Area 14 Day Camp 2019 Celebrating You June 24-28, 2019 Camp Shantituck Training Dates for volunteers and AIDEs May 19, June 24 @Camp Shanituck Based upon the interests of the campers the possibilities are endless. Some potential activities / programs include: Cadette Program, AIT Program, Crafts, Creek Stomping, Swimming, Archery Area 14 Day Camp: June 24-28, 2019 Monday Thursday: 9 am 4 pm Friday: 9 am 3 pm Location: Camp Shantituck $100 for Campers $50 for Aides & AITs No Charge for one Kindergarten, Pixie or Boy of Adult Volunteers Each additional Kindergarten, Pixie or Boy is $5 per day. Three or more siblings in the same household can register at a discounted price of $90 for each general camper and $40 for Aide/ AIT campers.
Girl Scouts of Kentuckiana Day Camps and Summer Camporees Any girl may attend camp. If she is not currently a Girl Scout, all you need to do is submit her Girl Scout Membership online. This fee will provide membership through September 30th of the current troop year. REGISTRATION IS ON A FIRST COME BASIS! Registration opens 3/1/2019 and closes WHEN CAMP IS FULL. There is a limit on the number of campers allowed at camp. You may continue to apply for camp up until the week before camp. Please email to see if spaces are still available. Please remember camp often fills up by the end of May, so please get your registrations in as early as possible. Send the completed registration form and signed health history with a check or money order for $100 payable to Area 14 Day Camp. **Do not wait on GSK Rewards or Financial assistance. Remove and complete the registration form and health history in this brochure. Financial assistance will only paid ½ the fee or less depending on funds. Please send in $50 with your forms.** If you will be using GSK Rewards, make the check payable for the balance due ($100.00 less GSK Rewards amount). Email GSK Rewards cards to daycamparea14@gmail.com as soon as it is received. Incomplete registrations will not be processed. All registration materials should be mailed to: Area 14 Day Camp PO Box 81 Hillview, KY 40129 Financial Assistance Financial assistance is available to registered Girl Scouts. Mail the Financial Assistance Request (RS 526) with your other camp forms to the camp registrar or email the Financial Assistance Request (RS 526) only to council. The Girl Scout office will notify both you and the camp registrar of the decision concerning your financial assistance. Each family must be prepared to pay ½ or more of the fee. Council only pays ½ or less of the camp fee depending on funds. The earlier you send the form in the better. Refunds The camp registration fee may be refunded for a cancellation due to illness, family emergency, or relocation. Requests for refunds must be made in writing to the camp director at least four weeks prior to the first day of camp. After this time, food, Shirts and supplies have already been budgeted and bought for you camper to attend. Health and Safety Girl Scouts of Kentuckiana camps adhere to the standards for health and safety set by the state and the Girl Scouts as printed in Volunteer Essentials and Safety Activity Check Points. Lost and Found Please label all belongings with your name. Promptly contact the camp director about lost items. Girl Scouts of Kentuckiana and camp staff cannot be responsible for loss of or damage to campers personal belongings.
Local Girl Scout Office Metro Louisville - 502-636-0900-888-771-5170 More information about camps can be found on the GSK website www.gskentuckiana.org. QUESTIONS? Day Camp Director: Day Camp Registrar: Angie Arbaugh Email: daycamparea14@gmail.com Lisa Hester Area 14 Day Camp PO Box 81 Hillview, KY 401290 Email: daycamparea14@gmail.com General Information and additional forms will be available at the Kentuckiana Girl Scout web site. Please remember that Area 14 s camps are coordinated and run by volunteers. These volunteers are also parents, hold jobs and are busy people. Please make sure to read over all camp information before contacting us with questions. These volunteers devote a great deal of time and energy to planning and running an excellent camp program. Also, consider volunteering your time to assist with camp. We can t have camp without the volunteers. Outdoor training will be available during May through the council which will help you prepare for day camp. REMINDERS:. You will receive a confirmation email if your daughter gets into camp. Check you spam folder if you haven t received anything. Please remember we can only take as many scouts as we have Adult volunteers to meet ratios. Please consider volunteering your time to ensure as many scouts can have the camp