Camp Quickinfo: When: July 12-16th Cost: $175 Camper (Deposit of $80 due with application) Application: DUE
SUNDAY MAY 8th!!!! Remember: The camp fills up EXTREMELY quickly. This is one of the premiere church camps in the nation. Turn your forms in ASAP to ensure you have a spot. Last year we had people turn in their forms after the deadline, in hopes of us being able to come to the camp. Unfortunately, due to popularity of the camp they were unable to attend. PLEASE turn your form in on time. We will also have an all parent/youth meeting before we leave on Thursday July 8th 7-8pm. We’ll have last minute instructions for everyone, and answer any questions anyone might have. If you have any questions feel free to email or call me.
Cell- (940) 230-0512 Email- Robert.firstname.lastname@example.org
YOUTH CAMP APPLICATION
This form is to be completed by applicant’s Parent/Legal Guardian and signed by both the Parent/Legal Guardian and the Camper. All information must be complete. Incomplete applications will incur a $3 charge upon receipt of the application. Missing information must be received before application will be accepted.
(optional $15/ea – Lakeview Camps only)
Name Phone Camp Week Attending Week 2 Address City State Zip Male Female Date of Birth / / Grade next fall T-shirt Size (adult) S / M / L / XL Email address email@example.com Church TheChurchOfCorinth Church City Corinth, TX Is there anyone your child should NOT be released to? Yes No If yes, Name(s)
The camp insurance carrier does not cover pre-existing medical conditions.
IMMUNIZATIONS: List the last date given (the State of Texas requires the dates to be listed). Oral Polio [ DPT (Diptheria/Pertussis/Tetanus) MMR (Measles/Mumps/Rubella) Date ] We have chosen not to immunize. Parent Signature
CHRONIC/RECURRING CONDITIONS: Check all that apply.
Asthma/Respiratory Problems Bleeding/Clotting Disorder Constipation Diabetes Ear Infection Emotional Disturbances Epilepsy Fainting Headaches Hearing Impairment Heart Disease Hypertension Kidney Disease/Bed Wetting Musculoskeletal Disorder Nosebleed Seizures Sickle Cell Trait or Disease Special Dietary Regimen Other
Date of last examination If yes, please explain ALLERGIES:
Animals Food Insect Bites Medicines/Drugs
Are activities restricted?
Plants Pollen Hay Fever Other
Can your camper swim? Yes May your camper swim at camp? Yes Check if your child wears Contact Lenses May be given Tylenol? Yes No
A little Glasses Dental Appliances Yes No May be given Ibuprofen? Yes No
May be given Benadryl?
My Camper may be given over the counter, non-prescription medications or applications, not to exceed the recommended dosage for stomach discomfort, burns, cuts, insect bites, rash or scrapes. Yes No List Exceptions Physician Name Health Insurance Carrier Phone Policy/Group #
Name Day Phone Evening Phone If Parent/Guardian cannot be contacted, please notify: 1) Name 2) Name Day Phone Day Phone Evening Phone Evening Phone
I authorize the adult in charge to consent to medical treatment when either my assignee or I cannot be contacted. I understand that every effort will be made to contact me regarding medical attention given to my child. I also understand that participants at Lakeview Camp are liable for damage caused intentionally or maliciously. Damage caused by a participant will be billed directly to the participant responsible and their legal guardian. I understand that youth camp is a voluntary activity. Student must be willing to cooperate with the overall spirit and schedule of the camp. Finally, I understand that every effort will be made to room church groups in the same cabins. However, due to the structure of the camp and the limited number of beds, this is not always possible. I also grant my permission to North Texas District Council to use photographs (individual or group) and/or multimedia images and recording in the best interest of the North Texas District Council. I have reviewed the camp information sheet and gone over the camp and dress code policies with my child. Camper signature required: Agree to abide by camp and dress code policies.
Parent Signature Camper Signature
(signature required if camper under age 18) (signature required)
Important Camp Information for Parents
Please read the following information and review the Camp Policies & What to Wear with your child. Registration & Check Out Registration on the first day of camp is from 2:00p-3:30p. When you arrive at camp, the Youth Pastors will register in the Activity Center while the youth enjoy pre-camp kick-off activities in the Multi-Purpose building. The Camp gates will open no earlier than 2:00p. You may pay your campers’ balance by check or credit card. Please make all checks payable to NTDC. To expedite registration, church groups should pay with one check. On the last day of camp, we will dismiss around 11:00a. Cabins must be cleaned out and all items removed. We are not responsible for lost items or items left at camp. Meals Meal times will be at 9:00a, 12:30p, and 6:00p. The snack bar will be open 3 times a day in case campers would like some candy or sodas, so you may want to send $3-5 per day for concessions. No lunch will be served on Monday or Friday. Medication/Special Medical Requests Please be sure to complete and sign the Youth Camp Medication Form if your child needs to take any kind of prescription medication while at camp, or if there are any special needs that our nurse should be made aware of. Asthma Inhalers are the only form of medication that the camper will be allowed to keep with them. Please send two in case one is lost. All medication must be in the original container. Mail If you are interested in sending your camper mail while at camp, please forward it to the student c/o Lakeview Camp, 5128 FM 66, Waxahachie, TX, 75167. Not available for El Har Camps. We do not forward mail that is sent to the District Office. Security & Phone Policy We are fully aware of our great responsibility in the care of your child. In the case of an emergency, you will be notified immediately. Incoming calls are not allowed, except in cases of emergency, out of consideration for other campers and planned activities. Camp Staff maintain 24-hour security staff and restricts access to workers and campers. Camp Policies By registering for camp, you agree to abide by all rules set forth by the North Texas District Council of the Assemblies of God, Lakeview Camp, Camp El Har, and the District Youth Director. • • • • • • • • • • Serious offenses such as possession of banned substances (drugs, alcohol, tobacco, firearms, etc.) shall be met with immediate dismissal from camp and will be reported to local authorities. Anyone who leaves the camp without approval of the Camp Director will be dismissed from the camp upon his or her return. In addition, local authorities will be notified. We restrict the use of vehicles operated by campers who provide their own transportation. No camper will be allowed to leave the property after check-in, unless a parent has contacted our office and made prior arrangements. No hazing of other students will be tolerated. No pagers, cell phones, CD players, walkmans, etc. will be allowed at camp. In addition, students and their parents/guardians will be held fully responsible for any damage caused to Lakeview Camp’s or Camp El Har’s property. The Discipline Policy includes: warnings, timeouts, KP duty, work details, etc. Refusal of discipline will result in dismissal from camp. Refunds will not be issued for camp dismissals. Lice Policy: Lice is virtually impossible to treat in a cabin community such as camp. Therefore, if a student is found to have lice, we will have to ask that they be picked up from camp, treated, and be nit free for 48 hours before returning to camp. No refunds will be issued. Please check your student before coming to camp. NO Visitors are allowed on the campgrounds.
Lodge Policy (Lakeview Camp only) Because we want as many students as possible to be able to attend camp, we are offering additional lodging in the McDonnell Lodge in the case that the cabins are filled to capacity. Who stays in the Lodge will be determined by the following factors: Female camper, District Youth Director approval, and Youth Leader approval. Female Adult Workers will be in the Lodge as well. Camp Security will also monitor the surrounding area. The camp does not provide towels or bedding.
Important Camp Information for Parents
What to Wear Shorts can be worn during the day but must be at least mid-thigh. Athletic shorts or Cheerleaders shorts, like those worn in gym class, should not be worn. Abbreviated attire such as half shirts, tank tops, sundresses, spaghetti straps, halter-tops, or crop shirts will not be allowed. This includes shirts with the sides ripped out. No basketball jerseys without undershirts are allowed. Shoes must be worn at all times. This does include to and from the pool, as regulated by the state insurance board. Cover clothing must be worn to and from the swimming pool. Guys, this includes you. T-shirts to cover chest are required. Recreation during the day is often messy! Keep this in mind when you are planning what clothes to bring. You will want to bring older clothes and shoes that you can get wet, muddy and generally dirty! Ladies may want to wear a bathing suit under their clothing or a dark colored t- shirt for recreation. Pajamas are not allowed for recreation activities. What to Bring • A Good Attitude • Bible, Notepad & Pen • Clothes for Recreation/Church • Comfortable Shoes • Dirty Clothes Bag • Modest Swimwear & Cover Ups • Linens or a Bedroll & Pillow • Soap, Toothbrush, Toothpaste • Shampoo & Hairdryer • Towels & Wash Cloths Cancellations and Refunds Deposits can only be refunded based on the following schedule: 60 days before your camp begins – 100% refund. 45 days before = 75%, 30 days before = 50%. NO REFUNDS AFTER 30 DAYS. Any late fees incurred are non-refundable. Lakeview Camp Directions On 1-35E, go to the south edge of Waxahachie to Exit 399A (FM 66). Go west on FM 66 for 7 miles. Lakeview Camp is on the right (Large stone gate through white pipe fence). Camp El Har Directions Heading west on Interstate 20, take the last Duncanville exit – Cedar Ridge Rd. Turn right at the exit stop sign, and go north to the first left (about four actual blocks) to Red Bird Lane. Turn left, go past the Boy Scout Camp and turn right when it dead ends onto Kiwanis Rd. after five speed bumps, the camp is on your right. Heading east on Interstate 20, take the last Grand Prairie exit, Spur 408. Take the very next exit, Grady Niblo Rd. On the exit road, there is a sharp u-turn to your right, taking you around a curve to the left, up the hill, past the Assembly of God church, past our horse pasture and a sharp curve to the right. Camp is then on your left. Heading south on Loop 12, get onto Spur 408, and take the exit after Kiest, called Grady Niblo Rd. At the stop sign, go left, under the freeway and then right onto Grady Niblo. Take the sharp curve to the left, up the hill, past the Assembly of God church, past our horse pasture and a sharp curve to the right. Camp is then on your left.