camp info and medical release forms · fort mountain retreat center & conference center - 40...

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RBC TEENS 6-12 th GRADE SUMMER CAMP $375 (includes food, lodging, camp tui3on, & whitewater ra8ing Sun, April 8 th ($60 non refundable deposit is due) JUNE 11-15 Sun, May 6 th (final camp payments are due) WHAT IS GLOBAL YOUTH CAMP? Global Youth Camp provides a unique window in which young people can be exposed to the claims of Christ! Students are surrounded by His love, His people, His Word! Teens are so distracted today with so many things tugging at their busy schedule. Camp is a shot at getting their undistracted attention for a week. Camp is a great opportunity to spend a week building the loyalty, togetherness, and focus of the youth group! Students will be encouraged in their commitment to Christ and in their call to glorify Christ by reaching their unsaved friends. globalyouthministry.org WHERE WILL WE BE STAYING? Fort Mountain Retreat Center & Conference Center - 40 Blackhawk Trail, Chatsworth, GA 30705 The Christian Ministry conference center is located on top of Fort Mountain in North Georgia. Recreation includes an alpine tower with multiple high ropes courses, blob, high swing, paint ball, and numerous hiking trails. fortmountainretreat.com WHERE WILL WE BE WHITE WATER RAFTING? We will be whitewater rafting through the WhiteWater Express outfitters located in Decatur, GA. We plan on rafting the Middle Ocoee River, outfitted in Ducktown, TN. “Since 1980, WhiteWater Express has been one of the country’s premier river outfitters. We were one of the pioneer outfitters that worked with the United States Forest Service to develop the rivers of the Southeast. In 1990 we were selected by the Olympic Committee to oversee all of the water sports for the 1996 Olympics! It has been our pleasure to guide over one million people since 1980 and over 1000 youth groups through high adventure each year.” whitewaterexpress.com

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Page 1: Camp Info and Medical Release Forms · Fort Mountain Retreat Center & Conference Center - 40 Blackhawk Trail, Chatsworth, GA 30705 The Christian Ministry conference center is located

RBCTEENS6-12thGRADESUMMERCAMP$375(includesfood,lodging,camptui3on,&whitewaterra8ing

Sun,April8th($60nonrefundabledepositisdue)

JUNE11-15

RBCTEENS6-12thGRADESUMMERCAMP$375(includesfood,lodging,camptui3on,&whitewaterra8ing

Sun,April8th($60nonrefundabledepositisdue)

JUNE11-15

Sun,May6th(finalcamppaymentsaredue)WHATISGLOBALYOUTHCAMP? Global Youth Camp provides a unique window in which young people can be exposed to the claims of Christ!Students are surroundedbyHis love,His people,HisWord!Teens are so distracted todaywith somany thingstuggingattheirbusyschedule.Campisashotatgettingtheirundistractedattentionforaweek.Campisagreatopportunity to spend aweek building the loyalty, togetherness, and focus of the youth group! Studentswill beencouraged in their commitment to Christ and in their call to glorify Christ by reaching their unsaved friends.globalyouthministry.orgWHEREWILLWEBESTAYING?FortMountainRetreatCenter&ConferenceCenter-40BlackhawkTrail,Chatsworth,GA30705TheChristianMinistryconferencecenterislocatedontopofFortMountaininNorthGeorgia.Recreationincludesan alpine tower with multiple high ropes courses, blob, high swing, paint ball, and numerous hiking trails.fortmountainretreat.comWHEREWILLWEBEWHITEWATERRAFTING?WewillbewhitewaterraftingthroughtheWhiteWaterExpressoutfitterslocatedinDecatur,GA.WeplanonraftingtheMiddleOcoeeRiver,outfittedinDucktown,TN.“Since1980,WhiteWaterExpresshasbeenoneofthecountry’spremierriveroutfitters.WewereoneofthepioneeroutfittersthatworkedwiththeUnitedStatesForestServicetodeveloptheriversoftheSoutheast.In1990wewereselectedbytheOlympicCommitteetooverseeallofthewatersportsforthe1996Olympics!Ithasbeenourpleasuretoguideoveronemillionpeoplesince1980andover1000youthgroupsthroughhighadventureeachyear.”whitewaterexpress.com

