You must or mail an Individual Registration Form, Health Form, and Awanita Release Form for each camper, including chaperones.

Transcription

1 Thank you for registering for the Carolina Youth Camp at Awanita Valley Christian Retreat Center for We are so excited about what God has in store for this year s camp! You will find 2018 registration materials and directions for copying and distributing permission forms and liability release forms for each camper. You must or mail an Individual Registration Form, Health Form, and Awanita Release Form for each camper, including chaperones. Due dates for each item are listed in the packet, but if you have any questions, please call Mrs. Cindy at the office at , M-F or camp@cttownsend.com. Awanita Valley Christian Retreat Center requires each group to submit a copy of a Certificate of Liablility Insurance. Please mail or this certificate prior to camp. ALL forms may be ed to camp@cttownsend.com or mailed to CYC c/o CTM at 403 Warner Road in Anderson, SC The safety of your young people and those attending camp is our number one priority. Therefore, we are including one additional form - a Secure Check Form. We ask that each chaperone or camper, 18 years or older, complete a Secure Check form and have it signed by your church pastor. Our legal counsel has advised us that this form is necessary in order to be safe in regards to the adults working with our teens. We are looking forward to seeing you and your group at Carolina Youth Camp; thank you for entrusting your teens to us. Please continue to pray with us that the Lord will move in a mighty way during this week set apart for your teens. In His Service, Carolina Youth Camp Team

2 CAROLINA YOUTH CAMP 2018 Location: Awanita Valley Christian Retreat Center, 600 Gap Creek Rd., Marietta, SC Dates: July 16-20, 2018 Check In: Monday, July 16 from 9:00 a.m. - 12:00 p.m. Check Out: Friday, July 20 by 10:00 a.m. (no activities on Friday) REGISTRATION INFORMATION Total cost per camper is $275 including chaperones. This includes: Lodging Meals T-Shirt Activities A $50 non-refundable deposit is required when registering. Deposits should be remitted to Carolina Youth Camp as soon as possible to reserve your spot. Please make all checks payable to CTM. CHECKLIST FOR VERY IMPORTANT INFORMATION PLEASE READ CAREFULLY q We understand that your numbers may change as camp approaches. Please keep us informed of these changes as they occur by ing us at camp@cttownsend.com. This information is critical to our records and planning of rooms, meals, activities, and sessions. q Ages for camp are Campers ages may serve as Leaders in Training. Adults over 21 are considered chaperones. All Leaders in Training and Chaperones must turn in a completed Secure Check Form signed by their church pastor. We must have 1 chaperone per 5 campers. Please assign both a male and female chaperone if you have both boys and girls attending with your group. q Please roster to camp@cttownsend.com by May 7, You may also mail these by May 7, to CYC c/o CTM at 403 Warner Road, Anderson, SC or mail Individual Registration, Health Forms, and Awanita Release Forms (sorted by type, not by camper) by June 4, Each camper must complete an Individual Registration Form, Health Form, and Awanita Release Form. q Final payment is due May 7, Please mail one church check to CYC c/o CTM at 403 Warner Road, Anderson, SC Please make all checks payable to CTM. q Please do not forget your Certificate of Liability Insurance. Mail or it to camp@cttownsend.com q **NEW!! Early Bird Registration - Get VIP seating for the event and your choice of meal time by registering by November 1, 2017! DATES TO NOTE June 4, All forms mailed or ed to CTM

3 GROUP REGISTRATION 2018 DATE DUE - May 7, 2018 OFFICE USE ONLY DATE RECEIVED: Church Name: Address: City: State: Zip: Phone: Pastor: Cell Phone: Youth Pastor: or Group Leader Cell Phone: Estimated Total Attending: Total Females: Total Males: Estimated Number of Vehicles: Church Van: Large Van/Bus: Office Use Only Total Females: Total Males: Total Attending: Personal Vehicle: COMPLETE GROUP REGISTRATION AND RETURN WITH $50 PER CAMPER NON-REFUNDABLE DEPOSIT TO: CAROLINA YOUTH CAMP C/O C.T. TOWNSEND MINISTRIES 403 WARNER ROAD ANDERSON, SC Deposit Amount: Check #: BALANCE DUE: Date:

4 2018 GROUP ROSTER DATE DUE - MAY 7, 2018 OFFICE USE ONLY DATE RECEIVED: Church: Youth Leader: City, State: Cell Phone: Males Age Shirt Size Females Age Shirt Size Chaperones (Male) Chaperones (Female) Please assign a male and female chaperone if you have both guys and girls attending even if you have a small group. You should assign 1 chaperone to every 5 teens. Group Total:

5 INDIVIDUAL REGISTRATION 2018 First Name: Last Name: Shirt Size: Date of Birth: Age at time of Camp: Address: City: State: Zip: Mom s Name: Dad s Name: Home Phone: Mom s Cell: Dad s Cell: Mom s Work: Dad s Work: Emergency Contact: Phone: Relationship to Child: Permission Form (campers under age 18 must have parent/guardian signature) I, give to attend the Carolina Youth Camp from July 16-20, 2018, at Awanita Valley Christian Retreat Center in Marietta, SC. Liability Release (all campers must complete): I, release, Your Printed Name C.T. Townsend Ministries, Inc., ALL directors and staff, and Awanita Valley Christian Retreat Center from any responsibility involving injury that may occur. General Medical Release: In the event of medical emergency, I understand every effort will be made to contact parents/guardians of attendees. In the event I cannot be reached, I hereby give permission to the physician selected to hospitalize and secure proper treatment for and order injection and anesthesia or surgery for my child as named above. I agree to the release of any records necessary for treatment, referral, billing, or insurance purposes. Photo/Video Release: I understand by attending camp that my child may be photographed or videotaped during normal camp or event activities, and that these photos/videos may be used in promotional materials for C.T. Townsend Ministries, Inc. By signing below I agree to all of the above statements. Name of Church Signature (Parent/Guardian Signature is required if Camper is under age 18.) Date

6 Carolina Youth Camp 403 Warner Road Anderson, SC HEALTH FORM EVERYONE (Students, Chaperones, and Staff) must complete a Health Form. Please Print Neatly. Name Birthdate: / / Gender M F Address Cell Phone Church City, State, Zip Home Phone Emergency Contact Name Emergency Contact Phone Church City and State PLEASE CIRCLE YES OR NO (PROVIDE DETAILS ON BACK IF NECESSARY) Allergic to any Medicines Y N Asthma Y N Tetanus Shot Current Y N Diabetic Y N Allergies Y N Convulsive Disorder Y N List allergies: List any other medical problem of which we need to be aware: Doctor prescribed medications - list and dosage: Make sure your child will have enough medication while at Carolina Youth Camp. All medication will be checked in upon arrival. Camp nurse will store and administer narcotic medications; youth group chaperones will store and administer all OTC and other medications. Special Diet as prescribed by a doctor: Y N If yes, specify: Any activity in which your child should not participate: Is your child covered by health insurance? Y N Insurance Company: Group Number: Please complete the following insurance information. Policyholder name: Policy Number: I/We agree to hold C.T. Townsend Ministries, Inc., harmless of any liability resulting from injuries or loss of property sustained by me/our child during any Carolina Youth Camp function. I/We give consent for my/our child to receive medical treatment by a registered nurse or licensed physician when deemed necessary by the camp director. I/we including insurance coverage for me/my child while I/my child am participating in Carolina Youth Camp activities. I/We agree that I/we are responsible for all medical expenses incurred from injuries/illnesses that I/my child might sustain. SIGNATURES (ALL THREE REQUIRED IF INDIVIDUAL IS UNDER 21 AND LIVING WITH BOTH PARENTS. IF UNDER 21 AND LIVING IN A SINGLE PARENT HOME, ONLY THE ONE PARENT/GUARDIAN SIGNATURE IS REQUIRED.) Minor Father/Guardian of Minor Mother/Guardian of Minor Adult over 21 Date Date Date Date

7 WHAT TO BRING 1. Supplies: Bible, notebook, pen 2. Linens: Blanket, sheets, and pillow or sleeping bag, towels (including beach towel) 3. Personal Items: Toiletry items, hair dryer, soap, deodorant, toothpaste, toothbrush 4. Medication: ALL narcotic type medicines will be checked in at registration. The camp nurse will administer all narcotic medicines. Group chaperones will store and administer OTC and other medications as prescribed. 5. First Aid Kit: Small first aid kit with band aids, bug bite cream, sun screen, etc. 6. Spending money: Meals are included; however, campers may wish to purchase snacks or items from the camp store. Also, music CDs will be available for purchase. DRESS CODE We understand that every church has different standards concerning a dress code. We do not desire to be legalistic in any way, and our main desire of the camp is to reach the hearts of these teenagers; however, there has to be a line somewhere. We are asking you, as a group leader, to make sure each registered camper has a copy of the Code of Conduct and Dress Code. Our goal is to run a clean camp with a practical yet modest dress code. To help with this, and to be very clear, we have included pictures of what is considered acceptable for camp. Use these photos to be communicate with your teenagers what they need to bring to camp. We have found that it can be very embarrassing and hurtful to campers if they come unprepared. We do not want that to happen! SO PLEASE HELP US! Be proactive and prepare your teens for camp with this information so once we get there we can have a great time and see lives changed! Youth leaders and Counselors, please encourage your group to follow the dress code while attending Carolina Youth Camp. All fashions worn should be conservative and professing Godliness in appearance. GIRLS Evening Services: Please wear skirts or dresses. All skirts and dresses should cover the knee. Shirts should cover the shoulders and midriff. Necklines should be modestly designed and not low cut. Morning Services and Activities: Skirts, dresses, capris, or walking shorts (bermuda shorts), or loose fitting garments that are at least knee length Water Activities: One piece swimsuit covered with a dark t-shirt or dark swim shirt; knee length swim shorts. Water shoes or old tennis shoes are suggested. GUYS Evening Services: Long, casual pants or jeans; shirts with sleeves Morning Services and Activities: Long, casual pants, jeans, or shorts, and shirt with sleeves Water Activities: Dark swim trunks and dark t-shirt or dark swim shirt. Water shoes or old tennis shoes are suggested.

