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FLORIDA 4-H Camping Handbook FLORIDA 4- H CAMPING

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Page 1: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

FLORIDA 4-H Camping Handbook

FLORIDA 4- H CAMPING

Page 2: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive
Page 3: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

FLORIDA 4-H Camping Handbook

Developed by: Wendi A. Zimmerman

Coordinator, State Camping Program/4-H Youth Partnership 4-H Youth Development Office

with Contributions and Review from:

Marilyn Norman, State 4-H Leader and Associate Dean, 4-H Kim Gumbiner, Business Manager, 4-H Camps

Neva Batzell, Program Coordinator, Camp Cherry Lake 4-H Center Jessica Osborne, Student Assistant, University of Florida

Marilyn Lesmeister, Assistant Professor, 4-H Volunteer Development Steve Cooper, Resident Director, Camp Cloverleaf 4-H Center

Shawn Batzell, Resident Director, Camp Cherry Lake 4-H Center Bob Walker, Resident Director, Camp Timpoochee 4-H Center

Chad Meyers, Resident Director, Camp Ocala 4-H Center

Produced from Florida 4-H EDIC Grant

State 4-H Headquarters

2142 Shealy Drive PO Box 110225

Gainesville, Fl 32611-0225 Phone: (352) 846-4444

Fax: (352) 294-3544 http://florida4h.org

Page 4: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

The Institute of Food and Agricultural Sciences (IFAS) is an Equal Opportunity Institution

authorized to provide research, educational information and other services only to individuals

and institutions that function with non-discrimination with respect to race, creed, color, religion,

age, disability, sex, sexual orientation, marital status, national origin, political opinions or

affiliations. U.S. Department of Agriculture, Cooperative Extension Service, University of

Florida, IFAS, Florida A. & M. University Cooperative Extension Program, and Boards of

County Commissioners Cooperating.

The 4-H name and emblem are protected under 18 U.S.C. 707

Page 5: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

TABLE OF CONTENTS

Page # Purpose and Use of the Florida 4-H Camping Handbook (tab 1) 1-2

Purpose 1 Application 1 Users 1 4-H Specific Information 1 History of the Operational Guidelines 2

Introduction to 4-H (tab 2) 3-5 What is 4-H? 3 4-H Foundations and Value Set 4 4-H Organization 4 The 4-H Pledge 5 The 4-H Motto 5 The 4-H Slogan 5

Introduction to 4-H Camping (tab 3) 7-10 Definition of “Camping” 7 Florida 4-H Camp Philosophy 7 Florida 4-H Camping Goals 8 Benefits of Camping 9 Florida Camp Map 10

Camp Programming (tab 4) 11-15 Purpose 11 “Beginning With the End in Mind” 11 Defining Goals and Objectives 11 Camp Planning Committee 12 Programming for Camp Success 12 Developing Camp Budget 13 4-H Camp Marketing 14 Notification of Numbers and Schedule to 4-H Camping Facilities 15 Camp Activities 15 Evaluations 15

American Camping Association (ACA) Requirements (tab 5) 17-22

Camp Policies (tab 6) 23-26 4-H Camp Age Policy 23 Supervision Guidelines 23 Camper Release Policy 23 Emergency Evacuation Policy 23 Freedom of Expression 24 Bathing Suit Policy 24 Cell Phone Policy 24 Visitors and Resource People 25 Camp Disciplinary Procedures 25-26

Page 6: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

Risk Management (tab 7) 27-28 Definitions 27 Our Assets = 3 P’s 27 Why is Risk Management Important to 4-H Camping 27 Risk Management Strategies 27 What is Liability? 28

4-H Camp Health and Wellness (tab 8) 29-36

Emergency Numbers 29 4-H Participation Form 29 Health Exam Prior to 4-H Camp 29 Injury/Illness Insurance 29 Cost and Handling Method 30 Instructions for Handling Insurance Claims 30-31 Health and Safety Coordinator (Camp Nurse) 32 First Aid 32 Special Dietary Needs 32 HIPPA 33 Overview of Blood-Bourne Pathogens Guidelines 34-36

Camp Facilities (tab 9) 37-39 Facility Check 37 Maintenance and Repairs 37 Dining Hall 37 Meal Serving 38 Motor Vehicles 38 Camp Vans/Buses 38 Mail 38 Telephones 38 Keeping the Camp Clean 39 Damage/Clean-up Policy 39

Specific Camp Information (tab 10) Florida Map 4-H Camp Cherry Lake 4-H Camp Cloverleaf 4-H Camp Ocala 4-H Camp Timpoochee

Appendix A: Camp Programming (tab 11)

Essential Elements Walk Around for the Camp Delivery System Camp T-shirt Contest

Sample Evaluations

Permission to Use Personal Vehicle

Memorandum of Agreement

Life Skills Wheel

Visitor Record Log

Camp Inspection Report

Page 7: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

Appendix B: Job Descriptions (tab 12) Camp Nurse Summer Program Coordinator

Summer Waterfront Coordinator

Summer Waterfront Staff

Summer Staff

Food Service Manager (Kitchen Supervisor)

Food Service Assistant (Kitchen Worker)

Maintenance Personnel

Housekeeping

Appendix C: Health and Wellness (tab 13)

Communication Record Log Medication Log Accident/Incident Report Form Medical Report of Accident (goes with Accident/Incident Report Form) American Income Life (AIL) Form How to File AIL Form Special Dietary Needs Form

Appendix D: Best Camping Practices (sample materials)

Attached as a CD References

Page 8: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive
Page 9: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

1

PURPOSE AND USE OF THE FLORIDA 4-H Camping Handbook

(January 2006) Purpose:

1. The Florida 4-H Camping Handbook (2006) will outline the structure, policies, and procedures to run a safe and fun state wide camping program.

2. By 2011, we hope to have all the Florida 4-H camps accredited by the American Camping Association. There is a section on the required standards from the Accreditation Standards for Camp Programs and Services (1998).