Page 2: Camp Info and Medical Release Forms · Fort Mountain Retreat Center & Conference Center - 40 Blackhawk Trail, Chatsworth, GA 30705 The Christian Ministry conference center is located

RBCTEENS6-12thGRADESUMMERCAMP$375(includesfood,lodging,camptui3on,&whitewaterra8ing

Sun,April1st($60nonrefundabledepositisdue)

JUNE11-15

RBCTEENS6-12thGRADESUMMERCAMP$375(includesfood,lodging,camptui3on,&whitewaterra8ing

Sun,April1st($60nonrefundabledepositisdue)

JUNE11-15

SCHEDULEMonday• 8:30AM MeetatRBC• 2:00PM Check-in• 4:00PM WelcomeandOrientation• 5:30PM DinnerEveningRally,Worship,ChurchGroupsTuesday,Wednesday,Thursday• Morning Devotion,Breakfast,Rally,Worship• Afternoon Lunch,Tourneys,Free-time,Dinner• Evening Rally,Worship,ChurchGroupsFriday• Morning Devotion,Breakfast,Rally• 10:00AM LoadUpandTraveltoWhiteWater• 2:00PM Whitewater• 11:00PM ApproximateArrivalatRBCWHATTOBRING• GLOBALMedicalReleaseForm• GLOBALOutdoorActivitiesParticipationAgreement/Waiver• WhiteWaterExpressRaftingWaiver• ClothesforMonday-Friday(5Days)• ClosedToedShoes• EveningWorshipattire(longpants)• Lightjacket• Bible• Notebook• Pen• Toothbrush/Soap/Shampoo/Deodorant/etc.• Sleepingbagorsheets• Pillow• BathTowel/HandTowel/etc.• (Optional)Equipmentforvarietyshow(guitar,music,etc.)• (Optional)ExtrafundsforSnacks,Souvenirs,extraT-shirts,Paintball,&Missionsoffering!

WHATNOTTOBRING• Fireworks/Weapons(IncludingKnives)• Jewelry/Valuables• Alcohol/Tobacco/Contraband• QuestionableMagazines• Clothingwithobjectionablewordsand/orimages• VideoGames• WaterBalloons

Page 3: Camp Info and Medical Release Forms · Fort Mountain Retreat Center & Conference Center - 40 Blackhawk Trail, Chatsworth, GA 30705 The Christian Ministry conference center is located

RBCTEENS6-12thGRADESUMMERCAMP$375(includesfood,lodging,camptui3on,&whitewaterra8ing

Sun,April1st($60nonrefundabledepositisdue)

JUNE11-15

RBCTEENS6-12thGRADESUMMERCAMP$375(includesfood,lodging,camptui3on,&whitewaterra8ing

Sun,April1st($60nonrefundabledepositisdue)

JUNE11-15

TOURNAMENTSEachdayyouwillhavetheopportunitytowinaribbonandearnextrapointsforyourteamintournaments.• SportsTourneys

BasketballVolleyballUltimateFrisbee• StudyTourneys

DailyTeamBibleQuizScriptureMemoryTournamentawardribbonswillbeawardedforfirstandsecondplace.Counselorsandcampstaffarenoteligibletocompete.Mostteamsrequireacombinationofmale/femaleand/ormiddleschoolmembers.

• TournamentAwardsRally

Therewillbeaspecialawardsrallyonthelastnightofcamp.Awardswillbedistributedforthefollowing.AllTourneyWinnersTeamChampionsMostSpiritedCamperVarietyShowWinnerTheServantHeart

VARIETYSHOWTherewillbeavarietyshowfeaturinganyactthatyouwanttoperform!Auditionstakeplaceonthefirstandsecondafternoonsofcamp.Checkatregistrationdeskuponarrivalfordetails.RECOPTIONSGlobaloffersseveralfreeRecreationoptions:FreeRecOptions:• SwimmingPool• RecField• BasketballCourt• AlpineTower• GagaBall• Blob• Volleyball• 9SquareintheAir• Paintball–Requires$25Global offers dorm style rooming with bunk beds. You will want to bring

