decisions
 Social comfort
 Spirituality
CAMPERS SAY
PARENTS SAY

Camp helped me make new friends. (96%)


Camp helped me get to know other campers
who were different from me. (94%)
My child gained self-confidence at camp.
(70%)

Camp helped me feel good about myself.
(92%)
My child continues to participate in activities
learned at camp. (63%)

My child remains in contact with friends
made at camp. (69%)


At camp, I did things I was afraid to do at first.
(74%)
Girl Scout Leadership Experience
This is what makes Girl Scout camp unique. Troop Adventure Camp offers a unique environment for
leaders to guide their girls to achieve the council goals utilizing the three program processes:



Girl-Led
Cooperative Learning
Learning By Doing (Experiential Learning)
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Girl Scouts of Western Ohio Council Goals
Camp is a place where the council goals for girls come to life in extraordinary ways. Think about these
examples:
1. Girls will understand themselves and their values.
 Girls develop a strong sense of self.
 Girls develop positive values.
2. Girls will use their knowledge and skills to explore the world.
 Girls gain practical and healthy life skills.
 Girls seek challenges in the world.
 Girls develop critical thinking.
3. Girls will care about, inspire and team with others locally and globally.
 Girls develop healthy relationships.
 Girls promote cooperation and team building.
 Girls can resolve conflicts.
 Girls advance diversity in a multicultural world.
4. Girls will act to make the world a better place.
 Girls can identify community needs.
 Girls are resourceful problem solvers.
 Girls advocate for themselves and others, locally and globally.
 Girls educate and inspire others to act.
 Girls feel empowered to make a difference in the world.
Girl Scout Promise and Law
Camp is a place guided by the principles found in the Girl Scout Promise and Law
GIRL SCOUT PROMISE
GIRL SCOUT LAW
On my honor, I will try:
To serve God and my country,
To help People at all times, and
To live by the Girl Scout Law.
I will do my best to be:
honest and fair,
friendly and helpful,
considerate and caring,
courageous and strong, and
responsible for what I say and do,
and to:
respect myself and others,
respect authority,
use resources wisely
make the world a better place, and
be a sister to every Girl Scout.
Girl Scouts of Western Ohio
Camp is a place where we help build girls of courage, confidence, and character, who make the world a
better place.
Camp is about all the little things that come together to make a world of difference in the lives of girls!
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Important Dates
 February 24, 2016
Troop Adventure Camp Registration Opens
(Includes $10 non-refundable deposit)
 May 7, 2016
TAC Leader Orientation (9:00 a.m.–12:00 p.m. at Camp Libbey)
 May 27, 2016
Final deadline for all camp fees and forms:
Pre-Camp Forms:
 Registration Roster
 Activity Request Form
 Pack-out Request Form
 T-Shirt Order Form
Camp Fees:
 Two-night Session:
 Upon arrival
$90 per girl
Camp Forms (Due when you arrive at camp):
 Registration Roster—updated
 Caregiver Permission Form
 Health Information Form—must remain on file at camp permanently
 High Risk Form (Only if taking archery or canoeing)
 Adventure Challenge Education Form (Only if participating in challenge
course activities)
 Release for Minor/Adult (Photo release)
You must meet the deadlines to ensure the best possible experience for your
troop. If you submit your fees or forms after the deadlines, we cannot guarantee
your attendance, activities, pack outs, or T-shirt orders.
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Planning Checklist
May
 May 7, 2016, TAC Leader Orientation (Camp Libbey, 9:00 a.m.–12:00 p.m.)
 May 27, 2016, Final deadline for all camp fees and forms
 Plan camp with your girls during troop meetings (“Planning With Girls,” page 9)
 Prepare girls for outdoor living (weather, bugs, etc.)
 Prepare girls for overnight camping (sleeping away from home)
 Label all troop gear
 Hold a caregiver meeting (see “Caregiver Meeting,” page 10)
 Create troop rules/agreements with each other to use while at camp
Two Weeks before Camp
 Familiarize girls with camp rules/agreements, procedures, and kapers
One Week before Camp
 Purchase troop supplies (see “Troop Packing List,” page 31)—bring enough of everything for entire
session
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Paying for Camp/Refunds
Basic Fee
The basic registration fee includes all on-site program activities, staff, lodging, meals, and supplies:
 Regular 2-night session:
$90 per girl
 Extended 4-night session:
$160 per girl
Refund Policy
Girl Scouts of Western Ohio will not refund deposits unless the desired program opportunity is full or is
cancelled. Caregivers may submit written refund requests for the balance of the camp fee only under the
following special circumstances:




Serious illness or accident (With a physician’s statement).
Death in the immediate family.
Camper moves from Girl Scouts of Western Ohio service area before camp begins.
Camper is required to attend summer school that will conflict with the camp schedule.
All refund requests must be submitted 30 days before your camp date.
Troop Registration Fee
When you submit your Troop Adventure Camp Registration Form (found online at gswo.org), you must
include the deposit for your troop. You should deduct this fee when making your final payment.
Balance Due (May 27, 2016)
The balance of your troop registration fees is due on May 27, 2016. Please remember to deduct the $10
per girl registration fee from your balance. The deposit fees are transferable to other girls with in the
same troop. If you do not submit your deposit by May 27, 2016 your spot will go to a troop on the waiting
lists.
The balance due can be paid together as a group or by individual participants. If sending in individual
checks, please include the participants name and troop number on the memo line. Checks should be made
out to Girl Scouts of Western Ohio and should be mailed to:
ATTN: Debbie Santel
4930 Cornell Road
Cincinnati, OH 45242
Registration Rosters
Please complete the Registration Roster at the end of the manual and turn it in with the balance due. Bring
an updated copy with you to turn in at check in.
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Camp Libbey Description
Nestled along the banks of the scenic Maumee River just outside of Defiance, Ohio, Camp Edward
Drummond Libbey has almost 350 acres of fields, forests and ravines. This modern facility includes hot
running water and flush toilets in all living units (lodges or tents). Camp staff instructs a variety of program
activities for girls that include swimming, archery, crafts, hiking, nature and environmental activities, a low
and high challenge course, and much more. When not participating in a selected activity, troops can use
their own time to pursue badge or Girl Scout Journey requirements, or plan their own activities.
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Camp Street Address— Camp Libbey
28325 State Route 281
Defiance, OH 43512
Camp Phone Number—Camp phone is for official camp business and emergencies only: 419.784.5888.
Directions to Camp
Directions from South Cincinnati/Dayton)
Take I-75 North all the way to the Cygnet Exit (Exit 171). At the end of the exit ramp, turn left and cross over I-75. Just
on the other side of the bridge you are going to turn right onto State Route 25 (it looks like an access road). Follow
State Route 25 to State Route 281. Turn left onto State Route 281. You will be on State Route 281 for about 35 miles.
On State Route 281, you will go through four stop signs at State Routes 235, 65, 109 and 108. Once you go through the
stop sign at State Route 108, Camp Libbey is about 7−8 miles on the right.
Directions from I 80/90 coming either East or West
Get off of 80/90 at the State Route 15/Bryan Exit (Exit 13). After you pay the toll, head south into Bryan on State Route
15. Follow 15 through Bryan. As you leave Bryan, the first stop light is State Route 6. Take a left onto State Route 6.
Take it to State Route 66 turn right. Follow State Route 66 in Defiance, once you pass Meijer’s, you will cross over
State Route 24 and turn left onto State Route 24. Once on State Route 24, go to the next exit (exit 28) and get off at
the end of the exit, turn right. You are now on State Route 281. Go to second stop light and turn left (still on 281).
Camp Libbey is about 2.3 miles down the road on the left.
Directions from Napoleon, OH
Take 108 south to State Route 281, turn right onto State Route 281. You will go approximately 8 miles and Camp
Libbey will be located on your right.
Or
Take State Route 24 towards Defiance. Take Exit 28 (for Defiance) and turn left at the end of the exit ramp. You will
cross over State Route 24. You are now on State Route 281. Go to second stop light and turn left (still on 281). You will
see the GM Powertrain Plant on the left. Camp Libbey is about 2.3 miles down the road on the left.
Directions from Toledo, OH
Take State Route 24 West. Go through Waterville and past Grand Rapids. State Route 24 will then go into four lanes at
Napoleon, OH. Continue on State Route 24 towards Defiance. Take Exit 28 (for Defiance) and turn left at the end of
the exit ramp. You will cross over State Route 24. You are now on State Route 281. Go to second stop light and turn
left (still on 281). You will see the GM Powertrain Plant on the left. Camp Libbey is about 2.3 miles down the road on the
left. Drive into camp (through the front gate) go to the second right hand gravel road and turn right into the parking lot
(there is a sign that says baggage parking/office).
Directions from North via 23 South
Take State Route 23 South to Toledo, it will merge with I-475. Go to exit for Maumee/ Napoleon (US24). Then follow
above directions from Toledo.
Leader Orientation
Leaders accompanying their troops to camp do not need to be Troop Camp Certified; however, at least
one adult from each troop who has never attended TAC must attend TAC Leader Orientation in May.
Leader Orientation is not required for experienced leaders; however, all leaders are welcome and
encouraged to attend since every summer is a little different. TAC Leader Orientation does not qualify you
as Troop Camp Certified. The orientation date is:
Leader Orientation—May 7, 2016, 9:00 a.m.–12:00 p.m.—Camp Libbey Dining Hall
Note: If you did not attend orientation, you may still attend TAC.
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TAC Session One at Camp Libbey
July 11, 2016–Check-In, 10:00 a.m.
Check-In Procedures
1. Arrive at camp and back into Parking Lot A.
2. Troops will be greeted by staff upon arrival in the parking lot and be directed to the front porch of
the Administration Building for check-in.
3. Each person (campers/adults) must complete and turn in all paperwork at check in.
4. Troops will be asked to load all of their gear into one or two vehicles, which can be driven to their
assigned unit and unloaded (everyone else will walk to the unit).
5. Once all cars are unloaded, one vehicle per troop can remain parked at the unit as an emergency
vehicle. All other vehicles must be moved to the designated parking lot.
July 13, 2016–Checkout, 10:00 a.m.
Check-Out Procedures
1. Troops will pack up their belongings and clean their units prior to breakfast.
2. Final closing will begin after breakfast.
TAC Session Two at Camp Libbey
July 13, 2016–Check-In, 2:00 p.m.
Check-In Procedures
1. Arrive at camp and back into Parking Lot A.
2. Troops will be greeted by staff upon arrival in the parking lot and be directed to the front porch of
the Administration Building for check-in.
3. Each person (campers/adults) must complete and turn in all paperwork at check in.
4. Troops will be asked to load all of their gear into one or two vehicles, which can be driven to their
assigned unit and unloaded (everyone else will walk to the unit).
5. Once all cars are unloaded, one vehicle per troop can remain parked at the unit as an emergency
vehicle. All other vehicles must be moved to the designated parking lot.
July 15, 2016–Checkout, 2:00 p.m.
Check-Out Procedures
1. Troops will pack up their belongings and clean their units prior to breakfast.
2. Final closing will begin after lunch.
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Planning With Girls
Camp is for the camper, so it is critical that you engage your girls in planning every aspect of camp. When
you engage girls in planning, they learn important skills, such as leadership, teamwork, communication and
problem solving. In addition, you are helping them get the most from their camp experience, by actually
listening to their wants, needs and interests. Involving the girls in planning takes extra time, but your time
and energy will be worthwhile, so start the planning process early (refer to the planning checklist).
Girls should help plan all of the following:

Choosing activities.

