1 We are pleased and proud to announce Victory Valley at Greenbrier Christian Retreat's Third annual youth summer camp! This year, your young people can get away from the business and stress of the world, make new friends, enjoy some fantastic outdoor activities, and spend some alone time with God. Greenbrier Christian Retreat is so excited for the upcoming summer of 2018. We are blessed to present an exciting opportunity by God's grace to encourage young people to serve Him with their lives. This summer, your young people can experience God in their hearts and minds, and strengthen our Christian community. Campers will experience nature's best on our beautiful 400-acre farm, located just 3 miles from Interstate 64 in Crawley, WV. They will enjoy a hike to Calvary's Mountain, or along the breathtaking trout stream that flows for over a mile on the property. There will be all camp game times, with visits to our General Store for snacks and souvenirs. Plus, summer evening campfires will offer serene testimony times with God. Girls and Boys cabins are located several hundred yards from each other. Daily Services will be provided to our campers in a fully renovated, 100-year-old barn, sure to delight every youth member at camp. Greenbrier Christian Retreat has so much to offer your young people, and we are eager to welcome them to our youth summer camp. Included are the dates of the 2018 camp, contact information, and an example of a day in the life of our campers. Would you join us in prayer that God will do something great in our hearts this year? Thank you so much for considering Greenbrier Christian Retreat. We look forward to hearing from you. Sincerely, Blaine Comer Executive Director
2 Victory Valley Registration Form Registration By Mail: Send this form with the camp fee to: GCR Victory Valley Camp 246 Grand Ave. Lewisburg, WV 24901 *In order to guarantee a spot, funds MUST accompany registration forms! Camp Fee: $125 if paid prior to June 1 st, $150 if paid after June 1st Camper Information Name Please Check Week Junior Week June 25-29 Jared Shumate/Chase Whitten Teen Week #1 July 16-20 Mark Brandon Teen Week #2 July 23-27 Chris VanNatter/Ron Cole Parent/Guardian Information (Only 1 required) Name Birthdate Age Male Female Relationship to Camper Address City State Zip Email Phone: Home Cell Grade for upcoming school year Church Name Email Emergency Contact Phone Numbers: Primary Secondary Name T-Shirt (circle size) YM YL AS AM AL AXL Relationship to camper Email Medical Information Camper Physician Phone Campers must be immunized against: Mumps, Measles, Whooping Cough, Polio, Diphtheria, Rubella, Tetanus Tetanus current? Yes No Medications taken regularly Reason for taking medication Emergency Contact Phone Numbers: Primary Secondary Insurance Information Insurance Company Name Policy/Group ID Cardholder Name Health or Behavioral concerns that you would like our staff to know about Your child Drug allergies or other allergic reactions Dietary needs/restrictions Pre-existing Conditions I DO NOT WISH MY CHILD TO PARTICIPATE IN: I have read the general information (see page 2), and I agree to support Victory Valley at Greenbrier Christian Retreat in their dress and conduct regulations for my child. I also give permission for my child to attend and to use photos and video including the camper in camp publicity. In case of medical emergency, I understand that every effort will be made to contact parents or guardian of campers. In the event I cannot be reached, I hereby give permission to the physician selected by the camp director to hospitalize and secure proper treatment for my child. I agree to the transportation of my child for activities at Victory Valley. Parent/Guardian Signature- Date
3 Permission to Use Photographs I grant to Greenbrier Christian Retreat and its representatives and employees the right to take photographs/videos of my child/children while they are at camp. I authorize Greenbrier Christian Retreat it s assigns and transferees to copyright, use and publish the same in print and or electronically. I agree that Greenbrier Christian Retreat may use such photographs/video s with or without my child/children s name for any lawful purposes, including for example such purposes as publicity, illustration, advertising, and web content. I have read and understand the above: Signature: Date: Print Name: Child/Children Name:
4 GENERAL INFO Registration: Each camper must have a registration form along with a copy of parents insurance card and medical release form. Arrival: Registration begins at 1 p.m. on Monday with arrival at Lewisburg Baptist Church if wishing to have transportation. If not, arrival at camp facility by 2:00 p.m. Departure: Campers should be picked up at Lewisburg Baptist Church at 10:00 a.m. on Friday. Or campers can be picked up at the Greenbrier Christian Retreat around 9:30 a.m. on Friday. Victory Valley is a Christian camp and desires to maintain a testimony of modesty in dress and decency in conduct. Campers who use alcohol, tobacco or illegal drugs will be dismissed. Noncooperative campers will be subject to dismissal at parent/ church expense. Victory Valley Camp s dress code is as follows: Modest shorts (not above the knee) or long pants for guys are permitted for recreational activities. Clothes should not be tight or revealing in any way. Girls: Dresses or skirts are appropriate for services. During swim time, swimsuits must be one piece or tankini that covers the stomach and worn under long shorts and a dark t-shirt. Swim shoes are needed. No spaghetti strap or kami shirts, sleeves tops that cover the shoulder are acceptable. Guys: Long pants and a polo style shirt are required for services. No t- shirts with questionable writing. Swim shorts and water shoes are required for swim time. No muscle shirts or tank tops. Hair must be neatly trimmed and well groomed. No earrings. VICTORY