Some of the perks:

 Flushing outhouse
 Working showers
 Best view of the night sky
in JoCo
 Tornado shelter (hoping
not to be needing this)
 Barn the size of your house
 Most impressive talent show
in the Midwest
 Fireside worship
 Frisbee, yard games
Who: Any high school teen  Fellowship with area teens

What: Overnight camp-out

Where: Rantoul, KS
Why: Summertime fellowship
Sponsored by the JoCo YMs
June 4th-5th,
Hosted by Sacred Heart YM 2010
(Sign up with your local YM)
COST ONLY $5!!!
(Each parish must supply own chaperones)
 one heckuva night
Directions to ‘The Farm’:
‘The Farm’ is 160 acres just south of Rantoul Kansas (@40 minutes
south of Olathe). Take I-35 South to the Wellsville exit. Turn left
(highway 33 South) and go to the first stop sign. Turn right (highway 68
West) 1 mile. Turn left (South) on the road to Rantoul. Once you’re
through the traffic of Rantoul(that’s a joke), continue heading South 3 ½
miles. Turn left (you can’t turn right here) on Hamilton road (not
Hamilton Terr.). If you reach the stop sign (John Brown Memorial
Highway) you missed Hamilton road. We’re at the top of the hill on the
left side of the road. You can’t miss us.

What to expect:
ƒ Outhouse, that’s right
ƒ Flushing Outhouse
ƒ Working showers
ƒ Best view of the night sky in JoCo
ƒ Tornado Shelter…just in case
ƒ A Barn the size of your house
ƒ Fireside worship
ƒ Kickball, Frisbee, horseshoes, volleyball, fishing, tractor rides,
maybe some golf
ƒ Fellowship with area teens
What to bring:
ƒ TENT!!! Please let your youth minister how many it will sleep
(please note that there will be a distinct line where boys and girls cannot cross)
ƒ Sleeping bag
ƒ Drinks for your time there, we will have plenty of coolers
ƒ Snacks for in between meals
ƒ A change of clothes
ƒ Lawn chairs
ƒ Bug spray/sun screen
ƒ Anything that can be used outside
ƒ Musical Instruments
 Camp-Out

DRIVER INFORMATION SHEET

Driver
Name _________________________ Date of Birth ________________
Address _________________________ Home Phone ________________
_________________________ Cell Phone ________________
Driver’s License # ____________________ Date of Expiration ________________

Vehicle That Will Be Used

Name of Owner __________________ Model of Vehicle ________________
Address of Owner __________________ Make of Vehicle ________________
__________________ Year of Vehicle ________________
License Plate # __________________ Date of Expiration ________________
Registration Expiration Date____________

If more than one vehicle is to be used, the aforementioned information must be provided
for each vehicle.

Insurance Information
When using a privately-owned vehicle, the insurance coverage is the limit of the
insurance policy covering that specific vehicle.
Insurance Company ________________ Policy # _____________________
Date of Policy Expiration __________ Liability Limits of Policy* __________
(*Please note: The minimal, acceptable liability limit for privately-owned vehicles is $100,000/$300,000)

In order to provide for the safety of our students or other members of the
parish/school and those we serve, we must ask each volunteer driver to list all
accidents or moving violations they have had in the past five years:
_____________________________________________________________________________
_____________________________________________________________________________

Please be aware that as a volunteer driver, your insurance is primary. There is a

policy that would offer additional liability protection should a claim exceed the
limits of your policy.

Certification

I certify that the information given on this form is true and correct to the best of my
knowledge. I understand that as a volunteer driver, I must be 21 years of age or older,
possess a valid driver’s license, have the proper and current license and vehicle
registration, and have the required insurance coverage in effect on any vehicle used to
transport students. I agree that I will refrain from using a cell phone or any other
electronic device while operating my vehicle.

____________________________________________ ___________________
Signature Date
 ADULT LIABILITY WAIVER

Each adult participant, including group leaders and chaperons, must sign this form.

RELEASE OF LIABILITY

I, _________________________, agree on behalf of myself, my heirs, assigns,

Full Name
executors, and personal representatives, to hold harmless and defend
_Sacred Heart of Jesus______, _ArchDiocese of Kansas City, KS__, its officers,
Parish/School (Arch)Diocese
directors, agents, employees, or representatives associated with the field trip

from any and all liability claims, loss or damage arising from or in connection

with my participation in the field trip.

_______________________________ _________ __________________

Signature Date

_______________________________
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