Application:

The Florida 4-H Camping Handbook (2006) should be used as the primary resource for day, residential, special interest 4-H camps, and state events conducted at one of the four camping facilities.

Camp Cherry Lake, Madison Camp Cloverleaf, Lake Placid Camp Ocala, Ocala National Forest, Altoona Camp Timpoochee, Niceville

Users:

1. The Florida 4-H Camping Handbook (2006) is designed to be the primary administrative and planning resource for anyone responsible for 4-H camping at one of the camping facilities, including: Extension Agents, Program Assistants, Resident Directors, 4-H Camp Program Coordinators, 4-H Summer Camp Staff, 4-H Volunteers, and anyone else responsible for a camping program.

2. Sections of this guideline are also be used by camp personnel for outside user groups. 4-H Specific Information:

This camping handbook is designed to be used in conjunction with 4-H programs and publications that will be available as a separate section to be added in the future to the Florida 4-H Camping Handbook.(i.e. counselor-in-training curriculum)

Page 10: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

2

History of the Camping Handbook: 1. Clinton L. Shepard, Ext. 4-H Youth Specialist, Carey Newton, Camp Facilities

Manager, Fran Patton, 4-H Camp Secretary, and Mary Courneya, Staff Assistant created the first Florida 4-H Camp Operating Guidelines. This included philosophy, goals, fees, forms, procedures, summer camp rules, and responsibilities.

2. In 1983, it was revised through a Chevron USA, 4-H Leader Development Grant. The

Guidelines consisted of a three-ringed binder with five different 4-H publications. The Florida 4-H Camping Administrative Guidebook, Health and Safety Handbook for Florida 4-H Camps, Survival Skills Project 6, Outdoor Interpretation Program Planning Ideas, and Florida 4-H Counselor Handbook.

3. In 1991, the State Camp Advisory Committee revised the Florida 4-H Camp

Operating Guidelines. This went back to the 1983 version, and reduced to a single publication.

4. In 1997, Dr. Jerry Culen revised the Florida 4-H Camp Operating Guidelines. Each

section was updated to current state standards.

5. In 2005, the need to add additional information and update 4-H camping policies, guidelines, and training process resulted in this current version of the Florida 4-H Camping Handbook (originally Operating Guidelines) which is being revised by Wendi Zimmerman in cooperation with Kim Gumbiner, Resident Directors and other camp staff.

6. These Guidelines will be supplemented over the next several years in accordance with

ACA accreditation process, which in turn helps all programs.

Page 11: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

INTRODUCTION TO 4-H

What is 4-H? 4-H is happening: What do you want to learn?

4-H is a fun, educational program for young people, ages 5-18. 4-H has something for everyone—and anyone can join. No membership fees are required, although some project materials and activities may have a cost.

Joining a 4-H club is a great way to have fun, learn new things and meet people. Clubs meet in schools, community centers or at a 4-H volunteer’s home.

What’s great about 4-H are the many ways to get involved and to participate. The best way is to contact the 4-H extension office listed in your local phonebook. With the help of your 4-H agent, you’ll discover exciting new programs and activities.

The 4-H experience: 4-H offers a variety of ways to participate. That is what’s so great—you choose how you want to become involved.

Through a 4-H project, you’ll learn new skills and better ways of doing all sorts of things. 4-H projects teach through exciting “hands on” activities. In a project, you might go on a field trip, compete in a contest, give a speech, or work with an animal. 4-H projects and programs help youth develop leadership and communication

skills—and have fun at the same time!

Speaking of projects, Florida 4-H offers

many different projects in the following

areas:

*Animal and Plant Sciences

*Environmental Education

*Individual & Family Resources

*Science & Technology

*Citizenship & Leadership

*Communication Arts and Career

4- H’ ers make good friends: Making friends through 4-H helps young people understand and respect others. From large cities to small towns, nearby suburbs to family farms, 4-H’ers live in each of Florida’s 67 counties and the Seminole Tribes Reservations. Chances are there’s a 4-H club near you!

Page 12: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

4-H Foundations and Value Set: 4-H is based on seven foundations: it is community-centered, volunteer led, Extension staff supervised, research-based, home and family oriented, publicly and privately funded, and responsive to change. In addition, 4-H represents the following values:

1. Youth development is the focus of everything that we do. 4-H enables individuals to unlock

their potential as contributing members of society. 2. Volunteerism is fundamental to 4-H, and 4-H would not be possible without the contribution

of teen and adult volunteers. 3. Good character – trustworthiness, respect, responsibility, fairness, caring, and

citizenship – are necessary for youth and adults working with those youth to become contributing members of society.

4. Partnerships between youth and adults are essential for positive youth development.

5. Diversity strengthens the ability of 4-H to fulfill its mission.

4-H Organization: 4-H is America’s largest non-formal educational program for youth, and over seven million youth participate in 4-H. One of every six Americans has been affiliated with 4-H as a member. It is estimated that nearly 45 million American adults are former 4-H members. An American idea, 4-H has spread to over 80 other countries. National leadership for 4-H is provided by the United States Department of Agriculture (USDA), located in Washington, D.C. State-level headquarters for 4-H are located at the land-grant universities of each state and U.S. territory. Every state has a team of 4-H youth staff and subject matter specialists as part of the University Cooperative Extension System. County Extension agents direct 4-H work in the counties. Volunteer leaders assist agents by providing direct leadership and educational support to youth in local communities. State leadership for the 4-H youth development program is conducted by Florida Cooperative Extension System (CES), and educational component of the University of Florida, with USDA and local governments cooperating.

Page 13: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

The 4-H Pledge: I pledge My Head to clearer thinking, My Heart to greater loyalty, My Hands to larger service, and My Health to better living, for my club, my community, my country, and my world.