Establishing troop rules/agreements and consequences.

Planning cookout.

Deciding on T-shirt orders.

Planning Me Time and free time activities.

Planning rainy day activities.

Planning “Sister Troop” activities (SWAPS).

Establishing Unit Kapers and making a Troop Kaper Chart.
Helpful Hints for Girl Planning:
1. Get the girls in a circle.
2. Explain to them that they get to plan their camp experience by choosing activities from the list
beginning on page 15. Please remember that some activities have age requirements.
3. Give them any guidelines/rules or available options.
4. Ask the girls to brainstorm their ideas. Remember, there are no bad ideas in brainstorming.
5. Review the options and eliminate any that are impossible.
6. Ask the girls to vote on the ideas. You can use a hand count, secret ballot or sticker that they can
place next to their top choice(s).
7. Identify the top choice(s).
8. Fill out any necessary forms (i.e. Activity Request Form, Pack-Out Request Form, and T-Shirt Order
Form).
9. Create any necessary supply lists, based on the decisions.
10. Inform the caregivers of the plans.
Planning Tip
Before you go to camp, have each girl set a personal goal to meet while at camp. Evaluate/debrief with them
about their goals after camp.
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Caregiver Meeting
The caregiver meeting is critical to ensuring that the parents are “on the same page” with the troop plans.
Host the meeting in May so that everyone has plenty of time to finalize any details or preparations. If you
have any questions before this meeting, please contact Elizabeth Rogers, the Camp Director at
[email protected].
Caregiver Meeting Agenda
1. Camp Information
a) The purpose of camp
b) Location and phone number (Emergency use only)
c) Activities
d) Meals (Dietary requirements)
e) T-Shirts
f) Kapers
2. Health and Safety
a) Visitor Policy
b) Medication Procedures
c) Contagious Conditions Policy (Health Check and Lice Check)
3. Preparing for Camp
a) What to bring to camp (Individual Packing List)
b) What not to bring to camp (Drugs/alcohol, valuables, electronics)
c) Meeting location and pick-up/drop-off times
4. Camper Mail
a) They can give mail to you beforehand or send mail to:
Camper’s Name
Troop Number
Camp Libbey
28325 State Route 281
Defiance, Oh 43512
b) Mail sent through the US Postal Service should be mailed several days prior to camp or sent
express delivery to ensure the mail is received while their camper is at camp.
5. Paperwork
a) Collect signed Permission Forms from caregivers
b) Collect updated/signed Health Information Forms from caregivers

Every participant (girls and adults) must have a completed Health Information Form.
Individuals without forms (or with incomplete forms) will be sent home immediately.

All forms must have a caregiver signature at the bottom of the form.

All forms must have a caregiver signature in the “Permission to Treat” box.

All forms must be completed within the past 12 months.
6. Questions and Concerns
10
Paperwork Checklist
Pre-Camp Forms (due May 27, 2016):
 Registration Roster
1. Please complete the Registration Roster.
2. Turn in with the deposit.
 Activity Request Form
1. Select your activities.
2. Please note on the form if:

You would like to do an activity with a “Sister Troop.”

You would like to request a pack-out.

You would like to have a polar or jungle breakfast

You would like to have extra Free Time.
 Pack-out Request Form
1. Fill out one form for each pack-out
2. You must request a pack-out if you request Troop Camp Training, Polar Breakfast, or Jungle
Breakfast.
 T-Shirt Order Form (Patches are included in the camp registration fee for 2016)
1. Fill out the form if you would like to purchase T- shirts.
2. Pay for the T-shirts with your final balance of camp fees (you may use one check for everything.).
The T-shirts are a new design every year and will be different then the resident camp shirts this year.
Camp Forms (Due when you arrive at camp):

Registration Roster
1. Please bring the updated copy with you to camp.

Caregiver Permission Form (For every girl)
1. Every girl must have a signed Caregiver Permission Form.
2. Troop leaders will keep the permission forms throughout camp and for the ride home.
3. Any girl without a permission form will be sent home immediately.

Health Information Form (For every person attending camp—must remain on file at camp
permanently)
1. Every participant (girls and adults) must have a completed Health Information Form except
Section E. Individuals without forms (or with incomplete forms) will be sent home immediately.
2. All forms must have a caregiver signature at the bottom of the form.
3. All forms must have a caregiver signature in the “Permission to Treat” box.
11
4. All forms must be completed within the past 6 months.
5. The Health Information Forms will not be returned at the end of camp—they must remain on file at
camp. If you would like to have copies of the Health Information Forms, please make copies before
arriving at camp.
 Release for Minor/ Release for Adult (Photo/Media release form)
1. Every participant (girls and adults) must have a signed form in order to take part in pictures.

High Risk Form (If taking archery or canoeing)
1. If your troop is participating in archery, or canoeing every participant (girls and adults) must have a
signed High-Risk Form.

Adventure Challenge Education (A.C.E.) Agreement Form ( If doing low or high challenge course,
climbing wall, or ladders)
1. If your troop is participating in the low or high challenge course, Zip Line, or climbing wall, every
participant (girls and adults) must have a signed Adventure Challenge Education Participant
Agreement Form.
12
Schedule
The camp schedule is subject to change, without notice, depending on the needs of camp. You will
receive your camp schedule when you check-in. You will have an opportunity to make schedule
changes at the leader meeting.
July 11 - 13, 2016 Schedule
Day 1 - Monday
10:00–11:00 a.m.
10:00 a.m.–12:00 p.m.
12:15–12:30 p.m.
12:30–1:30 p.m.
1:30–2:00 p.m.
2:15–3:10 p.m.
3:25–4:20 p.m.
4:35–5:30 p.m.
5:45–6:00 p.m.
6:00–7:00 p.m.
7:15–8:10 p.m.
8:20–9:15 p.m.
9:15–10:15 p.m.
10:30–11:00 p.m.
11:00 p.m.
Day 2 - Tuesday
6:45–7:30 a.m.
7:45–8:00 a.m.
8:00–9:00 a.m.
9:10–10:05 a.m.
10:20–11:15 a.m.
11:35 a.m.–12:30 p.m.
12:30–12:45 p.m.
12:45–1:45 p.m.
2:00–3:00 p.m.
3:15–4:10 p.m.
4:25–5:20 p.m.
5:35–5:50 p.m.
5:50–6:50 p.m.
7:00–8:10 p.m.
8:20–9:20 p.m.
9:30–10:20 p.m.
10:30–11:00 p.m.
11:00 p.m.
Day 3 - Wednesday
Troop Check - In
Unit Orientation, Unpack, Swim Tests
Singing Porch and Hoppers
Lunch
Leader Meeting
Activity 1
Activity 2
Activity 3
Flag Ceremony, Singing Porch, and Hoppers
Dinner
Activity 4
Unit S'mores
Troop Time
Quiet Time
Lights Out
Polar Bear Swim (Optional)
Flag, Singing Porch, and Hoppers
Breakfast
Activity 5
Activity 6
Activity 7
Lunch
Me Time
Activity 8
Activity 9
Dinner
All Camp Game
Closing Campfire
Troop Time
Quiet Time
Lights Out
13
7:30–8:30 a.m.
8:45–9:00 a.m.
9:00–9:45 a.m.
9:45–10:00 a.m.
Pack and Clean Unit
Breakfast
Closing
July 13 - 15, 2016 Schedule
Day 1 - Wednesday
2:00–3:00 p.m.
3:00–5:00 p.m.
5:15–5:30 p.m.
5:30–6:30 p.m.
6:40–7:10 p.m.
7:25–8:20 p.m.
8:30–9:20 p.m.
9:30–10:20 p.m.
10:30–11:00 p.m.
11:00 p.m.
Day 2 - Thursday
6:45–7:30 a.m.
7:45–8:00 a.m.
8:00–9:00 a.m.
9:10–10:05 a.m.
10:20–11:15 a.m.
11:35 a.m.–12:30 p.m.
12:30–12:45 p.m.
12:45–1:45 p.m.
2:00–3:00 p.m.
3:15–4:10 p.m.
4:25–5:20 p.m.
5:35–5:50 p.m.
5:50–6:50 p.m.
7:00–8:10 p.m.
8:20–9:20 p.m.
9:30–10:20 p.m.
10:30–11:00 p.m.
11:00 p.m.
Day 3 - Friday
7:00–7:55 a.m.
8:05–8:20 a.m.
8:20–9:20 a.m.
9:30–10:25 a.m.
Check In
Unit Orientation, Unpacking, Swim Test
Flag Ceremony, Singing Porch, and Hoppers
Dinner
Leader Meeting
Activity 1
Unit S'mores
Troop Time
Quiet Time
Lights Out
Polar Bear Swim (Optional)
Breakfast
Activity 5
Activity 6
Activity 7
Lunch
Me Time
Activity 8
Activity 9
Dinner
All Camp Game
Closing Campfire
Troop Time
Quiet Time
Lights Out
Pack and Clean Unit
Breakfast
Activity 7
14
10:35–11:30 a.m.
11:40 a.m.–12:35 p.m.
12:35–12:45 p.m.
12:45–1:45 p.m.
1:45–2:00 p.m.
Activity 8
Activity 9
Lunch
Closing
15
Activities
Planning Your Troop’s Activities
1. Explain to the girls that they plan their camp experience by choosing activities from the list below.
2. Ask the girls to choose all the activities that interest them. Please remember that some activities
have age restrictions. Write all the activities down on a large piece of paper.
3. During TAC, there are 9 activity slots. One slot will be used for swimming, leaving eight (8) slots to
plan for.
4. Complete the Activity Request Form by writing the activities in order of preference—refer back to the
number of stickers each activity received. The form is due no later than May 27, 2016.
115. If the activity requires you to bring any materials (i.e. you must bring your own T-shirt for Tie-Dye),
make sure you add the supplies to your Troop Packing List.
Helpful Hints

