Central Hills Baptist Retreat

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Parents! Cut along the dotted line and keep this page for camp information. 2016 Central Hills Baptist Retreat Mississippi Baptists Complete Camping Experience At Central Hills, our goal is for every camper to grow in knowledge and appreciation of our Lord in a fun and safe environment! Campers will make new friends and learn new skills. All scheduled summer camps use our modern lodges. Children s Mission Camps are co-ed camps for grades 1-6. Cost is $120 per camper for the three-day camp and $150 for the four-day camp. Arrival time for each session is 10:00 a.m. and dismissal at 12:30 p.m. Traditional camp activities are combined with Bible study and worship for a unique camp setting. We request only one adult chaperone for girls and only one adult chaperone for boys for a total of two per church. Please adhere to this as it pertains to bunk space in the lodges. Chaperones must be at least 21 years old. Three Day Camps: June 30 July 2 July 11 13 July 14 16 July 25 27 July 28 30 Four Day Camps: July 6 9 Summer Mission Camp for Boys are five day camps that apply to young men in grades 3-12. The fee of $175 includes crafts, snacks, lodging, activities, meals, and limited first call insurance. Arrival time begins at 10:00 a.m. in the gym on Monday. Campers should arrive no later than noon in order to participate in all activities. Early arrivals must have adult supervision until registration begins. On the last day of camp there will be an awards ceremony during lunch at 11:45. Parents are welcome to join campers in the dining hall for lunch and the awards ceremony. Counselors will dismiss each camper to their parent/leader at 12:30 p.m. July 18 22 Lad/Dad Weekend is for boys grades 5K-3 and their dad or other trusted adult male. The $85 (42.50 per person) fee includes lodging, meals, activities, and limited first call insurance. Campers are asked to pay their church. Both lad & dad must complete separate forms. Registration begins at 3:00 p.m. on Friday. Please arrive before 5:00 p.m. in order to participate in all activities. The snack/souvenir shop will be open after lunch on Saturday. July 22 23 Last Chance Camp: August 1 3 During summer camps, a health supervisor will be on staff and a doctor will be on call. Each camper will be provided limited first call insurance for injury and illness. The family s personal policy will pick up after the first call. The medical history/health information section of the registration form must be fully completed. At registration all campers will have their scalp checked for head lice by trained personnel. Campers found with lice will be sent home. To be eligible to return to camp the next day the camper s hair must be washed with an approved head lice shampoo and their clothes/personal items washed in hot soapy water. There will be a refund (less the $20 cancellation fee) for campers who do not return to camp. No comic books, electronics, cell phones or other distracting materials will be permitted. Also, NO firearms, pocketknives, or fireworks are permitted. The use of tobacco, alcohol, or non-prescription drugs is STRICTLY FORBIDDEN. All last minute additions must be approved by the camp manager. Registration forms must be completed before actual camp date. The registration fee is payable in full with registration form to Central Hills Baptist Retreat. Campers are asked to pay their church so that a single receipt/confirmation can be mailed to the church. Refunds will be made no later than 15 working days prior to camp date. Substitutions allowed. A parent or legal guardian is required to sign the parent s authorization section of the medical history sheet. In case of emergencies, there will be a $20 cancellation fee. Campers may receive letters/cards only at 6377 Attala Road 4227, West, MS, 39192-7754. There is no mail distribution on the last day of camp and any mail received after campers have left will be returned to the post office. Please do not send snacks to campers by mail; no snacks will be allowed in the lodges. Campers may receive e-mail at chbrcamper@mbcb.org. Please make sure your camper s name is listed prominently in the subject line. We will print out the e-mails daily and deliver them to the recipients. There will be no e-mail distribution the last day of camp. Campers are to remain at camp unless a parent or guardian indicates otherwise.

Camp Activities (Weather permitting) The camper will be involved in the following activities: Archery (35# Recurve Bows) Bible Study Campfire Worship Service Canoeing (16 acre lake) Flag Assembly Field Games Hiking Horseback Trail Riding Lakeside Worship Service Miniature Golf Mission Emphasis Morning Watch Devotion Official Soft Dodge Ball Riflery (Prone position.22 Rifles) Ropes Course Skit Night: Campers and Staff Swimming (Jr. Olympic Pool) Tether Ball and Four Square Attention Not all GPS map services will give accurate directions. Please note on the map below that road 4227 is a gravel road from Highway 440 almost all the way to CHBR and it may be difficult for your car or bus to navigate. Phone Calls No camper will be permitted to bring a cell phone to camp. If a camper has a cell phone, it will be taken and locked up until the camp session is over. If for some reason he/she must contact you, the camp manager will actually make the call at no charge to you. Also, we find that it is best for parents not to call unless there is an emergency. The camp manager/camp director will gladly assist in conveying any emergency message from you. Homesickness is usually over in a few hours and staffers make an effort to make it as easy for the homesick camper as possible. What to Bring to Camp Listed below are suggested items your child may want to bring to camp. Encourage him/her to keep up with clothing and personal items so they will not be left at camp. We will help in this area as best we can. Please mark all items with camper s name. We will not be responsible for items left behind. Clothing Windbreaker or Rain Poncho Jeans and/or Shorts (No cut-offs) Shirts Underwear Socks Shoes (No flip flops) Modest Swimwear (1 piece suit for girls) Equipment Sleeping Bag or Bedding Pillow Personal Items Soap Soap Container Two (2) Towels Two (2) Washcloths Toothbrush Toothpaste Insect Repellent Comb/Brush Bible Optional Equipment Camera and Film Flashlight For scheduling information contact: Central Hills Baptist Retreat 6377 Attala Road 4227 West, MS 39192-7754 662.289.9730 Fax: 662.289.9718 Christian Camping International United States Division MISSISSIPPI BAPTIST CONVENTION BOARD P. O. Box 530 Jackson, Mississippi 39205-0530 A Ministry of the Cooperative Program and the Margaret Lackey State Mission Offering Jim Futral, Executive Director/Treasurer Barri Shirley, Associate Director/Business Services Camp Banking Each resident camper will deposit all of his/her spending money in the Camp Bank upon arrival at Central Hills during registration. The camper will be refunded on the morning of their departure. The camper will then be able to buy souvenirs. Men s Ministry Department Don Gann, Director dgann@mbcb.org Shane Thrash, Camp Manager sthrash@mbcb.org