The 4-H Motto: “To Make the Best Better”

The 4-H Slogan: “Learn by Doing”

Using the Name and Emblem: Go to the National 4-H Web Site at: http://www.national4-hheadquarters.gov/library/4-Hguidelines-v4-26-04.pdf Using the 4-H Name and Emblem by CSREES

Page 14: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

Camp Timpoochee Camp Cherry Lake Camp Ocala Camp Cloverleaf 4750 Timpoochee Lane 3861 NE Cherry Lake Cr 18533 NFS 535 126 Cloverleaf Road Niceville, FL 32578 Madison, FL 32340 Altoona, FL 32702 Lake Placid, FL 33852 (850)897-2224 (850)929-4429 (352)759-2288 (863)465-4884

Page 15: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

INTRODUCTION TO 4-H CAMPING DEFINITION OF “CAMPING” 1. As defined by the American Camping Association, organized camping is “a sustained

experience that provides a creative, recreational, and educational opportunity in group living in the out-of-doors. It utilizes trained leadership and resources of natural surroundings to contribute to each camper’s mental, physical, social, and spiritual growth.” (ACA, 1998)

2. Since 4-H camping is educationally focused, it is recognized as a delivery method for 4-H programming.

FLORIDA 4-H CAMP PHILOSOPHY Camping is an educational method used to extend informal, subject-matter-based learning experiences to youth and adult audiences. Residential camps include general member experiences, special interest programs, and family opportunities. State residential facilities are used for a variety of programs in addition to camping. Teen retreats, volunteer development institutes, and faculty in-service education programs are often conducted at the facilities. The reason these groups use the camp facilities are based in the belief that they too can benefit from the attributes afforded in the camping environment.

The main purpose for providing 4-H’ers with a camping experience is to enrich their total personal development. The “education” location is changed to include forests, fields, water courses, and other natural and man-made phenomena. Use of these ecosystems should be maximized because this is one of the few chances for youth to study these in such a firsthand manner. Because agents and staff take on the responsibilities of a 24-hour day care, there is a more varied range of learning that can take place than in regular programming. Every contact with the 4-H’ers is viewed as an educational opportunity - including the tasks of daily living, the scheduled classes, and the recreational opportunities. Although the goals of camping are encompassed by the goals of the total educational program, there are five that are especially important:

1. Understanding self and others 2. Respecting and enjoying nature 3. Applying knowledge, skills, and attitudes to real life situations 4. Living safely and healthfully outdoors 5. Developing lifelong environmental interests

Page 16: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

FLORIDA 4-H CAMPING GOALS All Florida 4-H camping experiences share the following goals:

EDUCATION Youth learn new skills and test new ideas in non-

threatening environment. Special attention is given to individual interests and rate of progress.

GROUP LIVING Youth learn how to live and work with a small group of

their peers, cooperatively making decisions that affect the group.

ADVENTURE Youth experience adventure and challenge not usually

found in daily home life.

OUTDOORS Youth develop an appreciation of their natural environment and experience direct contact with the out- of-doors.

SELF IMAGE Youth accept new responsibilities in leadership, conquer

fears practice new skills, and discover individual differences in an environment that reinforces the value of each person.

INDEPENDENCE Youth develop independence and self assurance.

FRIENDS Camp provides a place for youth to make new friends.

ADMIRATION Youth develop meaningful relationships with admired and trusted adults and older teens.

FUN Youth have the opportunity to play and develop healthy

leisure habits.

ENVIRONMENT Youth develop an awareness of the environment and a sense of their interconnectedness with the natural world.

Page 17: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

BENEFITS OF CAMPING The Camping Experience:

Camping in all of its various formats is one of the most effective educational methods to achieve the 4-H youth development mission.

Camping supplements all county 4-H programs.

Camping reinforces learning experiences provided in groups, clubs, and county settings.

Camping promotes the “learn by doing” approach.

The Campers:

Youth, their parents, and other adults grow through participation in camping experiences.

Camping participants develop greater confidence and self-esteem through an effective experience at camp.

The Camp Program:

The uniqueness of the 4-H camping program is the specific subject matter content that addresses educational needs and interests at the county level.

Camping utilizes the resources of natural surroundings to help participants attain life skills in interpersonal communications, group living, personality development, and leadership.

The camp setting provides a unique learning environment in which mental, physical, social and spiritual growth is maximized.

Page 18: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive
Page 19: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

4-H CAMP PROGRAMMING PURPOSE The purpose of this section is to provide guidelines for specific aspects of planning, implementing, and evaluating 4-H camp programs. This information is meant to serve as a primary source; however each camping cluster should refer to the camp residential director or camp specific appendix for additional information.

BEGINNING WITH THE END IN MIND “Beginning with the End in Mind” means thoughtfully and purposefully identifying what you hope to achieve with your 4-H camping program and how you hope to impact youth by the end of the program.

The first step in the 4-H camp planning process is to begin with the end in mind. In other words, what do you want to teach youth during the 4-H camp experience? How do you want them to develop?

Each camp cluster should establish goals and objectives for their 4-H camp program. See Appendix A for Essential Elements Walk Around for the Camp Delivery System.

DEFINING GOALS AND OBJECTIVES By defining the goals and objectives of a 4-H camp week, a sense of direction for the program is established; allowing for a better allocation of limited resources. It also helps define what programs/activities should be offered during 4-H camp. It allows faculty to directly link camper needs with the program and activities available.

Goals can be defined as broad statements that define the youth development program/services that are going to be provided.

In contrast, objectives are specific statements that are measurable and have some dimension of time. Objectives should be:

a. Specific – clear and concise b. Measurable – must be able to determine whether or not the desired results have

been achieved. c. Pragmatic – realistic, attainable, and based in reality. d. Useful – have value, worth, or benefit to the organization or to the youth who

participate in 4-H camping. They should be directly linked to the needs of youth and to the 4-H mission.

e. Time – include a dimension of time.

Page 20: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

CAMP PLANNING COMMITTEE The Camp Planning Committee consists of youth (ages 14-18) and adults from all counties in the camping cluster who come together to create, plan and organize the 4-H camp week. The committee should meet at their discretion, but it is recommended that they should meet regularly to plan.

When there is more than one county conducting the camp program, or an individual county has more than one faculty member involved in conducting the camping program, one county faculty should be identified as the Camp Coordinator. If only one agent is attending camp, that person will serve as Camp Coordinator. The name of the camp coordinator should be submitted to the Resident Director/Program Coordinator of the 4-H center, as soon as determined.

PROGRAMMING FOR CAMP SUCCESS Here is an example of a planning outline for a county summer camping program. Use it to your benefit and contact your camp resident director, program coordinator or the state 4-H office if you need any additional assistance.

Week After Camp: Have a round table discussion/meeting with the adults, counselors, and other county staff that attended the 4-H camp week to discuss specifically what should be changed, added or taken away from the 4-H week. It is also a good idea to speak with the program director and the resident manager of the camp to get their opinion or suggestions. No detail about the week is too small!! By the time that 4-H camp planning rolls around the next year, you will have forgotten about all of the details that needed to be addressed…write them all down immediately after camp so they can be addressed later!

January: If your county is planning to pick a theme for camp, this is the time to do it so that the youth, adults and agents have proper and adequate time to prepare for this theme. Establish goals, objectives and what should happen as a result of camp.

February: Determine major lesson/activity areas and discuss taking leadership for specific areas. Talk about how to develop lesson plans and establish a time frame to accomplish these things. Decide which evening programs your youth want to have at camp that summer. Letting them have an input in the planning will give them a sense of ownership and they will want to participate. They will also tell other youth about the exciting programs and they will encourage and promote camp for you!

This month is also the best time to do leadership training. Counselors and CIT’s need to know what their duties and responsibilities will be and what preparation needs to be done prior to camp. Doing a scenario and role playing experience is fun for youth and teaches them how to react to common situations that may come up at summer camp (i.e. home sick camper, stomach/headache).

March: Lesson plans from counselors and adults who will be teaching classes at camp need to be turned in for review by the agent to make sure it is appropriate for the age and objectives. Agents need to review with counselors and county leaders how to deal with campers during camp. Youth many times don’t know how to handle situations.

Page 21: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

At this meeting, youth need to bring music that they want to play or a suggested play list for the dance so it can be reviewed by the agent-in-charge. It is recommended that counties make a CD that has “camp dance songs” on it so there is no chance of offending anyone or playing inappropriate music at the dance.

April: Design a marketing campaign for camp (p. 14). Information about camp should be distributed with as many details as possible. Include information such as: who to contact for registration, the cost, the theme, some of the activities that will be offered and the other counties with whom you will be camping. You can send out a special mailer with this information, handouts during different county programs or include it in the county newsletter. Also, if your county has an email listserv, you can send information to the leaders and youth through that as well.

May: Counselor Applications are due! At this camp planning meeting, cabin assignments for counselors and youth should be made as well as any other assignments (i.e. activity groups, etc) should be made. Agents need to assign cabin themes or write down what theme the counselor chose. Themes make camp more fun and allow the campers to get excited about their cabin that is decorated.

**No later than two weeks before your county camps, a FINAL schedule should be sent to the program director at the camp you attend. This gives the program director a chance to schedule the camp staff for classes, make sure the camp has the proper supplies and to ask any questions of the agents if necessary.

**The week before your county camps, a training day should be held where the counselors and/or CIT’s come and make nametags and finish any last minute items.

June-July: CAMP! Everyone should have everything done PRIOR to attending camp! Shopping for supplies should be done in advance to make sure nothing was forgotten. The staff is prepared to participate with the campers and to show you how much beneficial it is for youth to camp!

After camp, the process should start over with the immediate reflection meeting to discuss changes that need to be made for the next summer!

Page 22: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

DEVELOPING CAMP BUDGET

A camp budget should include both “income” and “expenditures” Sample Income:

a. Camp registration fees collected from 4-H camp participants. b. Additional fees collected from 4-H camp participants for t-shirts, specialized camp

classes, etc. c. Fund-raising activities (i.e. bake sales, car wash, etc.) d. Private/corporate/organizational donations/scholarships e. Grants

Sample Expenditures:

a. Camp fees paid to the 4-H center b. Transportation c. Insurance d. County provided materials for classes e. Marketing and promotional materials f. Recruitment materials g. Awards and recognition for 4-H campers and volunteers h. Postage i. Camp T-shirts (often included in the camp fee) j. Name tags

Page 23: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

4-H CAMP MARKETING 4-H Camp Marketing and Promotion Checklist Adapted by Barry Garst, Extension Specialist, Virginia Tech

□ Use the 4-H logo on all of your printed materials.

□ Start a “tell a friend” or “bring a friend” campaign.

□ Submit news releases to promote the benefits of 4-H camping.

□ Participate in a local or regional camp fair.

□ Mail brochures to everyone on your mailing lists (and encourage recipients to share them

with others). □ Ask your local pizza parlors to include a 4-H camp flyer in all delivered pizza boxes.

□ Offer family discounts and/or early-bird discounts.

□ Understand that location means everything! Promote camp where kids (or their

parents/guardians) will see the information (e.g., schools, shopping malls, day-care centers, convenience stores, churches, doctors offices, community centers, libraries).

□ Talk to the 4-H center about new camp programs and other “new” aspects of camp and

promote these aspects heavily to past campers. □ Add graphics, color, pictures, etc. to your promotional flyers.

□ Participate in the state t-shirt design contest and the winner gets a free 4-H camp scholarship.

(Form can be found in Appendix A) □ Ask churches to allow you to promote camp in their weekly bulletins.

□ Send past campers a photograph of themselves from 4-H camp last year along with a note and

registration form for the upcoming year. □ Offer discounts to youth who successfully recruit a friend (new camper) to come to camp.

□ Submit public service announcements about camp.

□ Sponsor a “4-H Camp Night” at a local school or library.

□ Give presentations to local civic clubs and related organizations about 4-H Camp. Better yet –

ask campers to give presentations to local civic clubs and related organizations. □ Pull together a group of six to ten prior campers and ask them what would get them excited

about camp. Use their ideas! □ Promote camp through other youth service organizations and agencies.

Page 24: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive

NOTIFICATION OF CAMPER NUMBERS AND SCHEDULE Resident Director/Program Director must be notified of the number of campers, counselors, adult volunteers and county faculty attending a camp session at least one week prior to the arrival at camp. This allows for the proper ordering of food and supplies to ensure success.

The program director must have a copy of the camp schedule along with activity selections no less than two weeks prior to your arrival at camp. This allows the program director time to look over the schedule and adjust camp staffing numbers as necessary.

CAMP ACTIVITIES Will be emailed February of each year. Generally these include a series of activities that are core programs for the summer in the general areas of Land & Water Ed-ventures, Evening Activities, After Dark Activities, and Field Trips.

EVALUATIONS Please see Appendix A for a sample evaluation. Evaluations are provided at the close of camp each week for members, volunteers and professional staff. These usually cover the general areas of preparations, facilities, activities, and life skills. A local evaluation may be used; we just ask that once you compile your data you supply us with a summary report.

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AMERICAN CAMPING ASSOCIATION STANDARDS OVERVIEW The American Camping Association (ACA) is a nonprofit community of camping professionals whose mission is dedicated to “enriching the lives of children and adults through the camp experience” (ACA, 1998, p.3)

ACA ACCREDITATION The main purpose of the accreditation process is to “educate camp owners and directors in the administration of key aspects of camp operations, particularly those related to program quality and the health and safety of campers and staff” (ACA, 1998, p.4) The standards establish guidelines for the ‘best practices of the industry, including policies and procedures.

OVERVIEW OF ACA ACCREDITATION STANDARDS Each camp will have to meet the high standards in each of the following in order to be ACA accreditated:

1. Site and food service 1. Transportation 2. Health and Wellness 3. Operational Management 4. Human Resources 5. Program Design and Activities 6. Program-Aquatics 7. Program-Adventure/Challenge 8. Program-Horseback Riding 9. Program-Trip and Travel

ACA ACCREDITATION- COMING TO A CAMP NEAR YOU During the next five years the Florida 4-H Camping Centers will be going through the accreditation process. This will require changes in not only in facility operations but, also within program operations as well.

Site faculty and staff at each camping center are required to make sure that ACA standards are being followed in all areas of the center’s operation.

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ACCREDITATION STANDARDS FOR CAMP PROGRAMS AND SERVICES SITE AND FOOD SERVICE Kitchen usage The usage of the camp center’s kitchen and storage areas are limited to camp kitchen personnel only. If a county program needs to store food or program materials, the Camp Coordinator should notify the Resident Director and/or the Food Service Supervisor prior to the arrival at camp. County faculty should not under any circumstances enter the kitchen area without prior approval.

TRANSPORTATION Arrival and Departure TR-3 Agents should have a procedure for orderly arrival and departure and unloading of vehicles. Prior to arrival, county faculty should check with the resident director for designated parking and drop-off areas. Agents are also responsible for supervision of campers during arrival and departure times. If assistance from camp staff is required please notify the program coordinator prior to arrival.

Non-passenger Vehicles TR-4 Individual should not ride in any vehicle in which the seats are not attached to the vehicle, for example truck beds and wagons. An exception can be made for hayrides when wagons or trucks are driven at slow speeds (5-10 mph) off public roads, and where protective devices are provided to keep people from falling out or off of the vehicle.

Transportation Information to Parents TR-5 Parents must be given written information on pick-up and drop-off times and procedures, as well as, the safety rules for van and/or bus travel.

Transportation Polices TR-7 Supervision ratios must be followed for campers while in transit, to ensure that children are well supervised and not left alone. Also an individual must be placed in charge of the participation forms, to ensure quick access to them in the event of an emergency. (See Supervision Ratios on page 20)

Private Use Vehicles TR-13 All persons using their personal vehicles to transport youth must fill out a vehicle transport form and have it on record with the county office as well as, the camp if the vehicle is staying at camp during the encampment. (See form in Appendix A)

HEALTH AND WELLNESS Inform Staff of Special Needs HW-9 County faculty and the Health Care Supervisor (Camp Nurse) upon arrival to camp and review of the participation (health form) are required to inform the Resident Director and Program Coordinator of any camper who has a specific health concern that would limit their participation in the camp program. {For example: Asthma, allergies, seizures, hypoglycemia}.

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Health Care Personnel HW-10 The Health Service Supervisor (Camp Nurse) must be identified at the beginning of the camp week. He/She must meet the minimum requirements of the job description, which can be found in Appendix B, as well as, be present on the camp site daily. Also it is the county faculty’s responsibility to bring a copy of this individual’s certification/licensure to be left on record at the camping facility.

Supervision in Nurses Station/Infirmary HW-16 The Health Service Supervisor (Camp Nurse) must provide continual supervision when campers are in the health care facility (Nurses Station/Infirmary) for health or medical reasons. ‘Continual supervision’ means that at least one adult is always present when campers are in the health care facility (Nurses Station/Infirmary).

Parent Notification HW-17 Parents and Guardians must have a clear understanding of the procedures for notification of illness or injury to the camper. The Health Service Supervisor should keep a ‘communication log’ to ensure that parents are being notified in a timely fashion. (See Communication Log Appendix C)

Medication Management HW-18 The Health Service Supervisor (Camp Nurse) is responsible for insuring that all medication is properly secured and administered. All drugs (both prescription and non-prescription) must be stored under lock, except when in the controlled possession of the Health Service Supervisor (Camp Nurse). ‘Controlled possession’ means under the immediate and direct supervision or control of the person taking it or of a faculty member, to prevent access by unauthorized persons. (See Medication Log Appendix C)

Recordkeeping HW-19 The Health Service Supervisor (Camp Nurse) is required to keep a health log of all treatment. These logs will be found in the individual camping center health center (Nurses station/infirmary). The logs must contain the following:

1. Date time and name of person injured or ill. 2. General description of illness or injury. 3. Description of treatment. 4. Administration of any medication 5. Initials of person evaluating and treating.

At the end of each camp week, medication logs should be copied and given to resident manager, original copies should go to county faculty.

In the event that outside medical treatment is necessary, a camp incident/injury report must be completed and left on site. (See Appendix C Accident/Incident Report Form)

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HUMAN RESOURCES Camper Supervision Ratios HR-9 Campers are to be supervised by camp staff using the following ratios. In order to maintain proper ratios “staff” is to be defined as those persons with the responsibility, authority, and training to provide direct supervision to camper group. This may include counselors, camp staff (that stay over night), county staff and adult volunteers.

Camper Age Staff/Camper Ratio 4-5 yrs of age 1:5 {or better} 6-8 yrs of age 1:6 {or better} 9-14 yrs of age 1:8 {or better} 15-18 yrs of age 1:10 {or better}

The program day is defined as 7 am-11 pm. The end of the program day is defined as 11pm-7 am.

Supervision of Campers HR-14 County Faculty must ensure that all adult volunteers, counselors and other county staff are informed and trained as to their responsibilities for supervision during the camp week. This should include specifics such as: ‘on-duty’ times and responsibilities, nighttime supervision, in- cabin responsibilities, bed-check practices, roving nighttime patterns and general youth issues that are covered in county volunteer training. All paid and volunteer staff (including teen counselors) must complete 24 hours of training that is consist with ACA requirements.

Staff Time Off HR-21 County Faculty should be aware that summer camp staff is required to have a minimum of two- hours per day free from assigned camp responsibilities. ‘Free from assigned camp responsibilities’ means free time during which a staff member is not expected to be at a specific place or performing camp-related responsibilities.

PROGRAM DESIGN Out of Camp Activities PD-11 All activities taking place outside of camp must be planned in advance and provide the following information to the Resident Director or the Program Coordinator prior to leaving the camp facility. Also an individual must be place in charge of participation forms, to ensure quick access in case of an emergency.

1. Roster of all participants 2. Departure and return times 3. Inclement weather plan (as it applies) 4. Route to be taken 5. Contact information for the County Faculty going on the trip, as well as, any

predetermined contact times.

Supervision Qualifications PD-12 Any county faculty, adult volunteer or other non-camp staff personnel conducting a specialized class (shooting sports, canoeing, challenge adventure etc.), must provide a copy of certification or documented training and experience in the activity area. For example, if an adult volunteer is instructing both archery and riflery, documentation must be provided for each training area.

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Staff Skill Verification PD-13 Written evidence must be provided for each staff member teaching or assisting in teaching a specialized class/ program activity.

PROGRAM-AQUATICS Watercraft Supervisor Qualifications PA-20 In order to supervise each watercraft activity (canoe, kayak, etc) the county faculty must provide a copy of a current certification for each of the instructors they are providing. Also they must have training in water rescue and emergency procedures that are location specific.

All certifications must be from a nationally-recognized certifying body.

Personal Flotation Devices PA-23 Personal Flotation Devices (PFD’s) must be worn by all persons (youth and adult) at all times for all watercraft activities, regardless of age or training level.

PROGRAM-CHALLENGE/ADVENTURE Adventure/Challenge Supervisor PC-1 In order to supervise any adventure/challenge activity, county faculty must provide information that the identified individual is certified/documented/ experienced in all adventure/challenge activities offered. This person must have the knowledge and experience to make judgments concerning participants, equipment, facilities, safety considerations, and procedures for the activity.

PROGRAM-TRIP AND TRAVEL Trip Orientation PT-1 Prior to any/all trips away from the camp facility a pre-trip orientation must take place. It should at least include the following:

General Information 1. Safety regulations and emergency procedures for each activity conducted. 2. First Aid procedures 3. Health and sanitation practices 4. Practices to protect the environment 5. Areas that are off-limits 6. Rendezvous times and places 7. Site Specific Information as needed

Supervision Ratios PT-4 Each trip/travel group must be accompanied by at least two adults. If the group has a total of six or less participants who are all at least 14 years of age and have been selected and prepared prior to the trip one qualified group leader is all that is required.

Camper/ staff ratios should be no less than the minimums previously established. Camper Age Staff/Camper Ratio 4-5 yrs of age 1:5 {or better} 6-8 yrs of age 1:6 {or better} 9-14 yrs of age 1:8 {or better} 15-18 yrs of age 1:10 {or better}

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Trip Itinerary PT-11 A written itinerary must be left with the camp office. This itinerary must include: trip leader contact information, route to be taken, and any other pertinent information.

ACA ADDITIONAL INFORMATION FOR SUCCESSFUL WEEK OF CAMP

OPERATIONAL MANAGEMENT Personal Information OMA-16 Written permission must be obtained in order to use photos, access personal information (medical records) prior to campers coming to camp. This is included in the camper participation form.

Personal Items OMA-17 Campers and parents should be made aware of any policy regarding the use of and storage of personal items brought to camp. This policy should also include information on liability for loss or damage for such items.

Research Projects OMA-23 Research projects being carried out at camp should be pre-approved and follow any University of Florida or federal regulations regarding protecting human subjects. This is also included in the camper participation form.

Supervision while in Transit OMA-24 Supervision ratios should be followed during transit to and from the camp program.

PROGRAM DESIGN AND ACTIVITIES Contracts (excluding summer camp) PDA-30 Prior to the arrival of a camp week a signed memorandum of agreement must be on record with the camping facility. A copy of this document can be found in Appendix A.

Balanced Schedule PDA-32 When designing your camp schedule special attention should be paid to balancing the needs of all campers. A well balanced schedule provides for active as well as quiet time, and an opportunity to participate in camp activities as an individual and as part of a group.