If you select eight activities, your schedule will be completely filled; therefore, you will not receive
any free time, except the daily Me Time. Many troops request additional free activity times to relax or
work on patches/badges. If you would like to have free activity slots, please write “Free Time” on the
Activity Request Form.
Adventure Challenge Education Programs (A.C.E.)
• Team Games
Daisy–Ambassadors
Girls work through challenges focused on teamwork and communication.
Activity Slots: 1
• Climbing Wall
Brownie–Ambassadors
Take on the challenge of traversing our 30 foot climbing wall.
Activity Slots: 1
• Ladders
Junior–Ambassadors
Work in partners or individuals to climb the Giants Ladder or Firecracker Ladders on the Challenge
Course.
Activity Slots: 1 to 2 depending on troop size
• Crate Stacking
Girls will experience the challenge of stacking and climbing up crates. Girls will work as a team to see
how high they can get.
Activity Slots: 2
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• Zip Line
Cadette–Ambassadors
Girls will get the thrill of sliding off the 30-foot high platform and zipping nearly 350 feet to the end of
the zip line.
Activity Slots: 2
• High Challenge Course
Cadette–Ambassadors
Girls climb the wall and then work their way around five separate elements 30 feet off the ground
and zip down the zip line.
Activity Slots: 3
Arts and Crafts
• Candles
Daisy–Ambassadors
Create candles by pouring colorful wax and glitter into shaped molds.
Activity Slots: 1
• Classic Camp Crafts (New)
Daisy–Ambassadors
Spend time making all the classic camp crafts like friendship bracelets, Gods eyes, and Boondoggle.
Activity Slots: 1
• Dream Catchers (New)
Daisy–Ambassadors
Create an authentic looking Native American craft, while learning about its history and legend.
Activity Slots: 1
• Scout Staffs (New)
Find (or bring) and personalize your own scout staff using pocket knives and other adornments,
while learning the history and multiple uses for camping.
Activity Slots: 1
• Tie-Dye and Reverse Tie-Dye
Daisy–Ambassadors
Create fabric designs using colored dyes on white fabric and bleach on colored fabric. **Troops
must bring their own fabrics. Recommended 100% cotton, pre-washed.
Activity Slots: 1
• Sewing Silly Monsters (New)
Cadettes–Ambassadors
Learn the basics of hand sewing and make your own stuffed monster out of felt.
Activity Slots: 1
• Sculpy Beads
Daisy–Ambassadors
Use sculpy clay to create your own beads for a necklace or bracelet.
Activity Slots: 1
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• Exploding Scrapbooks
Juniors–Ambassadors
Create scrapbooks using paint, markers, stickers, and glitters.
**Troops must bring their own pictures
Activity Slots: 1
• Duct Tape (New)
Daisy–Ambassadors
Create some amazing projects out of Duct Tape. Girls will get to pick their project.
Activity Slots: 1
• Paracord Bracelets (New)
Cadettes–Ambassadors
Create your own paracord survival bracelet.
Activity Slot: 1
• Painting
Daisy–Ambassador
Learn fun new techniques and paint a beautiful picture to take home.
Activity Slot: 1
Nature and Science
• Creek Peek
Daisy–Ambassador
Walk in the creek and explore the ecosystem.
** You must bring shoes and clothing that can get wet and dirty.
Activity Slot: 1
• Creek Stomp
Daisy–Ambassador
Just good ol’ fashion down and dirty fun. Explore the creek as you stomp around getting wet
and muddy.
** You must bring shoes and clothing that can get wet and dirty.
Activity Slot: 1
• Fire Building (New)
Daisy–Ambassador
Learn how to safely build and light a fire.
** You must bring a hat or bandana for safety.
Activity Slot: 1
• Nature Hike
Daisy–Ambassador
Explore the trails of camp and check out everything nature has to offer.
Activity Slot: 1
• Sensory Hike
Daisy–Ambassador
Explore the outside world using your senses. Have fun learning about the five
senses and how they help you and other animals when you’re camping.
Activity Slot: 1
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• Orienteering
Brownie–Ambassador
Learn to use a map and compass by playing games and finding your way around camp.
Activity Slot: 1
• Egg Drop Engineers (New)
Drop a raw egg without it breaking using materials to engineer a protective covering.
Activity Slot: 1
• Bug Lab
Daisy–Ambassador
Have eye-popping fun while exploring the world of bugs.
Activity Slot: 1
• Messy Science
Daisy–Ambassador
Spend time making flubber, exploding film canisters, making secret messages and other fun messy
experiments.
Activity Slot: 1
• Survival Skills (New)
Junior–Ambassador
Learn outdoor survival skills, like how to make a matchless fire, obtain food and water if you were lost
in the wilderness, build a shelter, knife safety, and tie the right knots.
Activity Slot: 2
• Complicated Contraptions (New)
Junior–Ambassador
Rube Goldberg designed inventions that made simple tasks more complicated. Try your hand at a
creation inspired by him.
Activity Slot: 1
Sports & Games
• Archery
Junior–Ambassador
Learn how to safely shoot an arrow and work on your aim.
Activity Slot: 1
• Big Ball Soccer
Daisy–Ambassador
Play a silly game of soccer with a giant 48” ball. Fun for everyone – no skill needed.
Activity Slot: 1
• 9 Square in the Air (New)
Daisy–Ambassador
Imagine the playground game of 4-square combined with volleyball for 9 players at a time.
Activity Slot: 1
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• Footgolf (New)
Daisy–Ambassador
Play a combination of soccer and golf. No skill needed.
Activity Slot: 1
• Paintball Slingshots
Work on your target skills and play fun target games.
Activity Slot: 1
• Letterboxing
Create your own letterboxing stamp, learn the basics of letterboxing and then go on a hunt for
“treasure” around camp by following the clues.
Activity Slot: 1
• Geocaching
Junior–Ambassador
Learn the basics of Geocaching and then find the geocaches hidden around camp using
handheld GPS devices.
Activity Slot: 1
• Parachute Games
Daisy–Ambassador
Play some new parachute games as well as old favorites.
Activity Slot: 1
• Water Balloon Slingshots
Daisy–Ambassador
Play with the water balloon slingshots as you get really wet and cool off.
**You must wear clothing, sock and shoes that can get soaked.
Activity Slot: 1
Pool
Please note: All troops automatically receive one swim time per day. During your swim time, you may
request one of the activities below. If you do not request one of these activities, you will receive free
swim time. If you request one of the activities below, you will still receive only one swim time per day,
during which you will do the activity.
• Snorkeling
Daisy–Ambassador
Learn how to snorkel using masks, snorkels, fins, and diving toys.
Activity Slot: Counts as your daily swimming time.
• Water Aerobics
Daisy–Ambassador
Learn how to use water aerobics for simple non-impact exercise.
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• Pool Games
Daisy–Ambassador
Play your choice of pool games. Options include Sharks and Minnows, Extreme Spoons, relay
races, and more.
Other Camp Activities
• Ice Cream Making
Daisy–Ambassador
Make ice cream using zip-lock bags, ice, salt, and various ingredients.
Activity Slot: 1
• Rhythm Games
Learn fun rhythm games like Sevens, the Cup Song, and many more.
Activity Slot: 1
• Troop Camp Training
Daisy–Ambassador
For troops staying in tent units only. Complete the necessary training to take your troop tent
camping or to rent a tent unit on a GSWO property. Leaders that attend the session will receive their
certification. You must complete Overnight and Trip Planning and Lodge Camp Training prior to this
program (both available as home study manuals at gswo.org). With your troop you will learn basic
camping skills like how to set up a camp site, knife safety, fire building, knots, and orienteering. You’ll
also cook either lunch or dinner over the fire and learn proper cook out prep and clean up.
Activity Slot: 3
Evening Troop Time Activities
• Night Hike
Daisy–Ambassador
Learn how to safely take a nighttime hike and then explore camp under the stars.
• Sleeping Out
Daisy–Ambassador
Sleep under the stars in the field behind the Admin Building.
• Star Gazing
Daisy–Ambassador
Look at the stars, learn how to use star charts, listen to nighttime sounds, and tell fun stories.
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Me Time/Free Time
During each full day at camp, everyone receives Me Time, which is one hour of rest and relaxation
immediately following lunch—no formal activities happen during Me Time. While camp is a lot of fun, it can
also be very exhausting, especially for younger campers. Therefore, campers should use Me Time to nap or
do some other low-energy activity, such as rehearsing their skit for the campfire program, reading, writing,
chatting or easy crafts.
Helpful Hints
 Everyone in camp rests during Me Time (including staff); therefore, you may not request an activity
during Me Time.
 You might want to bring supplies (arts and crafts) to camp to keep your girls occupied during Me
Time.
If you request 8–11 activities on your Activity Request form, your schedule will be completely filled;
therefore, you will not receive any free time, except the daily Me Time. Many troops request additional free
activity times to relax or work on patches/badges. If you would like to have free activity slots, please write
“Free Time” on the Activity Request form.
Closing Campfire and Skits
On the last evening of camp, there will be a closing campfire where each troop performs a skit for the entire
camp. The troop should plan and practice their skit while they are at camp. Please make sure that your skit
is “camp appropriate.” If you need ideas, feel free to ask staff for help.
Rainy Day Activities
Inevitably, you will experience some rain while at camp. When it rains, attitude is everything! It is easy to let
rain put a damper on your experience, but if you keep a positive attitude, your girls will have a great time. If
you let yourself be miserable, your girls will be miserable too, and then you will have to deal with a bunch of
cranky girls!
In general, all camp activities will proceed as normal during rain; however, you may be moved to a drier
location. However, in the event that an activity must be cancelled due to weather, it is your responsibility to
entertain your girls. Therefore, you should plan with your girls to determine alternate activities during poor
weather.
22
Helpful Hints
 Use poor weather as resting time.
 If your girls are not tired, be creative and have fun. Ask the girls what they want to do.
If your girls would like to stay dry and under
shelter, think about:







If your girls want to get wet (and there is no
lightening), think about:

Low-movement games (like charades or
brown bag skits)
Sing songs
Practice your skit for the closing campfire
Make crafts
Tell stories
Read
Write letters to friends and family



