JR. 31 JULY 4 AGES 12-15 AUG CAMP REGISTER HILL COUNTRY CAMP 1325 HARPER RD KERRVILLE, TX #STXYC17 FACEBOOK.COM/SOUTHTEXASYOUTH INSTAGRAM.COM/SOUTHTEXASYOUTH
SOUTH TEXAS JR. HIGH YOUTH CAMP
YOUTH LEADER CHECK LIST Pray and fast for our South Texas Youth Camps. Complete ONE ONLINE registration for your youth group and workers at http://www.stxupci.com/ Print out the Camp Individual Registration and Health Forms. Have each camper fill out the health form and turn them into you. Bring them with you to camp. Print out the Youth Worker Forms. Have all youth workers fill out youth worker forms and turn them into you. Bring them with you to camp. Print out the Group Registration Form. Fill it out. Have your pastor sign it. Bring it with you to camp. Review guidelines with campers and workers. Email/Call Charlie Moore or Daniel Bernard if you have questions. (Contact info below.) COMPLETE REGISTRATION BY JULY 25 th. HAVE FUN AT CAMP!
FREQUENTLY ASKED QUESTIONS 1. What is youth camp? It s an incredible four-day camp just for the youth of the South Texas District UPCI. You will experience a powerful move of the Holy Spirit, Apostolic ministry and Biblical teaching, fellowship, food, sports, fun, and much more. We re anticipating hundreds of youth to share this experience with us. 2. How much is youth camp? $160 per-camper if registered by July 25 th. $185 after July 25 th. $100 for workers (must be 20+ to qualify for the worker rate) 3. What does this cost include? Includes all of your main meals, lodging, amenities, dynamic apostolic preaching and worship for the entire week! 4. Who gets to come? The Jr. High youth camp is available for teenagers 12-15 years of age. We encourage each group to have their own leaders who stay in the dorms with their group. The leader/camper ratio at youth camps is 1 leader per 10 youth. 5. How do I sign up? Fill out ONE ONLINE registration form for your church s youth group and all workers, including yourself. Link and directions at http://www.stxupci.com/ Please print out the Health Forms, Youth Worker Forms, Group Registration Form, and all other info online. Have all youth and youth workers from your church turn in their forms to you and bring them with you to camp. You will turn these forms in on the first day of camp. 6. How do I pay? Payments are made online when you fill out the church registration online. 7. What happens if I cancel? Once the final number of attendees is submitted, groups are responsible to pay the complete balance for all of the total number of attendees submitted. 8. What facilities and activities are available? Our camp is at the beautiful Hill Country Camp and Conference Center: 1325 Harper Road Kerrville, TX 78028: a Christian camp facility with a 1,000 seat venue, full service commercial kitchen, retreat quality dorms, 65 foot waterslide, lake activities, swimming pool, volleyball courts, basketball courts, softball field. More info at http://hillcountrycamp.cc. 9. Will our group stay in the same dorm? The time at camp is a special time for youth group unity. Our goal is to keep each group together. If a group is divided, we will work with the leader of the group to get the best arrangements possible. Late registrants, however, cannot be guaranteed being housed with their group. 10. When do I arrive and depart from the youth camp facility in Kerrville, TX? Youth Camp check-in begins at 3:00pm on Monday, July 31 st. Check-in and registration will be from 3:00pm-5:00pm. The departure time is 11:00am on Friday, August 4 th. Early release for groups will not be permitted except for unavoidable extenuating circumstances.
REGISTRATION INSTRUCTIONS 1. Fill out ONE ONLINE registration form for your church s youth group and all youth workers, including yourself, at http://www.stxupci.com/. This will ensure that your group is housed together and enable registration to run smoothly. a. Fill out ONE ONLINE REGISTRATION FORM for your church youth group and workers, including yourself, at http://www.stxupci.com/ b. Print the INDIVIDUAL REGISTRATION AND HEALTH FORMS. Have each camper fill out a form and turn it into to you. c. Print YOUTH WORKER FORMS have all youth worker s fill out the form and turn it into to you to be signed by the senior pastor. d. BRING THE FOLLOWING FORMS WITH YOU TO YOUTH CAMP. i. One Group Registration Form Have your SENIOR PASTOR SIGN GROUP REGISTRATION FORM for your church in order to verify the information on the group application. It will not be accepted without a pastoral signature. ii. All of the Camp Individual Registration and Health Forms iii. Youth Worker Forms 2. LATE REGISTRATION FEE is $185 and will be charged to all campers who register after JULY 25 th. a. Late registrants register at the camp check-in on Monday, July 31 st. b. No late registrations will be guaranteed a place in the dorms with a pre-registered or other designated church group. c. No group can save beds for late-registered Campers. d. The availability of space cannot be guaranteed. Late registration will end when capacity is reached. 3. On-site REGISTRATION will be from 3:00pm-5:00pm on Monday, July 31 st. a. PLEASE DO NOT ARRIVE UNTIL 3:00PM. ARRIVING EARLY DOES NOT HELP WITH YOUR DORM PLACEMENT. DORMS ARE PRE-ASSIGNED. b. When you arrive remain in vehicle and follow directions given by camp staff personnel. c. Send your whole group in to check-in, obtain armbands, pay for late registrants, and get dorm assignments. d. If you are pre-registered but are running late, please call (210-365-2189). 4. DORM ASSIGNMENTS It s important that campers go to their assigned dorm and room so we do not displace larger groups that arrive later. We ask that our leaders help us ensure that every group is in its correct area. We will have additional leaders helping direct people. 5. ALL CAMPERS MUST DEPART FROM THE CAMPUS BY 11:00 AM FRIDAY MORNING.
GROUP REGISTRATION FORM Church Name Church Phone Senior Pastor s Name Phone Youth Leader/Contact Person s Name Home Phone Cell Phone Email Total Count of Attendees* = (Including Adult Chaperones) Total Male Count = Total Female Count = PLEASE ATTACH A LIST OF THE FIRST & LAST NAMES OF EVERYONE ATTENDING WITH THIS FORM *The number of campers you enter should match your ONLINE registration number. If not, extra campers will be considered late and you will be responsible to pay $185 per each additional camper. Estimated time of arrival: (Registration is from 3:00PM 5:00PM) PLEASE READ Consent and Certification I, the undersigned, with the consent of the parents or legal guardians of the minors in our group, do hereby consent to the participation of our group in all scheduled activities during the South Texas District Youth Camp, and any other activities customarily associated with this camp. Further, I certify that every attendee is physically fit and adequately prepared to participate in all sporting events. I am personally aware of the nature of the activities conducted at Country Camp in Columbus, Texas. I have advised the applicants of all camp rules and their obligation to abide by them, and I hereby pledge to uphold the camp in all the Youth Camp policies and recommend all attendees for admission into Youth Camp. Medical Treatment Authorization I understand that I will be notified in the case of a medical emergency along with the parents. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. I authorize the camp staff to make emergency medical care decisions on behalf of my child. I understand that the South Texas District UPC will not be responsible for medical expenses incurred solely on the basis of this authorization. I agree to notify the Youth Camp in the event of any health issues, which would restrict anyone in our group from participating in any normal youth camp activities. I also understand that the adult supervisors reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child. Senior Pastor Youth Leader or Chaperone Date Signed Date Signed
GUIDELINES FOR CAMPERS (Please review with youth group.) DON T FORGET TO: Fill out the Individual Registration & Health Form with parental signature and turn it into your youth leader. Have the information from the Youth Camp Registration Packet explained to you by your youth leader. Check with your church leaders for all available information concerning the camp. Prepare your heart to receive all Jesus has for you at STX YOUTH CAMP! BRING Bible Linens/Sleeping Bag Pillow Towels Toiletries Flashlight Dress Clothes, Casual Clothes, Active Clothing Swim suit Spending Money DON T BRING Weapons Fireworks Valuables (Each camper is responsible for his or her own items.)
GUIDELINES FOR CAMPERS (Please review with youth group.) Dress Code Boys - The following items are prohibited: Shorts, jams, or short pants Extremely short-sleeved shirts or tank tops All jewelry (rings, necklaces, etc.) Mustaches, beards, or long sideburns Any other immodest apparel While swimming dark-colored t-shirt must be worn. Be fully covered to and from swimming area. Girls - The following items are prohibited: Skirts and/or slits that come above the knee Shorts, pants, or clothing that appears to be shorts Extremely short sleeves, capped sleeves or tank tops All makeup (eyeliner, lipstick, etc.) All jewelry (rings, necklaces, etc.) Immodest apparel While swimming dark-colored t-shirt must be worn. Be fully clothed to and from swimming area. Conduct Code The following conduct and items are prohibited: Cursing Disobedience Disrespect to Camp and Hill Country Staff Public display of affection Skipping class or church Abusing Country Camp property Shaving cream misuse and/or abuse Fighting Out of the dorm after curfew Media: ipods, radios, etc. Disobeying youth workers Other conduct that is not conducive to the spiritual nature of this camp Grounds for Immediate Dismissal Any combination of three issues listed above Possession or use of illegal drugs, alcohol or tobacco Possession of knives, firearms or any illegal weapon Possession of pornography Leaving the grounds without authorization Sexual Promiscuity Fighting Vandalism of camp property Destroying another camper s personal items Theft
HELPFUL GUIDELINES FOR YOUTH WORKERS (Please review with all adult chaperones.) Successful Discipline Discipline with a Smile 1. Follow the three warning rule: a. First give warning for inappropriate or disrupting behavior. b. Second, if the problem continues, have the youth stay with you and lose privileges for as long as your determine. c. Third, if previous two solutions do not help, bring the youth to your church leader or a member of the South Texas Youth team for further discipline. 2. Discipline in Love 3. Don t blow up. 4. Don t destroy their dignity, using ridicule, shame, or sarcasm. 5. Allow kids to be kids. (It is permissible for kids to act crazy sometimes, as long as they don t enter into an area of comprise, such as dangerous behavior or rebellion to authority.) 6. Let them know what you expect out of them. 7. Don t be afraid to confront inappropriate behavior. 8. Discipline is for the benefit of others. One person should not ruin the experience for others. 9. Give the benefit of the doubt. Ask yourself, was the conduct willful or just careless. Careless behavior may just warrant words of caution, not actual punishment or deprived privileges. 10. Don t be afraid to ask for help. 11. Get the story straight. Hear both sides before administering disciplinary actions. 12. Pray after discipline. This will let the camper know that you care about them. Dorm Supervision 1. Curfew: each leader is responsible to see that all campers in his group are accounted for and in their dorm by curfew. 2. Lights out: once a time is determined for lights out by the dorm leaders, youth should respect this time and not be disruptive. 3. Leader Presence: there should always be adult leadership in the dorms if youth are present. 4. Special Medical Cases: be aware and make nurse aware of any pre-existing physical conditions of campers in your group 5. Be Sensitive to Others 6. Personal Items: consistently remind those in your group and dorm not to leave personal items or valuable unattended 7. Cleanliness: all leaders monitor dorm cleanliness and see that areas are kept neat and presentable 8. Keep your eyes open: some youth may make plans for a late-night rendezvous after curfew. Leaders should strategically position themselves by the doors of the dorm to prevent such attempts. 9. Stop things when they first start: All leaders should be sensitive and quick to put a stop to any friction or inappropriateness 10. Don t Overlook Anyone: Make sure that everyone feels a part of the group. Don t let anyone be an outsider.
YOUTH WORKER FORM (Page 1 of 2) All attending adults must complete and turn in this youth worker form. This application must be completed in full by applicants seeking any position involving interaction with, or the supervision of young people. It will be used to help the South Texas District provide a safe and secure environment for youth who participate in our camps. Church Name First Name Middle Name Last Name Age Address City, State Zip Driver s License Issue State Date of Birth Gender Home Phone Cell Phone Email List any other churches you have attended regularly during the past five years: Name of Church Pastor s name Name of Church Pastor s name Are You Baptized in Jesus name? m Yes m No No Have You Received Holy Ghost? m Yes m Position applying for (must choose one): m Monitor m Dorm Dean / Dorm Matron m Other Have you ever worked at a South Texas District YOUTH CAMP? m No m Yes Have you ever been convicted of or pleaded guilty to a crime? m No When? / / m Yes If yes, explain:
YOUTH WORKER FORM (Page 2 of 2) References Name Phone Address City/State/Zip Name Phone Address City/State/Zip Name Phone Address City/State/Zip TO BE COMPLETED BY THE SENIOR PASTOR AS THE SENIOR PASTOR, I AM NOT AWARE OF ANY REASON WHY THIS WORKER SHOULD NOT BE ALLOWED TO WORK WITH YOUTH CAMPERS. TO MY KNOWLEDGE THERE HAS BEEN NO RECORD OF PHYSICAL OR SEXUAL CHILD ABUSE IN THE APPLICANT S HISTORY. I RECOMMEND THE APPLICANT TO BE ACCEPTED AS A YOUTH CAMP WORKER. I have have not conducted a background check on the applicant. (No application will be accepted without Pastor s signature.) Senior Pastor s Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Senior Pastor Date Signed Youth Worker Consent and Certification The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for YOUTH ministry. I understand a criminal record and background check will be conducted as a result of this application. In consideration of the receipt and evaluation of this application by the South Texas District YOUTH DEPARTMENT, I hereby release any individual, church, youth organization, charity, employer, reference, or any other entity, including record custodians, both collectively or individually, from any and all liability for damages of whatever kind or nature which may arise to me, my heirs, my family, on account of compliance or any attempts to comply, with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my application be accepted, I agree to abide by and be bound by the Bylaws of the South Texas District United Pentecostal Church, and the YOUTH CAMP policies, and will fulfill the job description given to me by the Executive YOUTH CAMP Committee, and refrain from unscriptural conduct in the performance of my services on behalf of the district. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement, which I have read and understand. I HAVE HAVE NOT COMPLETED THE STAFF TRAINING SESSION PROVIDED BY THE SOUTH TEXAS DISTRICT UNITED PENTECOSTAL CHURCH. Youth Worker s Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Youth Worker Date Signed
Discovery Camp Individual Registration and Health Form PLEASE PRINT CLEARLY AND DO NOT FAX IN Dates Attending: / - / Have you ever attended Discovery Camp? Yes No First Name: Last Name: Birthday: / / Age: Sex: M F Address: State: Church Name: E-mail: Parent(s) or Guardian (or Spouse) This document to be filled out by parents/guardian of minor or by adult camper/staff members themselves. Last: First: Address: State: Zip: Zip: City: Phone: ( ) - City: Phone: ( ) - If not available in an emergency, notify: Last: First: Address: Allergies: Insect Stings Penicillin Other Drugs Asthma Other: City: State: Zip: Phone: ( ) - Health History: Has this camper ever required psychiatric Check & give approximate dates: counseling or hospitalization? Yes No Ear Infections Explain: Heart Defect Hay Fever Ivy Poisoning, etc. Heart Disease Convulsions Diabetes Bleeding Disorders Clotting Disorders Hypertension Mononucleosis HIV-AIDS TB Cancer For Ages 17 & Under Operations or serious injuries(dates): Disability or chronic or reoccurring illnesses: Activities encouraged or limited by physician: Dietary modifications: Current medications(send with instructions): Name of dentist/orthodontist: Dentist phone: Name of family physician: Physician phone: Does your family carry medical insurance? Yes No If so, indicate : Carrier Policy or Group # Carrier phone: Has this person menstruated? Yes No If not, has she been told about it? Yes No If so, is her menstrual history normal? Yes No Special consideration:
Discovery Camp Individual Registration and Health Form Additional health information: Any medication to be administered at camp: Any medically prescribed meal plan or dietary restrictions: Diphtheria/Tetanus/Pertussis (DTaP/DTP/DT/Td/Tdap) Polio Measles, Mumps, and Rubella (MMR) Hepatitis B Varicella Meningococcal Hepatitis A Camper Immunization Proof Month-Year No Other No, my child is not up-to-date. OTHER, I choose to keep my campers immunization records private. Important- This must be completed for attendance. This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed camp activities except as noted. Authorization for treatment: I hereby give permission to the medical personnel selected by the camp director to order X-rays, routine test, treatment, and necessary transportation for me/or my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director to secure and administer treatment, including hospitalization, for my child as named above. The completed forms may be photocopied for trips out of camp. I hereby release Discovery Camp, Burchfield Ministries, Believers World Outreach Church, all camp workers, and Pastors Tommy and Rachel Burchfield from all liability, personal and/or property, and grant permission to Discovery Camp medical staff, Columbus Community Hospital or another medical facility to administer any necessary first aid and/or any medical treatment needed incase of an emergency. I also consent me/my child as a participant of Discovery Camp that I/they will be included in the television audience of Young Believer's Broadcast and I hereby permit any and all representations made of me during the camp to be used in promotional materials for the facility and it's events program(s). Completed by: Date: In order to keep you better informed on events offered by Country Camp, your e-mail address will be automatically added to our information system. If you do not wish to receive these updates please check the box.