Program Planning PDA-33 When planning your camp schedule there should be a deliberate attempt to identify the camper needs, interests, and preferences. (See Essential Elements in Appendix A)

Program Flexibility PDA-34 When preparing for a camp week, you should be aware that the camp schedule is a fluid entity and is subject to change depending on weather conditions, as well as, the development of ‘teachable moments’.

Decision Making PDA-35 When planning your camp week, thought should be given to the opportunity for individual campers to develop and practice decision-making.

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Planned Activities for Life Skill Development PDA-36/37 When planning your camp week, there should be a deliberate attempt to insure that campers develop life skills. Socially, as well as, gain a knowledge and understanding of individual differences and group cooperation. Other Life Skills can be found on Life Skills Wheel in Appendix A.

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CAMPING POLICIES

4-H CAMP AGE POLICY A new 4-H year starts September 1 and ends August 31 of the following year. 4-H enrollment and participation revolve around this 4-H program year definition.

The scheduled Summer Camp program is designed to accommodate youth of 4-H programs age (8-18), with appropriate adult volunteer and professional staff serving as chaperons and providing program support. The program must be provided on a nondiscriminatory basis and as such is open to all persons without regard to race, color, sex, or national origin.

We recommend that county camp be for 8 to 13 years old. Counselors and CIT be between 14-18 years old.

SUPERVISION GUIDELINES Campers are to be supervised by trained county agents/faculty, designated volunteers (adults and teens) and camp staff.

Supervision Ratio Camper Age Number of Staff Overnight Campers Day Only Campers 6-8 years 1 6 8 9-14 years 1 8 10 15-18 years 1 10 12

CAMPER RELEASE POLICY A camper will not be released to anyone without prior written authorization from the parent/legal guardian, that has been approved through the county faculty. When a camper is leaving the county faculty should immediately inform either the resident director or the program coordinator.

EMERGENCY EVACUATION POLICY In the event of a natural disaster or other situation that poses an immediate threat to the health and safety of the campers, they will be evacuated from the camping facility. This does not include thunderstorm or other moderate inclement weather situation such as, windstorm, severe thunderstorm watch, tornado watch or warning.

In the event of hurricane, fire or other natural disaster the decision to evacuate or cancel camp will be made after discussion with the county faculty, resident director and state camping office; with the expressed purpose of guaranteeing the safety of each and every camper. If during encampment it becomes necessary to evacuate campers, camp specific procedures can be found in the individual camp section in the back of this guideline.

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FREEDOM OF EXPRESSION The 4-H program embraces opportunities for young people to build skills, exercise leadership, interact with adult mentors, and help their communities. 4-H programs are required to be open to all youth and adult volunteers regardless of religious background or creed. The 4-H program must be consistent with the First Amendment of the United States Constitution as well as Article I, Section 3 of the Florida Constitution. The 4-H program, because it is both a state and federal governmental program, may not schedule or approve religious activities or exercises as a part of 4-H activities. At the same time, individual young people may express religious ideas in forums such as talent shows and speech competitions in free or unscheduled time. As leaders and role models in the 4-H program, we need to be aware that 4-H participants often see us with our formal organizational “hats on”. It is important for all of us in leadership roles to maintain our commitment to freedom of expression and not impose our beliefs on others through our actions or expectations for participation. As individuals, we have the right to freedom of expression. When we put our “leadership” hat on, we must think about protecting the freedoms of all those present – including those who may not think or act like us. This is always a challenge, but something that we should work on everyday.

BATHING SUIT POLICY All agents, adults, volunteers, campers and staff that attend any Florida 4-H Camp will be responsible for the bathing suit policy:

Females: All campers must wear a modest, one piece bathing suit any time they are at or will be encountering any water activity. This includes canoeing, swimming, snorkeling, seining, water relays, etc. If the camper does not have or own a one-piece bathing suit, a two-piece may be worn if the camper wears a dark colored t-shirt over the top that completely covers the waist area.

Males: All campers must wear a swim suit that fits their body. No Speedos will be allowed and no swim shorts that hang off the camper’s hips or come above mid-thigh will be allowed. Any camper seen wearing swim shorts that are too big or small, will be asked to put on a different pair of shorts.

The staff reserves the right to ask a camper to put a shirt on if the bathing suit is not appropriate for 4-H Camp.

**All agents, adults, volunteers and staff must also follow these guidelines! We are trying to protect everyone and we must appear to be modest and respectful of everyone’s presence as some people can be offended by immodest apparel.

CELL PHONE/ ELECTRONIC DEVICES POLICY The statement below is the minimum requirements of the state camping program. Camping clusters may establish a more conservative policy.

Cell phones are permitted on camp as long as they are kept in cabins during camp activity times. They may be used at meal time, free time, and after the last activity and before bedtime only. Cell phones and electronic devices that are used during activity times will be confiscated and returned at the end of the camping week. Please inform parents of this policy.

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VISITORS AND RESOURCE PERSONNEL You are welcome to invite visitors and resource personnel to participate in your camping program. Be sure that the Resident Director and Food Service Supervisor are notified at least 24 hours in advance of the arrival of guests. If more than ten guests will be present for meals, this information should be communicated at least two weeks before the camping session to allow for necessary food ordering adjustments. All camp users are expected to register and pay regular fees. The Agent-in-charge/Resident Director is responsible for monitoring the presence of visitors and collecting or paying for their expenses. Visitor record log is located in Appendix A.