Play games in the rain (be careful to choose
games in which girls will not slip)
Take a hike
Go creeking
Be sure that the girls have a change of dry
clothes/shoes. Do not let them stay wet too
long; even in the summer, people can
experience hypothermia if they stay wet too
long.
Sister Troops/Sharing a Unit
Camp provides an amazing opportunity for girls to make new friends and meet girls who are different from
them. You will probably share your unit with at least one other troop. You can create the best possible
experience for your girls by contacting the other troop leaders before camp. You will find their contact
information on your confirmation letter. When you contact them, you should discuss the following items.
1. Plan to get your girls together before camp so that they feel more comfortable during camp. If it is
not possible for your girls to meet before camp, think about exchanging letters through pen pals.
2. Plan at least one activity together at camp. If you want to request a joint activity, be sure to write a
note on your Activity Request Form.
3. Plan to make troop SWAPS for the girls to exchange. SWAPS are “Special Whatchamacallits
Affectionately Pinned Somewhere.” SWAPS are small gifts/remembrances girls exchange to
remember each other. Often, SWAPS are attached to pins, so that girls can pin them to shirts or
hats. SWAPS are generally cheap and inexpensive, and they should be handmade (in making them
by hand, girls are sharing part of themselves with other girls, as a showing of friendship).
4. Plan opportunities for the girls to learn from each other (new songs, games, crafts, skits).
5. Discuss group living expectations, such as quiet time and kapers. Think about how the girls should be
considerate and welcoming to each other.
6. Remember the Girl Scout Law: “Be a sister to every Girl Scout.”
Note: Housing units will not be assigned until the week before the session. You will get your housing
assignments upon arrival at camp. If you would like to request to be housed with a specific troop
you must arrive at check-in together.
23
Kapers
It is everyone’s job to keep camp looking great and functioning by performing daily kapers (chores). In
addition, kapers teach girls the value of taking care of their [camp] community. Every troop receives kapers
assignments at check-in. Camp staff will help you in completing your Kaper assignment.
All-Camp Kapers
You will be assigned at least one of the following during your stay at camp.
Hoppers
1.
2.
3.
4.
Set tables in the Dining Hall prior to meals
Bring each dish of food to their assigned table
Ask the kitchen for seconds when your table runs out
Return leftovers and empty serving dishes to kitchen at the end of the meal
NOTE: Each troop member will need to set a different table for the meal they are the hoppers. This
is a great opportunity for girls to meet new people.
Flag
1. Designate one girl as the flag bearer and one or two girls as the callers. All other girls will make up the
colorguard.
2. Properly raise or lower the flag. Staff will be available to assist for new troops.
Personal/Unit Kapers
Personal/Unit Kapers should be done every day. Each unit should create a Kaper chart to assign the jobs:
 Firewood
 Bathhouses
 Grounds and trails
 Tents
 Kitchen shelter
24
Meals and Pack-outs
Meals
You will eat all your meals in the dining hall, unless you request a pack-out. Times are as follows unless
otherwise noted on the schedule:
Breakfast:
8:00–9:00 a.m.
Lunch:
12:30–1:30 p.m.
Dinner:
6:00–7:00 p.m.
Dining Hall Procedures
1. All troops should arrive 15 minutes before the meal. For dinner and breakfast, troops should meet at
the flagpole for the flag ceremony. At lunch troops can meet at the singing porch and staff will lead
camp songs and teach grace. Everyone else should remain outside and participate in the songs.
2. When the dining hall is ready, the staff and leaders will go into the dining hall. The girls must line-up
outside the dining hall.
3. Leaders should each take a seat a different table and a staff member will join you.
4. Girls will be lead into the dining hall, while being serenaded as they find seats. Girls should not sit
together as troops; they should reach out to other girls and make new friends.
5. When everyone finds a seat, the staff will lead everyone in grace.
6. After grace, the hoppers will get the food from the kitchen.
7. Once all the food is at the table the hopper will start passing the food around the table. Everyone
must drink at least one glass of water before drinking juice (it helps keep everyone hydrated).
8. If seconds are available, the hopper will get additional food from the kitchen.
9. When everyone is finished eating, a staff member will assign each person at the table a number.
Staff will ‘spin the wheel’ and chores will be assigned to numbers.
Pack-Outs
Pack-outs are meals that you cook on your own (you may not eat them in the dining hall). You may request a
staff member to assist with your cook out. If your troop decides to request a pack-out, you must submit a
Pack-out Request Form no later than May 27, 2016. Whenever your troop eats a meal outside of the dining
hall, you must submit a Pack-Out Request Form (including Troop Camp Training, Jungle Breakfast, and
Polar Breakfast).
Helpful Hints




Pack-outs are very challenging for first-time campers or younger girls – be sure your girls
are ready to prepare their own meal.
You will pick up and return your pack-out materials to the Dining Hall.
You must wash all containers thoroughly before returning them.
If a food item is unavailable, the kitchen manager will use their discretion in providing a
substitute.
Jungle Breakfast
A jungle breakfast is like a treasure hunt. The staff will pick up the food from the kitchen and hide the
breakfast items along a trail. The girls will receive clues to help them find their food.
Polar Breakfast
A polar breakfast is at the pool. The staff will pick up the food from the kitchen and float it in the pool (with
the help of the lifeguards). The girls will swim for their breakfast and then eat poolside.
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Additional Pack-Out Information
Cold Breakfast Options:
Lunch/Dinner Options:
Hot Desert Options
Jungle/Polar Breakfast
 Cereal
 Milk
 Orange Juice
 Sugar
 Apples
 Oranges
Plus Choose One:
 Breakfast Bars
 Donuts
 Poptarts
Pie Iron Pizza/Dutch Oven
Pizza Casserole
 Bread (Pie Iron) or
Biscuits (Dutch Oven)
 Pizza Sauce
 Mozzarella Cheese
 Pepperoni
 Chips
Banana Boats
 Bananas
 Chocolate Chips
 Marshmallows
Hot Breakfast Options:
Breakfast Burrito
 Tortilla
 Cheese
 Salsa
 Apples and Oranges
 Ham or Bacon
 Eggs
Omelets in a Bag
 Eggs
 Ham or Bacon
 Cheese
 Onions
 Tomatoes
Foil Dinner
 Ground Beef
 Potatoes
 Corn
 Onions
 Chips
Chicken Pot Pie
 Chicken
 Cream of Chicken Soup
 Mixed Veggies
 Biscuits
Walking Tacos
 Fritos (single bags)
 Ground Beef
 Taco Seasoning
 Cheese
 Sour Cream
 Tomatoes
 Lettuce
Dump Cake
 Fruit Pie Filling
 Cake mix
 Butter
Pie Iron Turtles
 Biscuits
 Chocolate Chips
 Caramel
 Butter
Fruit Pies
 Bread
 Butter
 Fruit Pie Filling
Cold Desert Options:
S’morsh
 Cool Whip
 Graham Crackers
 Chocolate Chips
Brownie Smiles
 Apples
 Peanut Butter
 Raisins
Drinks
 Milk
 Orange Juice
 Apple Juice
 Lemonade
 Fruit Punch
26
Healthcare Policies
Medical Personnel
Troop Leaders:
At least one adult volunteer from every troop must hold current certification in First
Aid/CPR from a nationally recognized provider of training. The troop leader serves
as the primary healthcare provider to the troop.
Camp Staff:
All camp staff members hold certification in Red Cross First Aid/CPR. The camp
director is the primary healthcare supervisor at camp in case of emergencies;
however, troop leaders are responsible for medications and minor injuries/illnesses.
Physician:
Dr. Jeff Pruitt is Camp Libbey’s Health Care Provider and works at the Defiance
Clinic and on-call physicians are available in case of medical emergencies.
Medical Facilities:
In case of medical emergencies, camper will go to Defiance Clinic or the Defiance
Hospital.
Health Center
The Health Center is in the Administration Building. The Health Center contains basic medical equipment
and a bed in an air-conditioned room. The camp director oversees the Health Center. The Health Center is
not staffed continuously, so if you encounter a medical condition that you cannot handle, please contact
the camp director.
Health Information Forms
All participants (girls and adults) must submit a completed and updated Health History Form, completed
within the past 6 months. A caregiver must sign the forms. The forms must remain on file at camp
permanently, so please copy your forms before bring them to camp. Individuals without forms (or with
incomplete forms) will be sent home immediately.
Medication and Treatment Policy
All adult and camper medications will be held and dispensed by the leader of each troop. During check-in,
you will receive a lock-box with a combination padlock (you will also receive the combination). You must
keep all medications locked in the box at all times, with the exception of inhalers and Epi-Pens (participants
may keep them, to use in case of emergency). There will be an orientation to the medication procedures
during the leader meeting on the first night at camp.
All adult and camper minor injuries and illnesses will be treated by the leader of each troop. During check-in,
you will receive a basic first aid kit, which you should keep in your unit. In the case of minor injuries or
illnesses, you should treat the participant, and then you must record the treatment in the Health Log. If you
encounter a medical condition that you cannot handle, you should immediately contact the camp director.
If they cannot handle the condition, the camper will be transported to either Defiance Clinic or Defiance
Hospital, depending on the severity of the condition. Whenever a camper requires treatment at a medical
care facility, the leader will contact the caregivers and complete an Accident Report Form and an Insurance
Claim Form.
27
Health Log
During check-in, you will receive a health log. Any time you provide any treatment to someone, you must
record it in the health log. You will turn in the Health Log upon checkout.
Health Check—Contagious Conditions Policy
When you check-in, every participant (girls and adults) must go through a health screening to check for
observable evidence of illness, injury or communicable disease. Caregivers will be called to come pick-up
their child from camp if any of the following conditions exist:
1. Lice—Child has lice or lice eggs (nits) during the initial health screening

Camp Libbey has a “No Nit” policy, as recommended by the Health Department. Therefore, if a staff
member finds even one nit, the participant must go home for treatment.

Participants must wait 24 hours after treatment before returning to camp. Treatment includes, but
is not limited to washing hair with lice shampoo, washing clothes and linens in hot soapy water and
sealing anything that cannot be washed in airtight plastic bags for at least 48 hours.

Once the participant returns to camp, the health screening will start over again, including the head
check.

