doc2016 Summer Camp Packet.pub - Forsyth
download 
Report Transcription
2016 Summer Camp Packet.pub - Forsyth
Summer Camp Camp Kaleo 2016 Registration MEN’S MINISTRIES GEORGIA BAPTIST CONVENTION 6405 Sugarloaf Parkway Duluth, Georgia 30097-4092 1-800-746-4422 ext. 258 mens.gabaptist.org CAMP KALEO 463 Old Zebulon Road Forsyth, Georgia 31029 478-994-5333 www.campkaleo.org RA / Challengers Interest Event SUMMER CAMP Camp Kaleo www.ga-ra.org Camp Kaleo is located just south of Forsyth, Georgia, near Macon. Camp Kaleo is affiliated with the Southern Baptist Convention Camping Association. It was established in 1986 to teach and advance missions to the glory of God. It is to this end that we seek to lead boys and young men to follow in obedience as a disciple of Jesus Christ. Summer Camp is open www.campkaleo.org. to groups and individuals. View photos of Camp Kaleo at Lad Camps (Grades 1-3) are designed to provide a structured program for boys and their dads or leaders from their church to enjoy time together. The schedule provides opportunities for hiking, swimming, games, crafts, missions education and spiritual inspiration. We ask that a ratio of one adult to four campers be maintained. Lads check-in and check-out—Check-in is at 10:00 a.m. the first day of camp, and check-out is at 10:00 a.m. last day. Crusader Camps (Grades 4-6). Our program is skills based using the outdoors as a classroom. Environmental education and camp craft, along with other offerings provide fun, learning and exploration. Also part of our camp day are morning devotions, mission sessions, worship and evening activities. We encourage RA leaders to join their boys during this camp. It will be a learning experience. Younger Challengers (Grades 7-8). The goal of the program is to introduce outdoor skills that will provide a lifetime of enjoyment. Included are backpacking, canoe and climbing skills, as well as environmental education. Worship, morning devotions, and missions sessions round out the week. Older Challengers (Grades 9-12). Challenge, adventure, and personal grow th all describe the program. Challengers may choose from backpack, rock climb/rappel, and adventure camps. Discipleship material written for these camps add a spiritual dimension. Crusaders and Challengers check-in and check-out—Check-in is at 10:00 a.m. the first day of camp, and check-out is at 1:00 p.m. the last day. MEN’S MINISTRIES GEORGIA BAPTIST CONVENTION 6405 Sugarloaf Parkway Duluth, Georgia 30097-4092 1-800-746-4422 ext. 258 mens.gabaptist.org CAMP KALEO 463 Old Zebulon Road Forsyth, GA 31029 478-994-5333 Fax: 478-994-2925 www.campkaleo.org Email: [email protected] 2016 RA/Challengers Summer Camp Registration Serving Over 25 Years of Summer Programs At Camp Kaleo! (Please Use Separate Forms For Different Age Levels & Different Dates) Forms Available On Line At “www.ga-ra.org”. Send Forms to Camp Kaleo. Church___________________________________________________Association__________________________________________________________ Person Making Reservation _______________________________________________Fax # _________________________________________________ Daytime Phone _____________________________________Email______________________________________________________________________ Address______________________________________________________________________________________________________________________ City____________________________________________________State_____________________Zip_________________________________________ All information must be completed for insurance purposes. Boys & adults must register. Mark “1” by your first choice of date and “2” by your second choice. (Only one week available for Girls Adventure Camp — please circle below.) After May 26th, there will be a $15.00 late charge. Costs include lodging, meals, a limited accident insurance policy, a T-Shirt and Canteen Time; but does not include Store purchases. Lads $125 Older Challengers $235 June 9 - 11 July 21 - 23 June 20 - 24 June 27 - July 1 July 11 - 15 July 18 - 22 Crusaders $235 Younger Challengers $235 June 13 - 17 Girls Adventure Camp, Grades 4 - 6, Available Week of July 11-15. June 13 - 17 June 20 - 24 June 20 - 24 June 27 - July 1 June 27 - July 1 July 11- 15 July 18 - 22 Remember: Required Immunization Certificate, Health History Form, Photo Release & Camper Release and a Child Protection Form for chaperones are included in this packet. July 11 - 15 July 18 - 22 Camper Name ____________________________ T-Shirt Size ____________________________________________________ Birth Date ________________________________________ Grade _____________________ Emergency Phone__________________ Mailing Address ________________________________________ City _______________________ State ___________ Zip_______________ Parent/Guardian ________________________________________ Camper Name ____________________________ T-Shirt Size ____________________________________________________ Birth Date ________________________________________ Grade _____________________ Emergency Phone__________________ Mailing Address ________________________________________ City _______________________ State ___________ Zip_______________ Parent/Guardian ________________________________________ Camper Name ____________________________ T-Shirt Size ____________________________________________________ Birth Date ________________________________________ Grade _____________________ Emergency Phone__________________ City _______________________ State ___________ Zip_______________ Mailing Address ________________________________________ Parent/Guardian ________________________________________ Camper Name ____________________________ Birth Date ________________________________________ Grade _____________________ Emergency Phone__________________ T-Shirt Size ____________________________________________________ Mailing Address ________________________________________ City _______________________ State ___________ Zip_______________ Parent/Guardian ________________________________________ Payment: Check ____________ Money Order ____________ Make Check / Money Order Payable to: Men’s Ministries 9/8/2015 Edited Send to: Camp Kaleo, 463 Old Zebulon Road, Forsyth, GA 31029 (Fax: 478-994-2925) FOR INFORMATION CONTACT: Mike Flowers, Consultant, RA & Camp Director Men’s Ministries, Georgia Baptist Convention Camp Kaleo, 463 Old Zebulon Rd. Forsyth, GA 31029 478-994-2925 (fax) 478-994-5333 This side to be filled in by parents/guardian of minors or by adult participants themselves. Name ______________________________________ Birthdate _____________________ Sex __________ Age _____________ Parent or Guardian__________________________________________________________ Cell ___________________________ Home Address _____________________________________________________________ Phone __________________________ Business Address___________________________________________________________ Phone __________________________ Second Parent and/or Guardian or Emergency Contact ______________________________________________________________ Home Address _____________________________________________________________ Phone __________________________ Business Address ____________________________________________________ Phone _________________________________ If not available in an emergency, notify ____________________________________ Phone ________________________________ Address ____________________________________________________________ Phone ________________________________ Health History (check approximate dates) Diseases Chicken Pox _______________ Measles ________________ German Measles ________________ Mumps __________________ Are you allergic to any Drugs ___________________ Foods ___________________ Insect Bites ___________________ Other _____________________ Present medical problems or tendencies (check where applicable) Has this participant had a DPT shot? _____________________________________ Date last tetanus shot______________ Has this participant ever required any psychiatric counseling or hospitalization? ___________________________________________ List all operations or serious injuries (dates)________________________________________________________________________ __________________________________________________________________________________________________________ List all disabilities, chronic and recurring illnesses___________________________________________________________________ List all dietary limitations_______________________________________________________________________________________ Sinusitis _____________________ Diabetes _____________________ Frequent Colds _______________ Heart Trouble ________________ Convulsions __________________ Fainting _____________________ Kidney Trouble _______________ Frequent Sore Throat __________ Sensitive Skin ________________ Sleep Walking ________________ Contact Lenses _______________ Epilepsy ____________________ Bronchitis ___________________ Bed Wetting _________________ Stomach upset ________________ Ear Infections ________________ Other _______________________ List all other diseases or illnesses not listed above__________________________________________________________________ Name of dentist/orthodontist ___________________________________________________ Phone __________________________ Name of family physician _____________________________________________________ Phone __________________________ Date of last physical examination _______________________________________________________________________________ Suggestions or health related information for camp personnel__________________________________________________________ There has been no changes in my health or physical abilities in the last year ________________yes ________________ no Please explain _____________________________________________________________________________________ ________________________________________________________________________________________________ IMPORTANT - THIS BOX MUST BE COMPLETED FOR ATTENDANCE This health history is complete and correct, and the person listed below has permission to engage in all prescribed activities except as noted. I hereby give permission to the program staff: 1. To provide ongoing health care. 2. To select medical personnel and to order x-rays or routine tests or treatment for the person listed below. To my knowledge this participant has not been exposed to a contagious or infectious disease within two weeks prior to this activity. In the event of a medical emergency and I cannot be contacted , I hereby give permission to the Camp Coordinator to select a physician and/or hospital for my child’s care. I hereby also give the hospital and/or physician, as selected by the Camp Coordinator, my permission to hospitalize, treat and to order, injections, anesthesia medical treatment and/or surgery for my child whose name is: ________________________________________________ Signature _________________________________________ Witness__________________________________________ Date ______________________________________________ Notary ___________________________________________ Relationship ________________________________________ Date ____________________________________________ List medications to be taken, dosage and/or Do you have medical/hospital insurance? _______________ frequency of use: ____________________________________ Name of Insurer ___________________________________ __________________________________________________ _________________________________________________ __________________________________________________ Group or policy # ___________________________________ CAMPER INFORMATION Name ____________________________________________ Age at Camp _______________ Birth Date_____________________ Parent(s) __________________________________________ Vocation ________________________________________________ __________________________________________ Vocation ________________________________________________ Address ___________________________________________________ City __________________________ Zip ______________ Brothers or sisters (names and ages) ____________________________________________________________________________ Church _____________________________________ Association _________________________ Pastor _____________________ School ____________________________________________________________________ Grade __________________________ Organization Memberships ____________________________________________________________________________________ Hobbies ___________________________________________________________________________________________________ Talents ____________________________________________________________________________________________________ Are you a member of an RA Chapter? _______ Challenger? _______ Have you made a profession of faith in Jesus Christ?_______ Have you been to a camp before? _______ If so, where?_____________________________ Do you swim? __________________ What do you hope attending Camp Kaleo will do for you? ____________________________________________________________ __________________________________________________________________________________________________________ What meaningful experiences do you hope your child will gain from attending Camp Kaleo? _________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ Camp Kaleo Policies and Procedures CHILD PROTECTION GUIDELINES FOR ADULT CHAPERONES AT CAMP KALEO To provide a safe and secure environment for all children and youth that use our facilities, adults attending Camp Kaleo as chaperones must comply with the following requirements: Any individual adult attending a GBC/Camp event with children or youth present must submit a Volunteer Application as follows: · Any Individual Adult Chaperone who is not part of a church group, and who is attending a Camp Kaleo youth/children’s event, will need to contact Camp Kaleo to request a Volunteer Application for a background check to be processed through the Georgia Baptist Convention. Please contact Camp Kaleo for an application at 478-994-5333. Please include a processing fee of $17.00 with the Volunteer Application to be returned to Men’s Ministries at the below address. Upon receipt of the application by the Georgia Baptist Missions & Ministry Center, two weeks must be allowed for processing prior to the date of Camp stay. Every church or organization who has adult chaperones must complete, sign and submit a Child Protection Indemnity form as follows: · For Churches and Organizations: the indemnity form states that a Child Protection Program is in place for background checks. (For a copy of the indemnity form, see the following page or go online at www.ga-ra.org) Only one indemnity form per group is required for each camp stay. For any church or organization who does not have a program in place, we can provide a Child