experience as possible. Scouts of volunteers are guaranteed a spot at camp. Requests for placement of girls to be with other girls in a unit will be taken into consideration (please put any placement requests in the space provided on the registration form). We cannot guarantee placement due to the number of girls attending. We do split up troops so girls can make new friends. NO Changes can be made within four weeks of camp due to logistics. EMERGENCY INFORMATION Safety is an important concern to us with Girl Scout camp. We work hard to ensure that all volunteer adults are trained for camp and that all Girl Scout safety standards are met. Please make sure that you have filled out your daughter s Health History Form for camp, including emergency contact number. EMERGENCY PHONE NO. FOR CAMP SHANTITUCK: 957-3920 Please use this number for emergencies ONLY Follow our face book page for updates, photos, and emergency information. Day Camp Area 14, Girl Scouts
Planned Bus Schedule Location Days Morning Pickup Afternoon Drop Off St Gabriel M,Tu 8:15am 4:30pm St Gabriel W 8:15am NONE St Gabriel Th NONE 4:30 St Gabriel F 8:15am 3:30pm Location Days Morning Pickup Afternoon Drop Off Mt Washington Elem M,Tu 8:15am 4:30pm Mt Washington Elem W 8:15am NONE Mt Washington Elem Th NONE 4:30 Mt Washington Elem F 8:15am 3:30pm Location Days Morning Pickup Afternoon Drop Off Southern High School M,Tu 8:15am 4:30pm Southern High School W 8:15am NONE Southern High School Th NONE 4:30 Southern High School F 8:15am 3:30pm Bus times subject to change dependent upon camp enrollment. **There is no bus service on Wednesday afternoon or Thursday morning due to the overnight. **Friday afternoon pickup is one hour earlier
Adults: Do you have some time you can give to camp? This camp is staffed by volunteers who give their time freely so that all interested may attend camp. We are looking for adults to help provide this wonderful experience for girls. We are limited in size by the number of adults willing to volunteer; to accommodate all the girls who want to attend camp, lots of adults are needed. No previous experience is required! Volunteers with GSK camp or adventure trainings are always needed. You might help out by being a unit leader with girls, boys, or Pixies. Volunteers are also needed to offer special programs such as crafts, fishing, archery, etc. In fact, almost any skill or interest you can share can probably be used! Volunteering at camp is fun and a unique opportunity for you to have an important impact on your camper. *****All camp volunteers must complete online the Volunteer Application (RS 503) which has a fee and is good for 3 years. Adults are also required to become registered adult members of the Girl Scouts for insurance purposes. Adults can register online for membership, do not send in with registration. Please note that adult volunteers are not placed with their daughter(s).***** TRAINING FOR ADULT VOLUNTEERS: It is preferred though not required for all adults working day camp to possess / obtain at least Camp In A training offered by the Council. Unit Leaders will need to have Camp Out certification. Information and registration is available through the council or by logging on to http://www.kyanags.org/calendar/. Outdoor training weekend is May 17-19, 2019, this is a great opportunity to get in camp in A,B or camp out certifications. Please consider attending. Our first day camp training will be Sunday after these sessions are over. Area 14 Day Camp Training is required for volunteers. New this year: Instead of 3 trainings there will be an online or home training that all adults will need to complete before the first training. This information will be emailed when we received your registration. Trainings will be held at Shantituck on the following dates: Sunday, May 19, 2019 from 6:30-8:30pm (after outdoor training weekend) Sunday, June 23, 2019 at 3:30 6:30 pm All Volunteers, Aides, and AIT s are expected to attend the camp setup day June 23. Daisy Scouts Kindergarten, Younger Siblings & Sons We offer a unit for Daisies grade K, Pixies (children 3-5 years of age and potty-trained) and a boys unit (ages 6-12) only for those adults that come out and work at camp. This service is offered at no charge for one child. Additional Kindergartner, Pixies, & Boys are $5 per day. Please note on the Adult Application that you will be bringing Daisies, pixies or boys with you. Also complete a registration form and health history for each. (Daisies, pixies & boys can only be at camp while their parent is working at camp.) FULL TIME VOLUNTEERS ARE GUARANTEED A SPOT FOR THEIR DAUGHTERS AT CAMP! (We can t have camp without Volunteers!)
Registration for Adult Camp Volunteers Complete a health history and this form even if you have pre-registered. (Please print) Name: EMAIL Phone Please circle all of the training that you have completed: Camp In A (Level 1) Camp In B (Level 2) Camp Out (Level 3) First Aid CPR Archery Wilderness Camping (Level 4) Teams Course Dr./Nurse/EMT Other: Have you completed a volunteer application form in the last 3 years? Yes No Are you a registered Girl Scout? Yes No Have you completed the Shield the Vulnerable online training? Yes No I am interested in working Day Camp. Circle all days or nights that you are available Mon. 6/24 Tues. 6/25 Tues Night 6/25 Wed. 6/27 Wed Night 6/27 Thurs. 6/28 Fri. 6/29 I will ride the bus to day camp Yes No I can serve as a bus monitor Yes Full-time volunteers receive a complimentary shirt. Circle size: S M L XL XXL XXXL No Name of adult volunteer you would like to be paired with Every attempt will be made to honor requests. This may not always be possible in order to meet Safety Activity Check Points I will be bringing a daisy, pixie or boy to camp with me: Y N Pixies must be 3 years old and potty-trained Please submit registration and a health history for you, the Kindergartener, Pixie or boys that you will be bringing. Shirts for Daisies, Pixies and Boys are $10. Indicate size on the corresponding registration form. I understand that I need to attend the training offered in order to serve as a camp volunteer, I also understand that my daughter will not be placed in my unit. Signature
PROGRAM AIDES FOR AREA 14 DAY CAMP Older Girl Scouts, if you are looking for an opportunity to share your leadership skills and to help our younger girls experience camp, then being Program Aide at camp might be for you! Area 14 Day Camp: June 24-28. 2019 Time: Mon-Thur 8:30am 4:00pm Friday 8:30am -3pm (Plus 3 overnight experiences) AIDES/ AIT s are invited to stay Sunday and Tuesday night. Wednesday night the whole camp stays overnight. To be an AIDE at camp you need to be entering the 9 th grade or higher in the fall of 2019 and have completed the AIT program or get camp director s approval. You will also need to be interviewed by the Day Camp Staff and sign a code of conduct. Aides-In-Training (AIT) must be entering 8th grade. Training: Program Aides and AITs must attend the scheduled day camp trainings and camp setup day. Training #1: Sunday, May 19, 2019 6:30 8:30pm Camp Setup Day: Sunday, June 23,2019 3:30 6:30 pm Send an email to: Angie Arbaugh at Daycamparea14@gmail.com. Email should contain your name, brief explanation of why you can t attend the training session and a phone number where you can be contacted. Things to consider before volunteering as an AIDE or AIT: Please make sure camp does not interfere with your summer job. When working with a unit, we need you all day, every day. In order to serve all the girls, we need aides. If you are not chosen to work as a Program Aide or AIT or if your summer job schedule only allows you to be at camp part-time, we would love to utilize your talents in other areas such as cooking, songs, games, fire building, etc. Remember, you are a wonderful role model for the younger girls and they will be WATCHING YOU! You do make a difference. Your application is important. If interested, be sure to fill out the application form along with the camper registration form and health history and mail it to the Area 14 Day Camp Registrar. Program Aide and AIT camp fee is only $50 for the entire week, and includes overnights, food for overnights, camp shirts and patch. The cost can be covered by GSK Rewards. Volunteering as a Program Aide or AIT may fulfill community service hours required for school. Check with your school counselor.
Campers Name Health History Form Complete one for each girl, pixie, boy and adult camper and mail to your camp registrar. Please PRINT clearly and legibly. Emergency Information: Custodial Parents/Guardians Names Birthday Home Phone Cell Phone Work Phone Emergency Contact (if parent/guardian cannot be reached.) Name Relationship to Camper Home Phone Cell Phone Work Phone Camper s Physician Office Phone If hospitalization is required, take camper to Allergies: Check those that apply, specify nature and if treatment requires the use of an Epipen, Benadryl, etc.) Allergy Nature of Allergy / Treatment Allergy Nature of Allergy / Treatment None Hay Fever Animals Medicine/Drugs Food Plants Insect Other: Illnesses, Injuries or Health Conditions: (check those that apply) None Bed Wetting Headaches Motion sickness ADD/ADHD Bleeding/Clotting Disorder Heart disease/defect Seizures Asthma Diabetes Hearing Impairment Other: Immunizations Immunizations are up to date. Family chooses not to immunize. (Provide state approved exemption form from Health Department) Date of last Tetanus shot: Camper may take acetaminophen (ex: Tylenol). Yes No Camper may take ibuprophen (ex. Advil) Yes No Camper may use antibiotic ointment (ex: Neosporin). Yes No Health Supervisor Permission for Medications: (check those that apply) Camper may take oral antihistamine (ex: Benadryl). Yes No Camper may use topical antihistamine (ex: Benadryl). Yes No If you checked yes to any illnesses, injuries or other health conditions, please attach a separate sheet of paper with explanation. Give nature, dates, period of any disability and results. Also, list any activities that should be restricted. Information about medications: Is camper taking any medication? Yes No If yes, attach a list of the camper s current medications to this form; send a list of any medication changes or updates the first day of camp. Medications for campers under the age of 18 must be kept in the possession of the