If an adult is found to have lice after the initial health screening, he or she must also leave camp for
treatment and return in 24 hours (free of lice and nits). If this should occur, the troop must attempt
to find a replacement adult to meet the Safety Activity Checkpoints ratios before staff is pulled from
vital activities.
2. Vomiting—Child gets repeatedly physically sick
 Child may return to camp once vomiting has stopped and with a doctor’s note stating that the child
is not contagious.
3. Fever—Child develops a fever greater than 100
 Child may return to camp after the fever subsides and with a doctor’s note stating that the child is
not contagious.
4. Pink Eye—Child has or develops viral or bacterial conjunctivitis
 Child may return to camp with a doctor’s note stating that the child is not contagious.
5. Other Contagious Conditions—Child has or develops any other contagious conditions (chicken pox)
 Child may return to camp with a doctor’s note stating that the child is not contagious.
Caregiver Notification
Troop leader will notify caregiver if:
 The child spends the night in the health center.
 The child must visit a medical care facility.
 The child develops any condition that poses a health or safety risk to the child or other campers (as
determined by the troop leader and/or camp staff).
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Camp Rules
Work with your group to set group rules prior to leaving for camp. Below are some basic rules for camp but
girls should think beyond these and set rules for themselves about how they will act and treat one another
while they are at camp. Use the Girl Scout Promise and Law as a starting point for your discussion. If you
already have group rules, ask the girls, if there are any to add that will help make their camp experience
better.
Basic Camp Rules
 Safety
o Always walk
o Always use the buddy system
o Wear socks and closed-toe shoes at all times (except inside the pool area)
o Wear swimsuits only in the pool area or under clothing while creeking or playing water games
 Respect
o Yourself—live by the Girl Scout Promise and Law
o Others—be a friend/sister to everyone
o Leaders/Staff—always follow directions
o Nature—leave camp better than you found it
Camp Health and Safety Considerations
 Report any serious accident or injury to the camp director immediately. Record any first aid
treatment in the health log.
 Always use the buddy system and conduct head counts regularly.
 There must always be at least two adults and two girls in any situation.
 Be sure that all girls are eating plenty of food during meal times.
 Be sure that all girls drink plenty of water and stay on the lookout for heat illnesses. A headache or
stomachache is often a sign of dehydration.
 Always wear appropriate clothing—underwear, ankle-high socks, shirt, shorts and closed-toe shoes.
 Maintain camp and personal cleanliness—unit kapers and showers.
 Do not damage or chop live trees or plants. Collect firewood from dead wood lying on the ground.
 Place all garbage into the garbage can. Do not bury trash. Throw trash into the dumpster.
 Do not wear halter-tops or sandals (including adults).
 Do not bring gum.
 No running in camp, except when given permission during games.
 “Take nothing but memories and leave nothing but footprints.” Do not disturb the natural areas at
camp.
 Girls may not use phones without the permission of the leader.
Additional Adult Rules
 Leaders may never smoke in front of girls. Leaders may smoke only behind the Dining Hall.
 Illegal drugs and alcohol are never permitted in camp.
 Firearms and weapons are never permitted in camp.
 Leaders may never bring “tag-a-longs” (leader’s younger children) into camp.
 Leaders may drive in camp only in case of emergency.
29
Camp Policies and Procedures
Adult Policies
All adults attending TAC must be a registered Girl Scout. At least one participating adult must be approved
through the Girl Scout leader approval process. At least one participating adult must be certified in first aid
and CPR.
Camper Supervision
Troop leaders accompanying the troop are responsible for maintaining Safety Activity Checkpoints ratios
and adequately supervising the girls. The camp staff provides camp expertise and leadership for the
program activities. Junior Counselors may be on hand to assist the staff and troop leaders with activities.
Junior Counselors are minors (younger than 18 years old) and will not be supervising campers.
There must always be at least two registered adults in attendance with each troop. Troop leaders must
provide supervision of girls in the following ratios:
 Daisies
1:5 (starting with 2 adults for up to 10 girls)
 Brownies
 Juniors
 Cadettes
Rotating Adults
Your troop must always have enough adults to fulfill the girl/adult ratios above; however, you may have
adults switch out during the session. For example, if you bring 12 Girl Scout Brownies to camp, you must
have two adults with them at all times; however, you may have two adults stay with the girls through part of
the session and then another two adults stay with them the rest of the session. The “rotating adults” policy
allows caregivers with busy schedules to participate in camp with their children, without having to stay the
entire session. All attending adults are responsible for knowing and understanding all camp policies and
procedures. You must have the exact number of required adults at camp at all times. Therefore, an adult at
camp cannot leave until his or her replacement adult arrives.
Swimming Time
All participants will swim at least once during their time at camp. If you sign-up for snorkeling, water sports
or water aerobics, that activity will count for your swimming time. Swimming gives everyone a chance to
cool-down. During swimming time, one adult from each troop must act as a watcher to help our
lifeguards keep everyone safe. You may rotate this position with other adults from your troop if you
choose.
Helpful Hints



On Check- in day, pack all swimsuits and towels separately or at the top of your bags. You will go to
the pool for your swimming tests immediately after checking-in.
During the swim tests, everyone will be given a swim wristband, which designates your swimming
ability and areas where you may swim. Girls and adults must wear their swim wristbands when at the
pool.
Adults and girls must dress in separate changing areas, which are clearly marked.
30
Emergency Procedures
You will find the camp emergency procedures posted in the kitchen (shelter) of every unit. Staff will review
the procedures with your troop upon check-in.
Basic Emergency Procedures






Weather Radios—monitor them regularly
Emergency Bags—every participant should have a change of clothing, hat, jacket, poncho and flashlight
Emergency Signal—continuous air-horn sound throughout camp
Intercom Phones—are located in each unit, these phones only call on property, each unit has a number,
number lists are located near the phones, press the number for the location you’d like to call once, in an
emergency press the number repeatedly until someone answers.
Procedures:
o Stay calm
o Remove everyone from danger
o Keep group together (Make sure everyone is present)
o Wait for further instructions from staff
Emergency Locations:
o Severe Storm—go to a site marked with a diamond/star
o Tornado—go to a site marked with a circle
o Fire—go to a site marked with a triangle
o Toxic Spill—go to a site marked with square
Visitors/Intruders
No outside visitors are allowed in camp without the prior approval of the camp director. Immediately upon
arriving at camp, all visitors must go directly to the camp office to sign-in on the Visitors Log.
If you encounter someone who looks as though they do not belong in camp, politely ask them where they
are staying (which unit). If they tell you that they are just visiting or give you a suspicious response, inform
them that camp is private property and ask them to leave. Do not state that this is a Girl Scout camp.
If a problem arises with an intruder in camp:
 Remove yourself and your girls from the situation
 Notify the camp director and camp ranger immediately
 Call 9-1-1
Behavior Management
All supervision of campers and behavior management is the responsibility of the troop leaders. Leaders
must remain with the campers at all times, according to the Safety Activity Checkpoints ratios. Working with
the girls to determine rules and consequences will assist with behavior management. Make sure to review
these rules when you arrive at camp.
Corporal Punishment
Corporal punishment is not an appropriate method of behavior management at camp:
 Girl Scouting meets the mental health and educational needs of girls.
 The use of corporal punishment as a disciplinary procedure negatively affects the social, educational
and psychological development of children and reinforces the opinion that hitting is an appropriate and
effective disciplinary technique.
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


Corporal punishment as a disciplinary technique can be easily abused and thereby contribute to the
cycle of child abuse.
Research indicates that corporal punishment is ineffective in teaching new behaviors, that a variety of
positive and effective alternatives are available to maintain discipline, and that children learn more
appropriate problem-solving behaviors when provided with the necessary models.
Girl Scouts of Western Ohio provides training for all staff to learn the techniques for providing positive
discipline measures for all children in their care.
Camp Behavior Management Procedure
When a child's behavior creates a risk to the emotional or physical health and safety of another child or the
staff, the following procedures shall be followed:
1. The child is separated from the problem activity or situation.
2. The leader listens to the child and discusses the consequences of further misbehavior.
3. Repeated misbehavior will be handled by a telephone conversation or conference with the child's
caregivers.
4. The caregiver, child and leader agree to a plan that will improve behavior or face the possibility of
termination from the program opportunity.
Tip: Have the girls create rules before attending camp. Write them on a poster or pieces of paper
and display them in your unit.
Techniques for Correcting Inappropriate Behavior
Before taking action, consider:
 Is the behavior really unacceptable?
 Is the behavior typical age-related behavior (annoying to adults)?
 Is the behavior attention getting (for the group's attention or your attention)?
Depending on the answers to these questions, it may be more effective to ignore the behavior. If the
behavior cannot be ignored, try using non-verbal methods such as:
 Meaningful eye contact
 Shaking the head "no" while looking at the camper
 Moving closer to the camper
If these cues do not work in guiding the girl to make a change in behavior, ask in a firm and courteous
manner, for the specific change of behavior. Give the camper time to stop the unacceptable behavior. If
there is still no change in behavior, restate the expectation and the reason. A camper who continues to
behave inappropriately may be removed from the activity. Ask what she wanted to happen in acting
inappropriately, and if there was another way to get her needs met. Ask if you can help her practice the new
behavior. Stress that each individual has a choice in how she behaves, and we are all responsible for our
own thoughts, words, attitudes and actions. Reassure the camper that you are displeased with her
behavior, not with her as a person.
After the discussion is over, the camper should rejoin the group when she is ready. No further reference
need be made to the incident.
32
Homesickness
According to Penny Warner, author of Parent’s and Kid’s Complete Guide to Summer Camp Fun, nearly 90
percent of kids experience some pangs of homesickness when they go to camp, but only one percent
become so homesick that they need to return home from camp. Most tough it out and grow in the process.
"Going away to camp is a tremendous step for many children, even if it's their third or fourth time doing it,
and those of us who have been doing it for a long time can easily underestimate the trepidation a child
experiences in the process.”—Bob Ditter, American Camp Association
An individual can be homesick for almost anything at any time depending on her personal need or her
feeling that something is lacking in the present environment. A child might be homesick not only because
she misses the nearness or affection of her family, but also because she misses her parents making
decisions for her. Homesickness is a depression caused by lack of familiar persons, places or things that
give security to the individuals.
What to do for homesick campers:
1. Acknowledge the feeling:
"It's scary to wake up in a new place."
"I feel badly that you feel like this."
"It's not easy being away from home."
2. Share your feelings:
"I know how you feel. When I went to college for the first time I was homesick too!"
3. Clarify the real issue:
"What is it that bothers you the most?"
"(If scared of the dark)” "Do you think a flashlight would help you?"
4. Reassure them:
"I think you're a neat kid."
"I know you can get through this."
5. Predict:
"Won't it be great when you get through this?"
"You will be so proud of yourself."
Marshmallow Campers
If you have tried to help the camper overcome her feelings of homesickness and nothing seems to work,
you may report a “Marshmallow Camper” to the camp director, who will recruit a staff member to “hang
out” with the girl. It can be amazing how you can spend hours trying to talk to a girl, and then she completely
opens up the moment staff sits down with her. Staff will talk with her, sing songs with her, tell her stories,
relate to her feelings of homesickness and work with her to overcome her homesickness.
Calling Home
If the homesickness reaches a point where it poses a risk to the girl’s health or safety (i.e. she will not eat or
is vomiting), then it is time to call her caregiver to pick her up. Be sure to notify the camp director if you
decide to send a camper home.
33
Individual Packing List
This list should help you in preparing for camp. You may bring your clothes to camp in a duffle bag, trunk
(footlocker), backpack, or whatever is convenient for you. Please note that dressers and chests of drawers
are not available at camp. You will be provided with a bed and a mattress. You bring the rest! Remember to
plan for warm days and cool evenings. Be prepared for a variety of weather conditions. Label each item
with your name!
When packing for camp, place all belongings inside a large black garbage bag. Twist and tie the top
closed and secure with a rubber band or tie.
Necessary Items:
Optional Items:
 Tennis shoes (open-toed shoes/sandals
are not permitted)
 Creeking shoes
 Hiking boots
 Socks (must be worn at all times)
 Blanket/sheets/sleeping bag
 T-shirts/blouses/shirts
 Shorts
 Long pants/jeans
 Underwear
 Pajamas
 Rain gear/poncho (no umbrellas)
 Bathing suit (no bikinis)
 Warm jacket
 Sweater/sweatshirt
 Bandannas/scarves/hats/sunglasses
 Flashlight/batteries
 Personal items
 Towels/washcloth
 Lip balm/lotion/sun screen
 Bug repellant (non-aerosol)
 Water bottle
 Mess kit (plate, bowl, cup, knife, fork and
spoon)—only if packing out
 Day pack/book bag
 Journal
 Stationary and stamps
 Camera
 Books
 Girl Scout Handbooks/Badge Books
Do Not Bring:
 Halter tops, tube tops, backless shirts or
sandals
 Avoid clothing with more holes than fabric,
overly worn clothing or clothing advertising
tobacco/alcohol or other inappropriate
content.
 Spaghetti strap tank tops—regular tank tops
that completely cover you are okay.
 iPods, iPads, MP3’s, tablets
 Electronic games
 Valuables/jewelry/money
 Cigarettes/drugs
34
Troop Packing List
Paperwork
You will need it as soon as you arrive at camp.
 Registration Roster—Updated
 Caregiver Permission Form
 Health Information Form—Must remain on file at camp permanently
 High Risk Form (Only if taking archery)
 Adventure Challenge Education Form(Only if taking challenge courses)
 Release for Minor/Release for Adult (For each participant able to have pictures taken of them)
Program Supplies
 Activities—Anything required for the activities (i.e. T-shirts for tie-dying)
 Me Time and Free Time Activities
 Rainy Day Activities
 “Sister Troop” Activities—SWAPS
 Troop rules and consequences on paper to hang in unit
Food/Beverage Supplies
You will have a refrigerator in your unit to store and food/beverage supplies. Food/beverages attract
animals, so please keep everything in the refrigerator.
 Snacks and beverages (s’mores are provided the first night)
Miscellaneous Supplies
 Alarm clock (battery operated)
Items Available In Every Unit
 Fire buckets
 Beaver buckets
 Rake
 Shovel
 Broom
 Hose
 Garbage cans
 Cots/mattresses
 Bleach
 Refrigerator










35
Fireplace/fire circle
Grill
Dutch oven
Skillet
Nested kettle set
Kettle (with lid)
Scrub brushes/sponges
Anti-Bacterial soap
Garbage Bags
Paper Towels
Arrival Day Checklist
Please try not to arrive early so camp staff have time to prepare for your arrival.
Before You Leave For Camp
 Update Registration Roster
 Check all Health Information Forms
 One form for every girl attending
 One form for every adult attending
 Forms filled out completely
 Forms completed within the past 12 months
 Caregiver signature in “Permission to Treat” box
 Caregiver signature at bottom of form
 Check Caregiver Permission Forms for all girls
 Collect all medication and confirm:
 Medications are listed on the Health Information Forms with instructions
 Medications are in their original containers with matching instructions
 Pharmacy label has correct patient name on it
 Check High Risk Permission Forms, if applicable, for the following activities:
 High Risk Form (archery)
 Adventure Challenge Education Form (Challenge Courses)
When You Arrive At Camp
Parking
 Staff will direct you where to park
 Back your car into the parking spot
 Leave all equipment in car
Preparing Paperwork

Remember to gather the following before going to the Administration Building:
o Registration Roster (updated)
o Health Information Forms (for every girl and adult)
o Permission Forms
o High Risk Forms
o Media Release forms
Paperwork/Health Screening
 You will check-in with your paperwork at the Administration Building (front porch)
 You will have your health screening after you finish with all the paperwork
36
Moving In
 Staff will direct you to the campsite
 You may drive one car to your campsite
 Your troop may leave one car at the campsite in case of emergencies (backed in).
Swim Tests
 You will receive a swim test at check-in.
 Remind everyone of appropriate clothing (closed-toe shoes, socks, shirts and shorts)
 You will meet a pool staff member at the pool entrance
 Make sure girls are fully dressed on their way back to their unit
Camp Orientation
Staff will review the following information with your troop once you arrive at your unit. You will then be able
to settle in before taking your swim test or heading to the dinning hall.
Camp Rules
 Safety
o Always walk
o Always use the Buddy System
o Wear socks and closed-toe shoes at all times (except inside the pool area)
o Wear swimsuits only in the pool area or under clothing while creeking or playing water games
 Respect
o Yourself—live by the Girl Scout Promise and Law
o Others—be a friend to everyone
o Leaders/Staff/PA’s—always follow directions
o Nature—leave camp better than you found it
Emergency Procedures

Weather Radios—monitor regularly

Emergency Bags (Change of clothing, hat, jacket, poncho and flashlight)

Emergency Signal (Continuous air horn)

Intercom Phones (Emergency Use only)

Red Lights (Cannot use water in unit until ranger is called)

Procedures:
o Stay calm
o Remove everyone from danger
o Keep group together (Make sure everyone is present)
o Wait for further instructions from staff
 Emergency Locations:
o Severe Storm—go to a site marked with diamond/star
o Tornado—go to a site marked with circle
o Fire—go to site a marked with triangle
o Toxic Spill—go to a site marked with square
Food/Beverages
 Keep all food/beverages in unit refrigerator (Not in tents—raccoons)
 Keep anything that smells good in unit refrigerator (Shampoo and lotions – raccoons)
37
Kapers
 All-camp and unit kaper assignments
Tent Care (demonstration)
 Unbuckle front and back flaps
 Unroll flaps at least once a day
 Unlace all corners when rolling up a flap
 Roll flaps to the inside of the tent
 After a flap is rolled, buckle clips or tie rope in a bow (not a knot)
 Keep four beds per tent (Beds must be on the outer edges of the tents—maintain four-foot fire aisle)
 Sleep head-to-foot or foot-to-foot (never head-to-head—Health Department Rule)
Unit Campfires
 Safety circle: six-foot diameter made of rocks—stay off rocks—ask permission from a leader or amp
staff before entering safety circle
 Fire circle: outside of the safety circle (made of logs for sitting)—avoid walking on logs and always walk
around the outside of the fire circle
 Always have a filled water bucket near the fire
38
ACTIVITY REQUEST—DUE MAY 27, 2016
Leader:
Troop #:
Session #:
Phone (H):
Grade Level (circle): D BR JR CD
Dates:
Activity
1.
2.
(W):
AMB # Girls:
Living Unit:
# Adults:
Activity Request—Do not request swimming (it’s automatic)
Notes
3.
4.
5.
6.
7.
8.

Activity
Jungle Breakfast
Polar Breakfast
Special Activity Request
Notes
You must complete a Pack-out Request Form
You must complete a Pack-out Request Form
Optional Troop Time Activities
Pool Activities (pick 1)
Pick up to 2
**Will be part of your scheduled pool times
 Activity
Night Hike

Activity
*Water Sports
Star Gazing
*Snorkeling
Sleep Out
*Water Aerobics
39
Pack-Out Request—Due May 27, 2016
Leader:
Phone (H):
Troop #:
# Girls:
(W):
Grade (circle): Daisy Brownie Junior Cadette
# Adults
Session #:
Senior
Dates:
Ambassador
Unit:
Check all pack-outs that the troop would like to participate in while at camp.

Pack-out
Breakfast Options
Options (Circle One)
Jungle Breakfast (Cold)
Breakfast Bars/Donuts/Pop Tarts
Polar Breakfast (Cold)
Breakfast Bars/Donuts/Pop Tarts
Breakfast Burrito (Hot)
Ham/Bacon
Omelets in a bag (Hot)
Ham/Bacon
(Office Use) Date scheduled
Lunch/Dinner Options

Pack-out
Chicken Pot Pie
Walking Tacos
Options (Circle One)
N/A
N/A
Pie Iron Pizza
N/A
Foil Dinner
N/A
Dutch Oven Pizza Beak
Dessert Options (Choose 1–2)
Dessert Pack-Outs can be attached to a lunch/dinner pack-outs
or during troop time activity.

Pack-out
Circle One
Banana Boats (Hot)
N/A
Pie Iron Turtles (Hot)
N/A
Dump Cake (Hot)
Chocolate/Vanilla Cake
Fruit Pies (hot)
N/A
Brownie Smiles (cold)
N/A
S’Morsh (cold)
N/A
Drinks (Choose 1–2)

Pack-out
Circle One
Milk
Orange Juice
N/A
N/A
Apple Juice
N/A
Lemonade
N/A
Fruit Punch
N/A
40
Please list how many participants have the following dietary needs if any:
Vegetarian
Gluten free
Corn allergy
Lactose intolerant
Vegan
Other dietary concerns:
Please call the Camp Director Elizabeth Rogers at 567.225.3524 or email at [email protected] to
inform of any dietary needs.
We must know at least two weeks in advance.
41
4/16
T-Shirt Order Form—Camp Libbey
Due May 27, 2016
Leader:
Phone (H):
Troop #:
# Girls:
Grade Level (circle):
Dates:
(W):
# Adults:
Daisy
Brownie
Session #:
Junior
Cadette
Senior
Ambassador
Living Unit:
Please fill out name of each participant with all individual orders in addition to special programs that have additional
costs. Add all of each individual total cost and total costs.
In T-shirt size, please mark the size each participant wants in the section. All T-shirts cost $10.
Child T-shirt Sizes:
 C–SM
 C–Med
Adult T-shirt Sizes:
 A–Sm
 A–Med
 A–Lrg
 A–X-Lrg
 A-XX-Lrg
 A-XXX-Lrg
Name Of Participant
First Name
Purchases
T-Shirt Size
($10)
Last Name
Total Cost:
42
Total
Cost
Name Of Participant
First Name
Purchases
Total
Cost
T-Shirt Size
($10)
Last Name
Total Cost:
Payment
 Credit Card (MasterCard, Visa, Discover or American Express)
I authorize $
to be charged to my:  MasterCard  Visa  Discover  AMEX
Cardholder’s Name:
Account #:
CVV:
Expiration Date:
Billing Zip Code:
 Check (payable to Girl Scouts of Western Ohio)—mail payment to:
4930 Cornell Road
Cincinnati, OH 45242
Order by May 27, 2016! By ordering in advance, you’ll reserve T-shirts in the sizes you want. The T-shirts
will be packaged and waiting for you at camp. We cannot guarantee any late T-shirt orders.
Please submit only one order form per troop.
43
CAREGIVER PERMISSION SLIP
Must be completed ANYTIME your troop goes ANYWHERE away from their usual meeting place.
Return the bottom portion of this form to Leader by (date):
Troop #:
Date(s):
Location:
Mode of Transportation:
Place of Departure:
Place of Return:
is planning a:
Time:
Phone:
Time:
Time:
ADULTS ACCOMPANYING THE LEADER:
Name:
Name:
Phone:
Phone:
EACH GIRL WILL NEED:
Expenses $:
Equipment:
CONTACT IN CASE OF EMERGENCY:
Name:
Phone:

My daughter, (name):
Has my permission to attend:
She is in good physical health and does not have any serious illness or has not recently had an operation.
Her updated health form is in the leader’s possession or is being returned with this form with information updated (as
needed) and signed on the back.
During the activity, I may be reached at:
Address:
City:
Work Phone:
State:
Home Phone:
Zip:
Cell Phone:
If I cannot be reached in the event of an emergency, the following person is authorized to act on my behalf:
Name:
Address:
City:
Work Phone:
State:
Home Phone:
Zip:
Cell Phone:
I understand that my child will not be released to any person other than the above named or myself. I understand
that, for my daughter’s protection, all persons will be asked for identification. Persons named above should be
prepared to provide identification to the satisfaction of the leaders in charge (i.e. current driver’s license with photo
identification).
Caregiver Signature:
Date:
EH:rs/1001331-002
44
Camper General Release and High-Risk Form
This form must be completed and brought to the first day of camp or activity.
Please check all the activities that apply below and sign the form at the bottom.
Camper’s Name:
Name and Date of Session/Event:
TRANSPORTATION PERMISSION
My daughter has my permission to participate in off camp activities as described in the program activity. My daughter may
also be transported to medical facilities/appointments if the need arises. I understand that she will be transported in a
camp vehicle designed for passengers.
MEDICAL RELEASE/PERMISSION
My daughter is in good physical condition and has not had any serious illness or surgery since her last health examination.
In case of an emergency, when I cannot be reached, I give permission for her to be treated by a qualified physician at the
nearest hospital.
ARCHERY RELEASE
Girls entering the fourth grade and above may have the opportunity to participate in archery. I understand the risk
involved with the activity and give my camper permission to participate if the opportunity is available. (All archery classes
are taught by certified instructors.)
HIGH RISK ACTIVITY RELEASE
I understand that if it is included in the description of my daughter’s camp session, she may be participating in activities on
and off camp property that are considered high risk. I feel that my camper is developmentally ready, both physically and
emotionally, and possesses the skills needed to participate in the activities I have marked below. I have discussed with my
daughter the importance of following safety guidelines, while participating in high risk activities. (There may also be
additional release forms specific to the activities listed below that need to be signed.)
I understand the risks inherent in the below activities: (Please, check all those that apply to the program activity your
camper is attending or that she has permission to participate in if given the opportunity.)
 Amusement Park Rides
 Caving
 Archery
 White Water Rafting
 Backpacking
 Bicycle Riding
 Canoeing/Kayaking
 Other:
The purpose of the Camper Release/High Risk Form is to inform caregivers of the risk and to provide the
opportunity for both their own evaluation of their camper’s readiness for the activity and the reinforcement
with their camper of the skills and behavior necessary to safely participate in the activity.
Date
Signature of Caregiver
If participating in any of the following high risk activities, you will be asked to sign a separate release form:
 Climbing Wall
 High Challenge Course
 Horseback Riding
 Low Challenge Course
 Rappelling
 Rock Climbing
 Team Initiatives
 Zip Line
VH:fs/1201617-004
45
A.C.E. Release Form
This form must be completed by and for each person participating in the
Adventure Challenge Education (A.C.E.) program, high challenge course, low
challenge course, or the climbing wall.
PLEASE READ CAREFULLY BEFORE SIGNING
Serious physical or psychological injury may result from your participation in this activity. Girl scouts of
Western Ohio does not guarantee your safety.
Registration of participant and agreement purpose—Girl Scouts of Western Ohio agrees to provide to
allow the following individuals to participate in its ACE, high ropes, low ropes and/or climbing wall program(s):
Participant’s Name
Age
Grade
Troop Number/
Name of Group
Date of Program
Does this participant have any physical and/or mental health conditions, problems and/or disabilities,
which may require accommodation or affect her/his safety and ability to participate in the teambuilding
activity?
YES NO (circle one) If “yes” describe each:
WRITE INITIALS BELOW AFTER READING EACH SECTION
Caregivers must also initial for minors
/
I understand that my participation in this activity is based on the “Challenge by Choice” philosophy. I
recognize that the program is designed to use experiential, engaging and teaching techniques, but that my
participation is purely voluntary. At all times, I will choose my level of participation in any activity. I have
read the full value contract on the back of this agreement, and agree to follow guidelines as presented.
/
I understand the employees of the Girl Scouts of Western Ohio have received extensive training, and will
work to protect the emotional and physical safety of myself and/or my child.
/
I understand that climbing, high challenge course, low challenge course, ground initiatives, zip line and
other activities in the program for which I and/or my child have enrolled, entail risk. I elect to participate, or
allow my child to participate, in spite of these risks.
/
Therefore, for myself/my child, I knowingly and voluntarily assume all risks involved in my
participation, and do hereby release the Girl Scouts of Western Ohio, and its members, trustees,
officers, employees, independent contractors and agents from any and all liability, damages, costs
and expenses arising out of or relating to bodily or psychological injury, loss of life or personal
property that may occur as a result of participating in this program.
/
I have read, understand and accept the terms and conditions stated herein and acknowledge that this
agreement shall be effective and binding upon the parties during the entire period of participation in the
said program.
/
I grant the Girl Scouts of Western Ohio, and persons acting through them, the rights to use, reproduce,
assign and/or distribute photographs, films, videotapes and sound recordings of myself or my child for use
in materials they may create.
Page 1 of 2
46
FULL VALUE CONTRACT
The Full Value Contract is a set of agreements designed to help groups create a positive, creative and safe learning
environment. While particular groups may choose to add to this list, the basic tenets of the Full Value Contract that
all participants are expected to uphold include the following:

BE SAFE: Create a level of safety so that people are able to relax and feel comfortable. An agreement that
participants must adhere to certain physical and psychological safety guidelines must be discussed and
agreed upon by the group.

BE COMMITED: Be present mentally, physically, and emotionally. The group members work together to
achieve the individual and group goals that have been developed, and share during the group experience.
Group members should work to minimize distractions, and spot with good attention.

BE RESPECTFUL: Share your thoughts and opinions openly and honestly. An agreement to give and
receive honest feedback. This involves caring enough about oneself and others to communicate in a
fashion that will be productive and facilitate growth. This includes being positive and not putting yourself or
others down. Listen to what others say, and focus on understanding their ideas.

CHALLENGE BY CHOICE: This is the most important part of the contract. Challenge by Choice means that
each participant may select the level of challenges that they are willing to experience.

HAVE FUN: Participants should balance fun with taking care of business. Just as in life, balance is required
on the challenge course. Too much fun, or too much seriousness, is not good for any group. Strike a
balance, and the job gets done and everyone wears a smile.
By signing below, all participants and parents or legal guardians acknowledge they have read, understand, and agree
to the terms of this document. One form per participant must be filled out. At least one caregiver must sign.
SIGNER STATEMENT OF AWARENESS
I/WE, THE UNDERSIGNED, HAVE READ AND DO UNDERSTAND THE FOREGOING TYPE OF ACTIVITY, THE RISKS OF PARTICIPATION
AND WARNINGS. I/WE FURTHER ATTEST THAT ALL FACTS RELATING TO THE PARTICIPANT’S PHYSICAL CONDITION AND AGE ARE
TRUE AND ACCURATE.
SIGNATURE OF PARTICIPANT
DATE
SIGNATURE OF CAREGIVER #1
FOR
NAME OF PARTICIPANT (PRINT)
DATE
SIGNATURE OF CAREGIVER #2
FOR
NAME OF PARTICIPANT (PRINT)
DATE
Address in full:
Home Phone #:
Bus. Phone #:
Page 2 of 2
VH:fs/1001666-004
47
SUMMER CAMP HEALTH HISTORY
AND EXAMINATION FORM - CAMPER
H.C.
 Yes
Meds
First Name:
Check-in:
Temp.
Last Name:
Date:
Unit Name:
Program Name:
Program Name:
Office use only
Unit:
 No
Instructions—This form must be completed for all girls attending a summer camp program. This form must be
completed and brought to the first day of camp.
1.
2.
3.
4.
5.
The information on this form is required to assist us in identifying appropriate care. Information on this form is
confidential and will be shared, as appropriate, with staff on a need to know basis.
All girls attending resident camp and mini sessions (overnight camps) must complete Sections A, B, C, D, and E for
camp. A Physician’s Health Exam is required. Campers without Section E completed and signed by a physician will
not be allowed to remain at camp.
Girls attending Troop Adventure Camp, Day Camp and One-Day/Overnight program activities need to complete
Sections A, B, C, and D of this form. Section E is not required.
All parts of this form must be current, the health history (Sections A, B, C, and D) should have been done within the last
six months. The Examination Form (Section E) must be completed by a physician and dated within the last 12 months.
Caregivers must provide a separate copy of this form only when their camper attends multiple summer
opportunities at different camps (i.e., camper attends a resident camp session at one camp and attends a day camp
session at a different camp).
Section A—General Information and Camper Transportation Release/Authorization Information
Camper’s Name:
Age
Address:
Birthdate:
City:
State:
Zip:
The persons listed below have permission to pick up the above camper at camp.
Custodial Caregiver:
Second Caregiver or Emergency Contact:
Name:
Name:
Address:
Address:
City/State/Zip:
City/State/Zip:
Day Phone: (
)
from:
-
Day Phone: (
)
from:
-
Eve. Phone: (
)
from:
-
Eve. Phone: (
)
from:
-
In case of emergency and caregivers cannot be reached, please notify:
Name:
Relationship:
Phone: (
)
Name:
Relationship:
Phone: (
)
Name:
Relationship:
Phone: (
)
Name:
Relationship:
Phone: (
)
Name:
Relationship:
Phone: (
)
Name:
Relationship:
Phone: (
)
Additional people to pick up camper:
48
Section B—Health History
Allergies:  No known allergies.  This camper is allergic to:
 Food  Medicine
 The environment (insect stings, hay fever, etc.)
 Other
(Please describe below what the camper is allergic to and the reaction seen.)
Diet, Nutrition:
 This camper eats a regular diet.  This camper eats a regular vegetarian diet.
 This camper has special food needs. (Please describe below.)
Restrictions:
 I have reviewed the activities of the camp and the camper can participate without restrictions.
 I have reviewed the activities of the camp and feel the camper can participate with the following restrictions
or adaptations. (Please describe below.)
General Health History: Check "Yes" or "No" for each statement. Explain “Yes” answers below.
Has/does the camper:
1.
Ever been hospitalized?
2. Ever had surgery?
3. Have recurrent/chronic illnesses?
4. Had a recent infectious disease?
5. Had a recent injury?
6. Had asthma/wheezing/
shortness of breath?
7. Have diabetes?
8. Had seizures?
9. Had headaches?
10. Wear glasses or contacts?
 Yes
 Yes
 Yes
 Yes
 Yes
 No
 No
 No
 No
 No
 Yes
 Yes
 Yes
 Yes
 Yes
 No
 No
 No
 No
 No
11.
12.
13.
14.
15.
16.
17.
18.
19.
Had fainting or dizziness?
Passed out/had chest pain during exercise?
Had mononucleosis ("mono") during
the past 12 months?
Have problems with periods?
Have problems with falling
asleep/sleepwalking?
Ever had back/joint problems?
Have a history of bedwetting?
Have problems with diarrhea/constipation?
Have any skin problems?
 Yes  No
 Yes  No
 Yes  No
 Yes  No
 Yes
 Yes
 Yes
 Yes
 Yes
 No
 No
 No
 No
 No
Please explain “Yes” answers in the space below, noting the number of the questions.
Mental, Emotional and Social Health: Check "Yes" or "No" for each statement.
Has the camper:
1. Ever been treated for attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (AD/HD)?
 Yes
2. Ever been treated for emotional or behavioral difficulties or an eating disorder?
 Yes
3. During the past 12 months, seen a professional to address mental/emotional health concerns?
 Yes
4. Had a significant life event that continues to affect the camper’s life?
 Yes
(History of abuse, death of a loved one, family change, adoption, foster care, new sibling, survived a disaster, others)
 No
 No
 No
 No
Please explain “Yes” answers in the space below, noting the number of the questions. The camp may contact you for additional
information.
Section C—General Information
Name of Family Physician:
Phone: (
)
Name of Dentist/Orthodontist:
Phone: (
)
Do you carry family medical/hospital insurance?
 Yes
 No
If so, indicate:
Policy or Group #
Name of Insured:
Relationship to Camper:
49
Prescription Medication
List any prescription medication your camper is bringing to camp, its use and dosage. All medication must be
brought in its original container.
 This person takes NO routine medication.
 This person takes prescription medication as follows:
Medication
Use
Dosage
Please identify any medications taken during the school year that camper does/may not take during the summer:
Camp Provided Over-the-Counter (OTC) Medication
For mild discomfort, your camper may be given the following over-the-counter (OTC) medicines that are provided by the camp.
Please initial any that cannot be administered. All OTC medication will be given according to dosage instructions on package, unless
otherwise indicated by the caregiver.
 Acetaminophen (Pain relief/fever)
 Pepto Bismol (Diarrhea)
 Ibuprofen (Pain relief/fever)
 Sudafed (Nasal decongestant)Robitussin (Cough cold/flu
symptoms)25 mg. Benadryl (Allergic reaction to insect
 Maalox (Upset stomach)
bites/poison ivy)
 Milk of Magnesia (Constipation)
 Calamine (Itch relief when giving Benadryl)
 Throat lozenges (Sore throat)
 Caladryl (Itch relief when not giving Benadryl)
 Tinactin (Athletes foot)
 Benedryl Cream (Itch relief when not giving Benadryl tablets)
 Blistex (Cold sores)
 Tums (Heartburn and indigestion)
Immunization History—Please record the date (month/year) of immunization and most recent booster doses.
Starred ( immunizations must be current)
 Had chicken pox
Diphtheria, tetanus, pertussis
(DTaP) or (TdaP)
Haemophilus influenzae type B (HIB)
Varicella (chicken pox)
Date:
Tetanus booster (dT) or (TdaP)
Pneumococcal (PCV)
Meningococcal meningitis (MCV4)
Mumps, measles, rubella (MMR)
Hepatitis B
Tuberculosis (TB) test
Date:
Polio (IPV)
Hepatitis A
 Negative  Positive
What Have We Forgotten to Ask? Please provide on a separate sheet any additional information about the camper’s health
that you think important or that may affect the camper’s ability to fully participate in the camp program.
Caregiver Authorization for Health Care
This health history is correct and accurately reflects the health status of the camper to whom it pertains. The person described has
permission to participate in all camp activities except as noted by me and/or an examining physician. I give permission to the
appropriate camp personnel to care for minor illness/injuries using over-the-counter medications/procedures as authorized in the
over-the-counter medication section. I give permission to camp personnel to administer medications I have listed on this form
and/or physician has prescribed on the physical exam. I will send medications in original containers. I give permission to the
physician selected by the camp to order x-rays, routine tests, and treatment related to the health of my child for both routine health
care and in emergency situations. If I cannot be reached in an emergency, I give my permission to the physician to hospitalize,
secure proper treatment for, and order injection, anesthesia, or surgery for this child. I understand the information on this form will
be shared on a “need to know” basis with camp staff. I give permission to photocopy this form. In addition, the camp has permission
to obtain a copy of my child’s health record from providers who treat my child and these providers may talk with the program’s staff
about my child’s health status.
Signature of Custodial
Caregiver:
Date:
Relationship
to Camper:
If for religious or other reasons, you cannot sign this, contact the camp for a legal waiver, which must be signed to attend camp.
50
VP:bd/05-1393-01
Photo Release for Minors
1/16
Date(s):
Photographer/Producer:
Assignment:
Location:
Activity:
For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby
consent and agree to the following:
1.
I hereby grant to Girl Scouts of Western Ohio, and others working for Girl Scouts of Western Ohio
or on its behalf, and each of its respective licensees, successors and assigns (each a “Releasee”),
the irrevocable, royalty-free, perpetual, unlimited right and permission to use, distribute, publish,
exhibit, digitize, broadcast, display, modify, create derivative works of, reproduce or otherwise
exploit my name, picture, likeness and voice (including any video footage of the same)
(collectively, “Media”), or to refrain from so doing, anywhere in the world, by any persons or
entities deemed appropriate by Girl Scouts of Western Ohio, for any purpose (except
defamatory) including, without limitation, any use for educational, advertising, non-commercial
or commercial purposes in any manner or media whatsoever (whether known or hereafter
devised) including, without limitation, on the internet, in print campaigns, in-store and via
television. I agree that I have no interest or ownership in any of the Media.
2.
I shall have no right of approval, no claim to compensation and no claim (including, without
limitation, claims based upon invasion of privacy, defamation or right of publicity) arising out of
any use, alteration, blurring, illusionary effect or use in any composite form of my name, picture,
likeness and voice. I agree that nothing in this Release will create any obligation on Girl Scouts of
Western Ohio to make any use of the Media or the rights granted in this Release. I hereby release
and hold harmless Releasees from any claim for injury, compensation or negligence resulting or
arising from any activities authorized by this Release and any use of the Media by Girl Scouts of
Western Ohio.
Name of Minor (please print):
Address:
City:
State:
Zip:
Daytime Phone Number: (
)
Additional Phone (optional): (
)
Release for minors (those under the age of eighteen): I, the undersigned, being a caregiver of the minor, hereby
consent to the foregoing conditions and warrant that I have the authority to give such consent.
Name of Caregiver (please print):
Signature of Caregiver (Required):
Caregiver Email Address*:
Date:
@
(*will not be used for any other purposes or distributed to third parties)
Region:
Troop#:
Service Unit:
1201281-005
51
Photo Release for Adults
1/16
Date(s):
Photographer/Producer:
Assignment:
Location:
Activity:
For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby
consent and agree to the following:
1.
I acknowledge that I am eighteen (18) years of age or older. I hereby grant to Girl Scouts of Western, and
others working for Girl Scouts of Western Ohio or on its behalf, and each of its respective licensees,
successors and assigns (each a “releasee”), the irrevocable, royalty-free, perpetual, unlimited right
and permission to use, distribute, publish, exhibit, digitize, broadcast, display, modify, create
derivative works of, reproduce or otherwise exploit my name, picture, likeness and voice (including
any video footage of the same) (collectively, “media”), or to refrain from so doing, anywhere in the
world, by any persons or entities deemed appropriate by Girl Scouts of Western Ohio, for any
purpose (except defamatory) including, without limitation, any use for educational, advertising, noncommercial or commercial purposes in any manner or media whatsoever (whether known or
hereafter devised) including, without limitation, on the internet, in print campaigns, in-store and via
television. I agree that I have no interest or ownership in any of the media.
2. I shall have no right of approval, no claim to compensation and no claim (including, without limitation,
claims based upon invasion of privacy, defamation or right of publicity) arising out of any use,
alteration, blurring, illusionary effect or use in any composite form of my name, picture, likeness and
voice. I agree that nothing in this release will create any obligation on Girl Scouts of Western Ohio to
make any use of the media or the rights granted in this release. I hereby release and hold harmless
releasees from any claim for injury, compensation or negligence resulting or arising from any
activities authorized by this release and any use of the media by Girl Scouts of Western Ohio.
Signature:
Date:
Name (please print):
Home Address:
Daytime Phone: (
City:
)
State:
Additional Phone (optional): (
Email Address*:
Zip:
)
@
(*will not be used for any other purposes or distributed to third parties)
Region:
Troop#:
Service Unit:
1201280-005
52
TROOP ADVENTURE CAMP REGISTRATION ROSTER
Unit Name:
Troop #:
Camp Dates:
Girl Scout Grade Level:
# Adults Attending:
Emergency Name/Phone #:
Full/Rotating
Name:
Full/Rotating
Name:
Full/Rotating
Leader’s Name:
Additional Adults Attending (list all):
Please list all additional full/rotating adults on the bottom of back page if necessary
GIRLS ONLY
Last, First
(Please list in
alphabetical order)
Name of Emergency Contact/
Phone #
Deposit
Paid
Financial
Assistance
Amount
Requested
Office Use Only:
Balance
Due
Final
Payment
Attended
Comments
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
LB:rs/110125-003
53
GIRLS ONLY
Last, First
(Please list in
alphabetical order)
17
18
19
20
21
22
23
24
25
26
Name of Emergency Contact/
Phone #
Deposit
Paid
Financial
Assistance
Amount
Requested
Balance
Due
Final
Payment
Attended
Comments
PAYING ADULT ONLY
Last, First
(Please list in
alphabetical order)
1
2
3
**NOTE: DEDUCT THE $10 DEPOST PAID FROM FINAL PAYMENT
GRAND TOTAL PAID:
Additional rotating adults attending (list all):
Name of Emergency Contact/Phone #
Full/Rotating
Name:
Full/Rotating
Name:
Full/Rotating
Name:
Full/Rotating
Name:
Full/Rotating
Name:
Full/Rotating
RETURN WITH FINAL PAYMENT TO: Girl Scouts of Western Ohio, 4930 Cornell Road, Cincinnati, OH 45242-1804
54

TAC Leader Manual 2016 - Libbey

Transcription

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