Protection packet that may assist you in establishing such a program. Should you have further questions, please contact Men’s Ministries of the Georgia Baptist Convention. Men’s Ministries, Georgia Baptist Convention 6405 Sugarloaf Parkway Duluth, GA 30097-4092 1-800-746-4422 or 770-936-5258 770-452-6575 (fax) 9/3/2014 Edited Camp Kaleo 463 Old Zebulon Road Forsyth, GA 31029-7133 478-994-5333 478-994-2925 (fax) Camp Kaleo Policies and Procedures INDEMNITY PROVISION CHILD PROTECTION PROGRAM: Camp Kaleo – Royal Ambassador and Challengers Camp of The Men’s Ministries Area of the Georgia Baptist Convention – is committed to providing a safe and secure environment for all children and youth that may use our facility and/or participate in activities or events. All churches/organizations that bring children and youth to our facility and/or participate in activities or events are expected to have a proper and adequate child protection program in place and in use for background checks and protection against child abuse. All adult chaperones at the facility and/or activities or events must have completed a background check and be approved through your church/organization's child protection program. By signing this document you are certifying on behalf of your church/organization that your church/organization has an ongoing child protection program in place for background checks and protection against child abuse and that the program is being enforced. INDEMNITY PROVISION: __________________________________ [name of church/ organization using the facility], for itself and for and on behalf of its officers, employees, representatives, volunteers and agents (hereinafter collectively "Indemnitor") covenants and agrees that it will indemnify, protect and hold harmless the Executive Committee of the Baptist Convention of the State of Georgia, and its officers, employees, representatives, volunteers and agents (hereinafter collectively "Indemnitee"), from and against all claims, damages, losses, liabilities, litigation, judgments, proceedings, or expenses of any kind or nature, (including attorneys fees), which may at any time be incurred by, or asserted or awarded against Indemnitee, arising directly or indirectly from, out of, or as a result of: (i) any acts or omissions of Indemnitor (specifically including any negligence), (ii) Indemnitor's breach of, violation of, or failure to fully comply with this agreement or any documents, agreements, commitments or policies provided to or for the benefit of Indemnitee, or (iii) Indemnitor's use and enjoyment of Camp Kaleo and/or participate in activities or events. Further, Indemnitor does hereby waive and fully release and discharge Indemnitees from and against any and all claims, demands, damages, and losses which Indemnitor may incur resulting or arising directly or indirectly from the use and enjoyment of such facility. Signed __________________________________________________________Date______________ Print Name_________________________________________________________________________ Representing Church/Organization_______________________________________________________ Position/Title________________________________________________________________________ Yates/Camps Indemnity Provision Current as of 06/30/05 MINOR PHOTO RELEASE For Camp Kaleo, 463 Old Zebulon Road, Forsyth, GA 31029 SDEFGH TIGJ FKLF WGHI RNOGJHLPHGKQ OL AH CINRS-IQ FKL ATT SHPHN CPFU KPTNK EVNQHJ The Georgia Baptist Convention occasionally uses pictures of campers participating in various activities in printed material, videos, and picture displays. Please read the following and sign as appropriate for your child. I hereby grant the Georgia Baptist Convention the right and permission to use pictures of the minor or pictures in which the minor may be included in conjunction with camp activities in photographs, videos, and printed material. Check one: I hereby state that I, as parent/guardian, have the right to give this permission and do so gladly. I hereby state that I, as parent/guardian, do NOT grant permission to use pictures of my child as stated above.* Minor’s Name: ________________________________________ Address: ____________________________________________ Attach photograph here ____________________________________________________ if you do not grant Parent/Guardian Signature: ______________________________ permission to use Date: _______________________________________________ pictures of your child. * In order to ensure that photographs taken of your child during camp are NOT used as descr ibed above, please attach a cur r ent head and shoulder picture of your child. This photograph will be for office use ONLY. If you have any questions, contact the Camp Kaleo office at: 478-994-5333. ————————————————————————————————————— —————————————— CAMPER RELEASE For Camp Kaleo, 463 Old Zebulon Road, Forsyth, GA 31029 NKH RNXDGLNY FKL FPHINL/SKQ OVNLQGOIH Camper’s Name: ______________________________________________________________________________ These people may under NO CIRCUMSTANCES pick up my child: 1.