Central Hills Baptist Retreat 6377 Attala Road 4227, West, MS 39192-7754 662.289.9730 FAX 662.289.9718 CAMPER S REGISTRATION FORM Mail after January 1, 2016 Camp Date Requested: 1st choice 2nd choice Information And Health Form OFFICE USE ONLY Chapter # Check # Date Received Amount Parent s/guardian s names Home Address Phone City State Zip E-mail address Father s work phone Cell phone Mother s work phone Cell phone Parents are: married deceased separated divorced single parent Camper s full name Male Female Preferred Name Height Weight Date of Birth Age (while at camp): Years Months Grade Completed Preferred Bunk Mate: Previous years at CHBR T-shirt size: Youth S Youth M Youth L Adult S Adult M Adult L Adult XL Adult 2X Is camper a: Christian? Church Member? Name of camper s church Phone Church Address City State Zip Pastor Denomination Association County Insurance Information Name and address of personal insurance company or organization providing benefits/services: Policy or Identification Number Insurance Member s Name Emergency contact/number (in case parents can t be contacted)

Please note health problems by answering yes or no. For use in case of sickness or injury STATEMENT OF PARENT OR GUARDIAN Medical History/Health Information Allergies: Diseases: Poison Ivy/Oak: Yes No Diabetes: Yes No Foods: Yes No Asthma: Yes No List: ADHD: Yes No On Meds ADD: Yes No On Meds Insect Stings: Yes No Epilepsy: Yes No Penicillin: Yes No Ear Infections: Yes No Other Drugs: Yes No Other Diseases: List: Operation/Serious Injuries (Please provide dates) Chronic, infectious, or recurring illnesses Personal care needs: Bed wetting Sleep walking Other Any specific activities to be encouraged? Any specific activities to be restricted? IMPORTANT! Please notify the camp if this camper is exposed to any communicable disease during the three weeks prior to camp attendance! All medications must be given to the Health Supervisor at Registration with clear written instructions. Medications will be administered according to written instructions of physician/parent. Tetanus immunization should be in effect before the camper attends camp. Date of last tetanus or booster Medication orders: My child can have the following with the agreement of the health supervisor on duty: Tylenol: Yes No Benadryl: Yes No Dramamine: Yes No Pepto-Bismol Yes No Topical Medications: Yes No In Case of Emergency Name Relationship Day phone Night phone Parent s Authorization The medical history section is correct, as far as I know, and the person herein described has permission to engage in all prescribed camp activities at Central Hills Baptist Retreat, except as noted by me. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director to hospitalize, secure proper treatment for, and order injections, anesthesia, or surgery for my child as named above. Signature Date

2016 Children s Mission Camps (co-ed) Three Day Camps: June 30 July 2 July 11 13 July 14 16 July 25 27 July 28 30 Four Day Camp: July 6 9 Summer Mission Camp for Boys July 18 22 Lad/Dad Weekend July 22 23 Last Chance Camp (co-ed) August 1 3 Central Hills Baptist Retreat Celebrating Christian Camp Ministry since 1979

Camp Policies Campers are asked to remain at Central Hills for the entire camp session. Campers and parents are asked to cooperate with camp personnel regarding living area assignments. Campers are assigned according to age division and, if possible, according to bunk mate choice. The counselor will supervise and guide the chapter group as a unit at all times from registration on Monday until the camper leaves on Friday after lunch. Campers should not be absent from their chapter group at any time without the permission of their counselor. Campers are expected to cooperate with corrective measures deemed necessary by the counselor and/or activity instructor. Corrective measures will never involve physical contact, emotional abuse, or verbal abuse. The counselor will consult with the program director regarding any matter. When serious problems arise, they will consult with the camp manager/director. Campers are expected to cooperate with the counselor and the counselor s chapter mate in his/her living area. It is necessary for the campers to work together. Parents are expected to pick up a camper in the event of serious disciplinary problems. By signing this application, you are indicating that your child may participate in all of our activities. I have read these camp policies. I understand that my child is expected to abide by them. The camp program is designed for him/her to participate in the following activities: archery, canoeing, horseback riding, riflery, swimming, ropes course, and various group games. Please list any limitations or exceptions: Signature Date (Parent or Guardian) Photo Permission Release Photography is a useful tool for promotion. Photos are often taken of Central Hills Baptist Retreat facility and people involved in its programs. Some may be used as slides to promote the ministry in various churches or associational meetings. Some scenes would be used for print promotion in The Baptist Record and in registration forms and posters. Yes you may photograph my child. No you may not photograph my child. Signature Date (Parent or Guardian) Suggestions/Comments from parents: