Some of the perks

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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 Fellowship with area teens

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Who: Any high school teen What: Overnight camp-out Where: Rantoul, KS Why: Summertime fellowship
Sponsored by the JoCo YMs Hosted by Sacred Heart YM

June 4th-5th, 2010
(Sign up with your local YM)

(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:
Outhouse, that’s right Flushing Outhouse Working showers Best view of the night sky in JoCo Tornado Shelter…just in case A Barn the size of your house Fireside worship Kickball, Frisbee, horseshoes, volleyball, fishing, tractor rides, maybe some golf Fellowship with area teens

What to bring:
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)

Sleeping bag Drinks for your time there, we will have plenty of coolers Snacks for in between meals A change of clothes Lawn chairs Bug spray/sun screen Anything that can be used outside Musical Instruments

Driver Name Address _________________________ _________________________ _________________________ Driver’s License # ____________________ Vehicle That Will Be Used Name of Owner __________________ Address of Owner __________________ __________________ License Plate # __________________ Registration Expiration Date____________ Date of Birth Home Phone Cell Phone Date of Expiration ________________ ________________ ________________ ________________

Model of Vehicle Make of Vehicle Year of Vehicle Date of Expiration

________________ ________________ ________________ ________________

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. ____________________________________________


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

I, _________________________, agree on behalf of myself, my heirs, assigns, executors, and personal representatives, to hold harmless and defend _Sacred Heart of Jesus______, _ArchDiocese of Kansas City, KS__, its officers, 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.
Parish/School (Arch)Diocese Full Name

_______________________________ _________ __________________
Signature Date

Print name

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