__________________________________________________________________________________________ 2. __________________________________________________________________________________________ Please list the person(s) who WILL be picking up your child from Camp Kaleo: Name Driver’s License Number (REQUIRED) 1._________________________________________ ______________________________________________ 2._________________________________________ ______________________________________________ 3._________________________________________ ______________________________________________ A staffer WILL check the driver’s license of the person picking up your camper. Parent/Guardian Signature: ______________________________________________________________________ Date: _______________________________________ LAD PACKING CHECKLIST (G 1 — 3) ______ 2 Flat Sheets or a Sleeping Bag or Bed Roll ______ Towels _____ A Light Blanket ______ Wash Cloths _____ Pillow ______ Soap _____ Play Clothes ______ Shampoo _____ Jacket or Sweatshirt ______ Laundry Bag _____ Raincoat or Poncho ______ Swim Suit _____ Underwear ______ Pool Shoes or Flip Flops _____ Socks ______ Canteen or Water Bottle _____ Extra Shoes _____ Flash Light _____ Insect Repellant _____ Bible _____ Spending Money ______ Camera _____ Mission Offering ______ Bandana _____ Immunization Certificate ______ RA Campcraft Book _____ Health History Information Form—Completed OPTIONAL EQUIPMENT ACTIVITIES AT CAMP Flag Assembly Morning Watch Fishing Canoeing Mission Study Hiking Nature Study Evening “Serendipity” New Games Handcraft: Wood & Leather Swimming/Water Sports Evening Worship Cabin Devotionals Campfire Volleyball Variations No Fireworks, Radios, Comic Books, or Tobacco in any form! CRUSADER PACKING CHECKLIST (G 4 — 6) ______ 2 Flat Sheets or a Sleeping Bag or Bed Roll _____ Towels _____ A Light Blanket _____ Wash Cloths _____ Pillow _____ Soap _____ Play Clothes _____ Shampoo _____ Jacket or Sweatshirt _____ Laundry Bag _____ Raincoat or Poncho _____ Swim Suit _____ Underwear _____ Pool Shoes or Flip Flops _____ Socks _____ Flash Light _____ Extra Shoes _____ Insect Repellant _____ Bible _____ Canteen or Water Bottle _____ Pencil or Pen _____ Notebook or Pad of Paper _____ Spending Money _____ Camera _____ Mission Offering _____ Bandana _____ Immunization Certificate _____ RA Campcraft Book _____ Health History Information Form (completed) OPTIONAL EQUIPMENT ACTIVITIES AT CAMP Flag Assembly Morning Watch Mission Study Group Activities Shooting Sports Archery Handcraft: Wood & Leather Campcraft New Games Evening “Serendipity” Horseshoes Evening Worship Swimming/Water Sports Canoeing Cabin Devotionals Overnight Camp-out Fishing No Fireworks, Radios, Comic Books, or Tobacco in any form! YOUNG CHALLENGERS PACKING CHECKLIST (G 7 — 8) ______ 2 Flat Sheets or a Sleeping Bag or Bed Roll _____ Towels _____ A Light Blanket _____ Wash Cloths _____ Pillow _____ Soap _____ Play Clothes _____ Shampoo _____ Jacket or Sweatshirt _____ Laundry Bag _____ Raincoat or Poncho _____ Swim Suit _____ Underwear _____ Pool Shoes or Flip Flops _____ Socks _____ Flash Light _____ Extra Shoes _____ Insect Repellant _____ Bible _____ Pencil or Pen _____ Notebook or Pad of Paper _____ Spending Money _____ Camera _____ Mission Offering _____ Bandana _____ Immunization Certificate _____ RA Campcraft Book _____ Health History Information Form (completed) _____ Pocket Knife _____ Canteen or Water Bottle OPTIONAL EQUIPMENT ACTIVITIES AT CAMP Flag Assembly Shooting Sports Morning Watch Adventure Recreation Mission Study Outdoor Living Skills Group Activities Handcraft: Wood & Leather Campcraft Horseshoes Swimming/Water Sports Fishing Rock Climbing Rappelling Evening “Serendipity” Evening Worship Cabin Devotionals Overnight Camp-out No Fireworks, Radios, Comic Books, or Tobacco in any form! OLDER CHALLENGERS PACKING CHECKLIST (G 9 — 12) ______ A Sleeping Bag or Bed Roll _____ Towels _____ A Light Blanket _____ Wash Cloths _____ Pillow _____ Soap _____ Play Clothes _____ Shampoo _____ Jacket or Sweatshirt _____ Laundry Bag _____ Raincoat or Poncho _____ Swim Suit _____ Underwear _____ Pool Shoes or Flip Flops _____ Socks _____ Flash Light _____ Extra Shoes _____ Insect Repellant _____ Bible _____ Pencil or Pen _____ Notebook or Pad of Paper _____ Spending Money _____ Camera _____ Mission Offering _____ Bandana _____ Immunization Certificate _____ RA Campcraft Book _____ Health History Information Form—Completed _____ Canteen or Water Bottle OPTIONAL EQUIPMENT ACTIVITIES AT CAMP Flag Assembly Shooting Sports Morning Watch Adventure Recreation Mission Study Outdoor Living Skills Group Activities Handcraft: Wood & Leather Campcraft Horseshoes Swimming/Water Sports Fishing Rock Climbing Canoeing Evening “Serendipity” Evening Worship Cabin Devotionals Overnight Camp-out No Fireworks, Radios, Comic Books, or Tobacco in any form!
