Professional Documents
Culture Documents
Praise ALLAH for our past and continued success in this uplifting act. Peace For ow!
Food All food (meals and snacks), as well as beverages will be provided by camp. Do ot Send Any Food or Snacks. Please indicate any food allergy on the camper application and/or medical form. Medication/Medical Send medication in original bottles, along with dosage instructions, to the camp staff. Your medical release form should list all medications. Health History and Examination Form Must be submitted by the start of camp or Immunization waiver must be signed and returned by the start of camp. Most recent school physical form may be used.
Our campsite will provide items such as life jackets for paddleboats. Were providing arts and crafts materials as well as supplies/equipment of all activities.
Spending Money Because all of our activities are on site and were providing all supplies for the activities, the camper will not need any finance. Camp T-shirts, group photos, or special items may be available. We will advise if additional funds are needed in ample time. Transportation Parents are responsible for getting campers to Shands Park 3:00 p.m. on Registration day, Sunday, 7/12/09 and for picking up campers at Shands Park by noon on Saturday, 7/18/09. Directions: I-95 South to Exit 33, right at stop sign. Travel until you come to a railroad track and cross the tracks. Pass St. John Bapt. Church on your left. Proceed to stop sign and make a right. Travel to Troublefield Road and make a left. Travel until you see the lake/park on the right Physical Examinations The Health History and Examination Form must be completed for each camper prior to camp. (Most recent school physical form)
2008 Campers
Camp site
MOORISH
LOVE Youth Summer Camp 2009
This space for picture of camper. Picture will be taken during registration and attached here.
Enrollment Application
CAMPER INFORMATION
Please Print Brother / Sister _______________________________________________________________________________ Address _____________________________________________________________________________________ City _______________________________________________ State_______________ Zip__________________ Home Telephone ( ) ______________________________ Date of Birth _________________________________ Grade September 2009_____________________________ Age as of July 1, 2009__________________________ Name of Campers School_______________________________________________________________________ Campers E-Mail Address________________________________________________________________________ We will use the following as contact information in case of an emergency: Fathers Name___________________________________ Home #_________________________________________ Work#__________________________________________ Cellular #________________________________________ E-Mail__________________________________________ Mothers Name_________________________________ Home #________________________________________ Work#_________________________________________ Cellular #_______________________________________ E-Mail_________________________________________
If parents are divorced, please indicate which parent has legal custody_________________________________________
PARE T SECTIO Emergency Contact Information (OTHER THA PARE T) We will contact parent(s) first. ame Phone Relationship to Camper
Is this the campers first time away from home for a week? ___yes
___no
Do you have any concerns about the camper being away for a week? If so, what are they?_________________ ________________________________________________________________________________________. Has the camper ever been to camp before? ___no ___yes Name____________________________________ List ANYTHING we should know about your childs personality and any special needs in order to assist his/her adjustment to camp. ________________________________________________________________________ _________________________________________________________________________________________ How does the camper spend free time?__________________________________________________________ Camper favorite activities:____________________________________________________________________ POLICIES & WAIVERS: Donation: Payments must be received by June 28, 2009. It will greatly assist us in planning of age appropriate activities as well as meal planning for the campers, if you would commit and respond as soon as possible. Payment may be made by money order only or cash in person. Cancellation and Refund Policy: Cancellation prior to July 1, 2009, there will be a $50 cancellation fee. Must be in writing and received on or by July 1, 2009. For cancellation on or after July 2, 2009, there will be no refund. Insurance: Camper health and/or accident insurance is not provided. The campsite is a privately owned park and does have insurance. There is a lake at the park and paddleboats are available as well as recreational fishing. Parents are asked to provide information on family health and accident coverage. A copy of the insurance card is required with the application.
Waiver: I shall not hold the owners of Shands Park, Individual camp coordinators and counselors and/or affiliates responsible for injury or any harm that may occur to my child(ren). I also give permission for the camp coordinators and/or counselor to secure medical treatment for my child(ren) in case of injury or illness. ____________________________________ ________________________________ Signature of Parent or Guardian Date Parents and Campers Peace Accord: Camper Dismissal: Every attempt will be made by the adult counselors in attendance to correct any disruptive behavior by a camper under the principals of Love, Truth, Peace, Freedom and Justice. Any camper whose behavior continues to be disruptive to the camp program or harmful to him/herself, others, or the property of the park will be dismissed, at the discretion of the Camp Committee, with no refund of fees. Any camper found possessing or using alcoholic beverages, illegal drugs, or weapons will be dismissed immediately from Camp, with no refund. ____________________________________________ Signature of Parent or Guardian Date _______________________________________ Signature of Camper Date
Parent/Guardian signature above indicates that youve read, understood, and accepted the plans, policies and requirements stated in the entire camp packet.