8 DIRECTIONS TO AWANITA FROM I-85 - ATLANTA, FLORIDA, GREENVILLE Take I-85 towards Greenville, SC Take EXIT 44 - Hwy 25 North on White Horse Rd. / Greenville Continue on Hwy there will be a split of Hwy. 276 & 25 Fork to the right, stay on Hwy. 25 You are now 30 min. from camp. Pass through the town of Travelers Rest. Continue on Hwy you will pass Cliffs Valley golf course on right. Look for green state road sign that says Awanita Valley Camp Turn LEFT onto Gap Creek Rd. and stay straight for 2.7 miles. Look for our Awanita Valley Camp sign and turn LEFT on a gravel road. Go about 100 yards until you reach our main gate and sign. Follow the gate instructions. If you happen to miss the turn and enter North Carolina, simply make a safe u-turn back into South Carolina. Gap Creek Rd. is the first road on the RIGHT once you enter South Carolina. FROM I-26 - CHARLOTTE, ASHEVILLE, TENNESSEE Take I-26 towards Asheville / Hendersonville, NC Take Exit 54 - Hwy. 25 / Greenville (you are still in NC) Continue on Hwy. 25 for about 20 minutes Once you pass the Welcome to South Carolina sign start slowing down. Look for a green state road sign that says AWANITA VALLEY CAMP Turn RIGHT onto Gap Creek Rd. and stay straight for 2.7 miles Look for our Awanita Valley Camp sign and turn left onto a gravel road Go about 100 yards until you reach our main gate and sign. Follow the gate instructions. **If using a mapping website or GPS you must put in our address (600 Gap Creek Road in Marietta, SC) If you search the camp name it will take you to a closed, dead-end road. You will find the correct entrance as long as you type in the address. EMERGENCY CONTACT NUMBER Awanita Valley Christian Retreat Center (Cell service is spotty, please provide parents with this number.)

9 SECURE CHECK FORM I, Pastor of do hereby affirm that the chaperone listed is in good standing with our church and that all applicable background checks have been performed to ensure the saftey of the children entrusted to his/ her care. In addition, I affirm that the listed chaperone is NOT listed on our state s or any other state s Sex Offender Registry. I affirm that this chaperone has no criminal record involving crimes against children, violent, or domestic crimes. Chaperone Full Name: Pastor Signature: Date: PLEASE RETURN SIGNED COPIES FOR EACH CHAPERONE OR CAMPER AGES 18 AND OLDER.

10 Awanita Valley Liability Release Form SPONSOR SHOULD MAKE COPIES FOR EACH CAMPER We reserve the right to refuse service to anyone who does not have an Awanita Valley liability release form signed by the proper individual, and/or parent or guardian. If you or your child has existing medical limitations, including allergies, which would affect or limit you or your child s participation in any camp activity, or of which medical personnel should be aware of, please indicate below. Without such notice, it will be assumed that you or your child is physically fit and mentally capable of participation in ALL activities. **Please notify the leader of your group of any medical limitations or special needs. **The leader of your group will be responsible for taking care of these special needs. Awanita Valley, Donald Baltz Foundation, and, Church or Group Name including employees and representatives of the aforementioned organizations shall be held harmless from any suit, action, damages, or claims at law or otherwise resulting from or arising out of any injury, accident, or illness which may befall on and his/her property while a camper at Awanita Valley. Name of Camper If the camper is a minor, this covenant is applicable to the camper and his/her parents or guardian. The undersigned parent or guardian hereby authorizes Church or Group Name or employee to take such action as may be necessary for the medical care or treatment including the administration of medication, permission for surgery, or other such action as needed in the event of injury or illness of camper or when parent or guardian cannot be reached for authorization. In the event the authorized person refuses or is not able to act, Awanita Valley personnel are authorized as set forth above. This authorization may be presented to medical personnel without liability of said personnel to seek further authority. I understand that as a participant, my child may be photographed or videotaped during normal camp or event activities and these photos/videos may be used in promotional materials. I authorized my child to share or not to share their address with Awanita Valley for future camp updates. Date Signature of Camper Date Signature of Parent/Guardian, if camper is under 18 years of age

11