Page 4: Camp Info and Medical Release Forms · Fort Mountain Retreat Center & Conference Center - 40 Blackhawk Trail, Chatsworth, GA 30705 The Christian Ministry conference center is located

Global Youth Ministry Global Youth Camps 40 Blackhawk Trail Chatsworth, GA 30705 877-251-1800 www.globalyouthministry.org

Camp Medical Information & Release Form

Name ___________________________________________ Gender _____ Age _____ Birthdate _____/_____/______

Church/Org ____________________________________________ City __________________________ State _______

In case of emergency, notify:

Name ________________________________________ Phone ____________________ Phone 2 _________________

Address _________________________________________________ Relationship _____________________________

Family Physician:

Name ________________________________________ Phone _____________________

Address _________________________________________________ City, State, Zip ___________________________

Insurance Information

Provider: ________________________________________ Policy No. _______________________________________

Address _________________________________________________ City, State, Zip ___________________________

Policy Holder _____________________________________ Type of plan: group individual

Allergies/Other Info

Penicillin Insect Bites Hay Fever

Poison Ivy Other: _____________________________

Date of last Tetanus shot: __________________

Is the participant on any prescribed drugs/medication: yes no

If yes, please explain: _______________________________________________________________________________

What medications will be brought to camp/retreat? ________________________________________________________

_________________________________________________________________________________________________ Photo Release: With participation, I give permission for myself/my child to be photographed, and/or videotaped while participating in the above stated camp/retreat for the purposes of publicity, staff training, and/or promotion. I, the participant/parent/guardian as signed below, hereby give consent and/or authorization for the individual listed on this form to be examined by medical or dental personnel, as dutifully licensed to practice under the laws of the state; and to provide necessary treatment and/or hospitalization that in their professional opinion is necessary to maintain the life, health, or well being of the individual. I also understand that my insurance is primary in any and all claims, and the sponsoring church or organization becomes secondary. I have examined this form and find that all information is correct and true to the best of my knowledge. __________________________________________________________ _______________________________ Signature of participant (over 18) OR Date Signature of parent or guardian (if participant is under 18)

NOTE: Any/all medications that are brought to

camp MUST be turned in to the designated adult from the sponsoring church/organization during a minor’s stay. No student/minor may be allowed to keep any prescription drugs/medication in their possession at any time, except as supervised by designated sponsor.

Page 5: Camp Info and Medical Release Forms · Fort Mountain Retreat Center & Conference Center - 40 Blackhawk Trail, Chatsworth, GA 30705 The Christian Ministry conference center is located

GLOBAL YOUTH MINISTRY OUTDOOR ACTIVITIES PARTICIPATION AGREEMENT

ASSUMPTION OF RISK AND RELEASE In consideration of the services of Global Youth Ministry, and Alpine Towers International, Inc, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as GYM/ATI), I hereby agree to release, indemnify, and discharge GYM/ATI, on behalf of myself, my children, my parents, my heirs, assigns, personal representative and estate as follows: 1. I acknowledge that my participation in ropes course, blob, hiking, paintball, and other outdoor activities entails known and unanticipated risks, which could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. GYM/ATI programs are based on the “challenge by choice” principle. At any time you and/or your group are free to withdraw from participation in any outdoor activities. The risks include, among other things, the potential for: slips, falls and falling, rope burns, pinches, scrapes, twists and jolts that could result in scratches, bruises, sprains, lacerations, fractures, concussions, or even more severe life threatening hazards. During and activity there may be contact with plants, animals, or insects that could create hazards such as stings, allergies, and associated diseases. Furthermore, GYM/ATI instructors have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities, they might misjudge the weather. 2. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks. 3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless GYM/ATI from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of GYM/ATI equipment or facilities, including any such claims which allege negligent acts or omissions of GYM/ATI. 4. Should GYM/ATI or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. 5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. 6. In the event that I file a lawsuit against GYM/ATI, I agree to do so solely in the state of Georgia, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against GYM/ATI on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. Signature of Participant _________________________________________________ Date ___________________________ Printed Name of Participant _____________________________________________________________________________ Address _____________________________________________________________ Phone __________________________

