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Crossover Ministries/ Richland Baptist Encampment SUMMER KID’S CAMPS 2012

Boys 1-6 grade July 9-12

Girls 1-6 grade July 16- 19

Boys and Girls 3rd GRADE THROUGH 8th grade JULY 23-26

 

Arrive at the Richland Baptist encampment 9 AM Monday

LEAVE or NEED TO BE PICKED UP at 5 pm Thursday

You need to bring a sleeping bag or bedding, towel/wash cloth, toiletries, & a Bible

Suggested Donation per camper -- $ 100

Includes meals, snacks, drinks, lodging, and swim fees

Deadline to fill out registration forms is JUNE 30TH, but does not guarantee a spot.

First Come--First Serve Basis -- REGISTER EARLY FOR BEST CHANCE TO GET IN!

For information call or write Shane or Marilyn Duke at 318 649 7720 or e-mail crossovermin@juno.com

239 Duke Road, Columbia La. 71418

 

CAMP RULES

 

1.         All campers and attendees must respect the beliefs of Richland Baptist Encampment and             Crossover Ministries.

2.         All campers and attendees must be responsible to follow all announced or posted policies, rules, and instructions.

3.         No use of tobacco products.

4.         Absolutely no alcohol or illegal drugs allowed on or near camp grounds.

5.         Absolutely no firearms or weapons allowed except by authorized personnel.

6.         Modest dress is required at all times (if deemed as inappropriate by camp leadership, you will be asked to change).

7.         Radios, TV's, tape/CD/DVD players, etc...to be used by program workers only.

8.         Cell phone usage will be controlled

9.         Profanity will not be permitted.

10.       All campers MUST stay with groups where there is adult supervision at all times throughout the             duration of camp.  No one should leave camp without leadership permission.

11.       NO boys allowed inside girl's rooms and NO girls allowed inside boy's rooms.

12.       No inappropriate physical contact or conversation.

13.       Remember that camp is for ministry and not for romance!

14.       All accidents/incidents MUST be reported to camp leadership as soon as possible.

15.       Each camper is responsible to furnish his/her own camp linens, blankets, pillows, sleeping bag, towels, and toiletries.

16.       Crossover Ministries nor Richland Encampment will not be responsible for damaged, lost, or stolen items.

17.       Rudeness will not be tolerated.

18.       Campers must not change dorm rooms without the permission of proper camp leadership.

19.       Campers are required to help with clean-up inside dorm rooms and throughout the camp             grounds.

21.       No food or medicines are allowed inside rooms.  All medicines must be administered only by designated camp personnel.

22.       Campers MUST follow all camp schedules and instructions.  All campers and workers are expected to arrive at all events on time.

 

REGISTRATION FORM:

Please read all attached Camp Retreat Rules and Instructions!

 

Full Name: _______________________________________ Age _____ Birth date: ______________     

 

__ Male   __ Female       Telephone: ___________________________   Full Address:  ___________

 

Which Camp are you registering for;  ___ 1- 6 grade Boys July 9-12, ___ 1-6 grade Girls July 16- 19, ___ 3-8 grade boys/ girls camp July 23-26

Home Church: _______________________________________________

 

Parent/Guardian Name/s: ___________________________________________________________

Emergency #'s:

Name: _____________________________ # _________________Relationship: ________________

Name:  ____________________________ # _________________  Relationship: _______________

 

Medical Problems/Needed Treatments/Special Instructions/Medications Needed: ________________

________________________________________________________________________________

________________________________________________________________________________

Medical Insurance Co.:                               _____________       Group#:         _____________________

Policy#:                                                         ____    Company’s Phone:(____)______________________

Company’s address            _________________________________________City:____________________ State:____ Zip:            ______Family Physician’s Name:                                    ____ Phone:(       )____________


                                    ALLERGY:                                                                   REACTION:
______________________________________        ______________________________________

______________________________________       _______________________________________

______________________________________       _______________________________________

 

DIABETICS: There will be limited access to supplies for specialized diets.

 

The Health History is correct, so far as I know, and the person herein described has permission to engage in all prescribed activities except as noted: ______________________________________________________

 

Emergency Authorization- I hereby give permission to the medical personnel selected by Crossover Ministries and/or Richland Baptist Encampment, their designee or the participant’s team leader(s) to order X-rays, routine tests, and treatment for myself/my child. In the event of an emergency and neither the secondary contact or myself can be reached, I hereby give permission to the physician selected by Crossover Ministries and/or Richland Baptist Encampment their designee or the participant’s team leader(s) to hospitalize, secure proper treatment, order injections and/or anesthesia and/or surgery for myself/my child as named above during camp duration in July 2012.

 

I further authorize the release of the above medical information to appropriate medical personnel and/or the health coverage insurance company.

 

___________________________________________________ Date: _____________________

Signature of Adult Participant- Worker or Volunteer*                                             

 

___________________________________________________ Date: _____________________

Signature of Parent/Guardian*                                      

 

ACCEPTANCE OF AGREEMENT TO CAMP RULES AND CONDITIONS WITH AUTHORIZED SIGNATURES:

 

 

CAMPER AGREEMENT:

 

I, ____________________________________________________, have read and agree to follow all

                                     (Full legal signature)

camp rules and instructions.

 

 

PARENT/GUARDIAN AGREEMENT:

 

I, ________________________________________________________, parent/legal guardian of

                                                (Full legal name printed)

 

__________________________________________________________, have read and agree to all

                         (Full legal name printed)

camp rules and instructions, and will encourage my child to obey and follow them.  I will assume responsibility for any and all acts of violence or damage to properties or to other persons which are a direct result of the intentional actions of my child.  I also give my permission for camp leaders to administer needed medicines or medical attention to my child for the duration of the camp or if it becomes necessary, to seek professional medical attention at the medical facility chosen by Crossover Ministries and/or Richland Baptist Encampment.  I will not hold Crossover Ministries’, Richland Baptist Encampment, or any of its workers/ volunteers responsible for any accidental injury or illness my child may receive during the camp/ retreat unless it is the direct result of negligence or intentional harm by camp workers.  In the case of unmanageable behavior, I agree to come to the camp grounds to pick up my child immediately after I am called.

 

PARENT/GUARDIAN LEGAL SIGNATURE:

 

______________________________________Date: ______________________________________

 

 

 

***BE SURE TO DETACH AND KEEP THE RULE SHEET*** FOR YOUR INFORMATION IN PREPARING FOR CAMP!!!

 

***RETURN THE REGISTRATION FORM EARLY***

TO HAVE A BETTER CHANCE TO GET A SPOT IN CAMP!

FIRST COME—FIRST SERVE!!!

ALL REGISTRATION FORMS ARE DUE BY JUNE 30TH

 

Last Updated ( Tuesday, 20 March 2012 )
 
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