health supervisor at all times (unless otherwise noted) Any medication to be dispensed should be indicated on the Health History Form. All medication, including over-the-counter products, should be in the original container and marked clearly with the participant s name and directions for use. Prescribed medications and over-the-counter products must be administered in the prescribed dosage by or in the presence of the health supervisor or as per written instructions of a custodial parent, a guardian, or a physician. Medication can only be dispensed to the person named on the prescription container. As per the Safety-Wise chapter of Volunteer Essentials; medications, including over-the-counter products, cannot be dispensed without prior written permission from a girl s custodial parent or guardian. the The Health History Form is for health care concerns at this camp only. All medical records will be held in limited access by the health care supervisor of this camp. Minimally necessary information may be shared with camp staff/volunteers in order to provide adequate participant safety and health care. The health history form will be retained by GSK along with all forms/records with noted treatment for seven years past the age of maturity of the participant. Access to the information will be limited. I have read the above procedures for handling the health form information and I agree to the release of any records necessary for treatment, referral, billing or insurance purposes. Parent s or Guardian s Statement & Signature - My camper has had a physical examination within the past 24 months and is in good health. I give full permission for my camper to attend camp and participate in all activities (except as noted on this health history.) The Girl Scouts of Kentuckiana is held harmless in the event of an accident. In the case of injuries, I give permission for medical treatment as deemed necessary. Permission is granted to use any pictures or video footage of my camper for Girl Scout promotional purposes. I agree that all information including immunizations is complete and up to date. Volunteer Statement & Signature - I am in good health and able to participate in all activities at camp (except as noted on this health history.) The Girl Scouts of Kentuckiana is held harmless in the event of an accident. In the case of an injury, I give permission for medical treatment as deemed necessary. Permission is granted to use any pictures or video footage of me for Girl Scout promotional purposes. Parent/Guardian or Volunteer Signature Date:
Girl Scouts of Kentuckiana Area 14 Day Camp Registration Form Complete a form for all campers, Program Aides/AIT s, Pixies, Boys, & Adults Mail with fee SIGNED Health History form, and Fee Summary Registration Type: General Camper $100 Non-Scout $100 Program Aide $50 Aide in Training $50 Childern of Adult Volunteers only: Kindergarterner Pixie Boy One child free, additional Child $5 per day Three of more siblings living in the same household can register at a discounted rate of $90 per camper and $40 for Aides & AIT s Camper s Name (Last, First) Address Birth Date / / Age Grade in FALL Troop# Years as a Girl Scout Fall Scout Level: Daisy 1 st Grade Brownie(2-3) Junior(4-5) Cadette(6-7) Senior/Ambassador T-shirt size: YS YM YL AS AM AL XL AXXL XXXL Please mark the size for your camper. NO exchanges at camp. Shirts are a 50/50 blend. Request placement with other scout. Name Placement requests are not guaranteed. Girls must be in the same level of scouting to be considered for placement togethert. Silblings will not be place together. Camper plans on staying the night Wednesday? Y N If not will need to be picked up at 4pm Wed Transportation to & from camp: Car Rider Bus Rider (Select Bus Stop Below) Morning Pick up time is 8:15am, Afternoon drop off time is 4:30pm (3:30pm on Friday) St. Gabriel Mt. Washington Elementary Southern High School There is no bus service on Wednesday afternoon or Thursday morning due to the camp overnight. Friday pick up is 3:30pm (1 hour earlier) Parent is willing to be a bus stop volunteer? The bus company requires one at each stop or they will not provide bus service to that stop. Custodial Parent/Guardian Information: Camper is in the custody of: Both Parents Mother Only Father Only Other: Mother/Guardian Name Phone no Email Alt no Father/Guardian Name Phone no Email Alt no Name of other persons authorized to pick up camper
Fee Summary Sheet Complete this page & send to Registrar Make checks payable to A14 Day Camp. Fees include registration, T-Shirts, Bus Transportation, Unit Photo, Snacks, Lunch everyday, Dinner on Weds night, Breakfast on Thurs, and program supplies. List each camper and their amount due. Items to include: Incomplete forms or non-payments will not be processed. 1. Completed Registration form 2. Completed & Signed Health History 3. Payment by check, money order, or Kentuckiana Credits 4. Financial Request form plus $50 for each camper (council only awards $50 or less) Fee Description Name Amount Camper $ Camper $ Camper $ Camper $ Pixie $ Pixie $ Boy $ Boy $ Fees Camper $100 Aide $50 AIT $50 Volunteers only: 1 Pixie or Boy free Each additional Pixie Or Boy $5 each day T-Shirt for Pixie or Boy $10 each X Quantity $ Part Time Adult T-shirt $10 each X Quantity $ Total fee $ Amount enclosed $ Ck # Kentuckiana Credits due $ Financial Assistance Requested $ Please Email Front & Back of Kentuckiana Card to daycamparea14@gmail.com ASAP Mail to: Area 14 Day Camp P.O. Box 81 Hillview, KY 40129 Checks made to A14 Day camp For Registrar s use only Date Received Outstanding Balance Amount Received: Cash Check Kyana Credits Financial Assistance Total Paid