Page 6: Camp Info and Medical Release Forms · Fort Mountain Retreat Center & Conference Center - 40 Blackhawk Trail, Chatsworth, GA 30705 The Christian Ministry conference center is located

WEX Form No. 5001 (Rev 2015-09)

TN WHITEWATER, LLC d/b/a WHITEWATER EXPRESS Waiver and Release of Liability

Name: __________________________________ Age: ____________ Gender: M / F (circle one) Group Name: ____________________________ Group Leader: _____________________________ Date(s) of stay at Whitewater Express: _____________________ In consideration of TN Whitewater, LLC furnishing services and/or equipment to enable me to participate in sponsored activities, I agree as follows: I fully understand and acknowledge that outdoor recreational activities have (a) inherent risks, dangers, hazards, and such exist in my use of TN Whitewater, LLC equipment and my participation in such activities; (b) my participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to, bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of the owners, employees, officers, or agents of TN Whitewater, LLC, the Ocoee River Outfitters Association, the Tennessee Valley Authority, the State of Tennessee, and the United States; the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature, or other causes. Risks and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, guide decision making, including that a guide may misjudge terrain, weather, trail or river route location, and water level, risks of falling out of or drowning while in a raft, canoe, or kayak and such other risks, hazards, and dangers that are integral to recreational activities that take place in a wilderness, outdoor, or recreational environment; and (d) by my participation in these activities and/or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, or employees of TN Whitewater, LLC, the Ocoee River Outfitters Association, the Tennessee Valley Authority, the State of Tennessee, or the United States, or by any other person. In addition, I hereby grant permission to TN Whitewater, LLC to make and use for promotion or other purposes, photographic records without recourse or compensation to me. I, on behalf of myself, my personal representatives, and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend, and indemnify TN Whitewater, LLC, the Ocoee River Outfitters Association, the Tennessee Valley Authority, the State of Tennessee, and the United States, and its owners, agents, officers, and employees from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of my use of TN Whitewater, LLC equipment or my participation in TN Whitewater, LLC activities. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers, or employees of TN Whitewater, LLC, the Ocoee River Outfitters Association, the Tennessee Valley Authority, the State of Tennessee, and the United States. The venue of any dispute that may arise out of this agreement or other-wise between the parties to which TN Whitewater, LLC or its agents is a party shall be either the City of Benton, Tennessee Justice Court or State Supreme Court in Polk County Tennessee. I HAVE READ THE ABOVE WAIVER AND RELEASE. BY SIGNING IT, I AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE TN WHITEWATER, LLC, THE OCOEE RIVER OUTFITTERS ASSOCIATION, THE TENNESSEE VALLEY AUTHORITY, THE STATE OF TENNESSEE, AND THE UNITED STATES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. Signature: _______________________________ Date: ____________ Parent/Guardian Signature (if under 18): ____________________________ Date: ____________ ___ Horseback: Helmets are available; use is required for all Scouts and all others under 18 years of age . Closed-

toe shoes must be worn. For the health and safety of our horses, a weight limit of 260 pounds must be adhered to.

___ Mountain Biking: Helmets are provided and required. Closed-toe shoes must be worn.

___ Paintball: ADDITIONAL RELEASE REQUIRED

A protective mask is provided and required; long pants and sleeves are suggested. A top-quality gun, CO2, and 200 paintballs are provided for each participant. Additional paintballs can be purchased in advance or on the field; we cannot allow individuals to bring their own paintballs. You are welcome to bring your own gun; we will gladly calibrate it to our course requirements.

___ River Rafting: An approved PFD, helmet, and paddle are provided and required. Safety instructions will be

given prior to each river trip. Shoes must be able to stay on your foot; no flip-flops. Ocoee rafters must be 12 years old or older!

___ High Ropes / Swing, & Challenge Course: Both High and Low elements are available. Closed-toe shoes

are strongly encouraged.