VALLEY RESERVES THE RIGHT TO ASK ANYONE TO CHANGE HIS OR HER OUTFIT IF IN THE ESTIMATION OF THE STAFF IT DOES NOT COMPLY WITH THESE STANDARDS. What to bring: Bible, notebook, pen, bedding, pillow, towels, toiletries, flashlight, swimsuit, jacket, sports clothes for activities, nice casual clothes for informal services, at least one old pair of tennis shoes, laundry bag, water gun, water bottle, water shoes, ball glove, and spending money most campers bring $25-$30. Do not bring: Alcoholic beverages, drugs, tobacco, fireworks, ammunition, guns, weapons, skateboards, magazines, apparel with inappropriate graphics or lettering, or any type of electronic device, including, but not limited to cell phones, CD, DVD, MP3, or other music/media players, computers, ipad, radios, TVs, and video games. Nothing for practical jokes. Meals: All meals are included in the camper fee. Please contact us for dietary restrictions. Nit-free policy: Each camper will be checked for head lice. If a camper is not nit-free, he/she will not be admitted. GCR reserves the right to treat any camper at our discretion. Non-discrimination policy: Rules for acceptance and participation in the program are the same for everyone without regard to race, color, religion or national origin. Contact Info: Victory Valley at Greenbrier Christian Retreat 1234 Victory Valley Drive Crawley, WV 24931 Phone: (407) 247-1566 Email: sfh210@aol.com Website:www.greenbrierchristianretreat.com Emergency contact info: Please call the following number for afterhours emergencies only: Camp Administrator 304-645-3797. Visitors: Safety is one of our primary concerns. For this reason, while camp is in session, all guests are required to check-in and check-out at the camp office. Some guests may be requested to remain with a staff escort while on camp property. Victory Valley reserves the right to decline any visitation request. If a visitor knowingly fails to comply with any of the policies laid out by the camp, they will be asked to leave the premises. If necessary, local authorities will be contacted. Lost and Found: Lost items not requested in 7 days will be disposed of. Requested items will be held for pickup. Please contact our camp office in search of lost items. Medication: Please do not pack medication. All camper medication must be turned in at registration. Only our staff is allowed to administer medication. Our camp stocks basic over-the-counter medications (Ibuprofen, Tylenol, Benadryl, etc.) and first aid supplies. It is not necessary to send these unless your child needs them on a regular basis. (See page 6 for Medication release) Ages for attendance: VBS Day Camp- rising 1 st 3 rd grade Juniors- rising 4 th 6 th grade Teens- rising 7 th 12 th grade Typical Sample Schedule: Rise and Shine 7:30 a.m. Camper Devotion 7:30-8 Breakfast 8:15-9 Morning Chapel 9:15-10 All Camp Game Time 10:15-12 Lunch 12-1:15 Guided Hike 1:30-3:00 Hay Ride/Games/Tubing 3:15-4:45 Dinner 5:45-6:45 Evening Service 7:00-8:30 Snack Shop/Prep for Bed 8:45-10 All Campers in Cabins 10:00 Evening Devotions/Testimonies 10:00-10:45 - Lights Out 10:45
5 CONSENT AND RELEASE FORM FOR CAMPERS AT VICTORY VALLEY - GREENBRIER CHRISTIAN RETREAT. I, the undersigned parent or guardian, hereby consent to my child,, who is years of age, participating in the activities connected with the trip to and from and the time at the Victory Valley-Greenbrier Christian Retreat in Crawley, West Virginia, an activity on, 20 through, 20. I certify that my child is able to participate in the activities (unless otherwise indicated). If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them on the registration form. If I cannot be reached within a reasonable period of time, I hereby authorize the adult sponsors, Blaine and Jessica Comer, to make emergency medical decisions for my child. If there are any activities I do not want my child to be involved in, I have listed them on the registration form. I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKES WHICH MAY BE ENCOUNTERED ON SAID ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do hereby agree to hold Victory Valley Greenbrier Christian Retreat, volunteers, board members, agents and employees, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of West Virginia and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto, and the terms of this release are contractual and not a mere recital. ALL RIGHTS OF VENUE WILL BE HELD IN GREENBRIER COUNTY, WEST VIRGINIA. 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. Parent/Guardian Signature- Date
6 FILL OUT ONLY IF YOUR CHILD HAS MEDICATIONS GREENBRIER CHRISTIAN RETREAT MEDICATION/INSTRUCTION FORM Date: Name: PLEASE LIST ALL MEDICATIONS YOUR CHILD WILL BE BRINGING TO CAMP Name of Medication Instructions I give Greenbrier Christian Retreat permission to administer medications to my child. Signed: Parent/Guardian Date: FORM ACCEPTED BY: DATE:
7 Summer Packing List THINGS TO BRING: Bible and Pen Bedding: Twin Bed Pillow Towels/washcloth Toiletries Camera Jacket Sunscreen Bug spray Casual clothing (and shoes) for informal services Clothing for activities At least 1 pair of old athletic shoes and water shoes Flashlight Spending money: Snack shop, souvenirs, ($25-30 recommended) Swimsuit: Ladies: Modest one-piece swimsuit or tankini that overlaps at waist with long shorts and a dark shirt Guys: Boxer type swim shorts or board shorts THINGS TO REMEMBER WHILE PACKING: -Pack modest, loose fitting clothing -Shorts should come to the top of the knee -No clothing with questionable logos or advertising -No spaghetti straps or low-cut tops. -No tank tops, sleeveless tops covering the shoulder are acceptable -Please label all items packed! THINGS NOT TO PACK: -drugs/alcohol/tobacco -apparel with inappropriate graphics skateboards/magazines -fireworks/ammunition/guns/weapons -any electronic devices including cell phones, ipad/ipod