CAMP DISCIPLINARY PROCEDURES Each camping unit should set up a disciplinary committee to handle all discipline related problems and decisions at camp. The membership for this committee should be selected before camp and the members oriented so that the policies and criteria for decisions of the committee are understood by the members before a problem occurs. The membership of the Camp Disciplinary Committee should follow the guidelines established in the 4-H Program Handbook which can also be found at http://4h.ifas.ufl.edu/FacultyStaffOnly/4HProgramHandbook2001/ Each camp also has a copy in their office. The Resident Director or other camp designee should be informed of any disciplinary action taken. All efforts should be made to enforce discipline equally. Rules and penalties should be the same for all youth in the camping unit (regardless of county) for legal as well as organized reasons. The professional staff will make every effort to ensure that reasonable rules and regulations are clear to each camper. A 4-H Code of Conduct can be found in the Participation Forms. Parents and campers are required to sign this form prior to attending camp. Rules will be distributed in written form and presented orally at assembly during the beginning of each camp week. When misbehavior is observed, it will be reported to the Agent-in-charge. The Agent-in-charge or his/her designee and a witness will counsel the youth. If an Agent or Volunteer Leader from the camper’s county is in attendance, they will be consulted prior to the conference with the youth. A written record of the misbehavior, of all meetings held, and action taken will be kept by the Agent-in-charge. If disciplinary action is contemplated after counseling the youth, a meeting of the Camp Disciplinary Committee should be called. The youth should be given and opportunity to reply to the accusation and present an explanation and, if available, have another youth or adult give testimony on his/her behalf. If appropriate, the committee may choose to take the following corrective actions depending on the severity of the misbehavior:

1. Restitution: The discipline administered should relate to the misbehavior as closely as possible. Examples: If a child damaged a building or piece of equipment, he/she would assist with repair or pay for repair. When a camper throws food in the cafeteria, appropriate disciplinary action may be for the camper to mop that area. Whatever the action, the safety and health of the camper will be of the utmost importance. Under no circumstances will the camper be subjected to corporal punishment or ordered to participate in an activity that would be detrimental to his/her health (i.e. duck walk), nor will food or canteen privileges be denied.

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2. In-Camp Suspension: This form of discipline would result in the camper being denied the opportunity to participate in the camping program for a limited time. Supervision will be provided at all times.

3. Expulsion: If it is deemed necessary to remove the camper from the camp site, the County Camp Coordinator will contact the camper’s 4-H Agent or CED. It is the responsibility of the county extension personnel to notify the camper’s parents that the child will be returning home. Responsibility for safe transportation rests with the county or parent. The camper will be isolated from the group until such transportation arrives. Every effort throughout the process should be made to involve volunteer leaders and Agents in conferences and counseling sessions, to establish positive correctional efforts before resorting to the extreme remedy of expulsion from the camp program.

There will be no fee refund granted to participants who are expelled.

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RISK MANAGEMENT WHAT IS RISK MANAGEMENT?

1. “Risk management” is the term given to the process we use to identify, analyze, and manage risks during 4-H activities. The objective of risk management is the protection of our human, financial, and physical resources and assets from loss or destruction.

OUR ASSETS= 3 P’s 1. People- members, the public, volunteer and paid staff. 2. Property- things the organization or individuals own or manage such as money,

buildings, equipment or materials. 3. Perpetuations- an organization or individual’s ability to continue doing what you do

effectively (good reputation). WHY IS RISK MANAGEMENT IMPORTANT TO 4-H CAMPING?

1. The health and safety of 4-H youth, volunteers, staff, and the public that we serve are critically important. Through cooperation with the University of Florida Office of Risk Management and the 4-H educational centers, the Florida 4-H program works to provide a safe environment for 4-H youth, volunteers, and staff using a risk management process.

RISK MANAGEMENT STRATEGIES

1. AVOID RISK a. Decide not to develop high-risk programs/activities; b. Discontinue existing high-risk programs/activities;

2. TRANSFER RISK

a. Purchase insurance to transfer risk to another company. b. Obtain a “Certificate of Insurance” which names University of Florida and, when

applicable, the 4-H educational center, as “additional insured”; and c. Develop a contract/agreement which transfers risk to another company.

3. REDUCE RISK

a. Prevent loss (e.g., human loss, financial loss, physical loss) through the development and use of a 4-H camp safety program and a 4-H camp teen and adult volunteer training program.

b. Separate or duplicate all 4-H camp records to prevent loss of records. c. Utilize the appropriate emergency response, fire protection, etc. to minimize

the loss once it has occurred.

4. RETAIN RISK a. You might choose to retain the risk (i.e., continue an existing 4-H

program/activity) situation if the amount of risk involved with a particular activity or situation is minimal.

b. Example: The minor medical problems that the 4-H camp medical staff manages on a day-to-day bases. This risk has been identified as minimal and a necessary and acceptable part of involving youth in residential out-of-door 4-H camping experiences.

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WHAT IS LIABILITY? 1. ELEMENTS OF LIABILITY

In planning a function, it is imperative to understand your responsibility as it relates to liability. The following information is provided for use in conjunction with your normal planning process. It is important to clearly know for whom you have duty of care and that you have a responsibility to perform as any other reasonably prudent person would be expected to perform in the same situation.

2. DEFINITIONS

i. Prudent – judicious or wise. ii. Liability – synonymous with responsibility and involves the concept of penalty when a

responsibility may not have been met. iii. Negligence – failure to do or not to do what a prudent person would have done in the

same or similar situation.

3. ELEMENTS i. In order to prove the negligence of another person, the following elements

must be present in the situation!

a. Existence of a legal duty to protect the injured party from reasonable risks of harm that can be reasonably foreseen.

b. A failure to perform that duty of care. Ignorance and inexperience is no excuse. Inability to perform will eventually lead to problems.

c. An injury suffered by the claimant (person filing the claim). Injury may be physical, mental, or property.

d. A reasonably close causal relationship between the breach of duty and the claimant’s injury.

ii. Your planning, documentation, and training for the activities must reflect

that you recognized those you have duty of care for, that you did what any normal, reasonable prudent person would have done to protect that duty, and that you recognized the possible resultant injuries and planned accordingly.

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4-H CAMP HEALTH AND WELLNESS

EMERGENCY NUMBERS

Florida State 4-H Office: (352) 846-0996 (Monday-Friday, 8am-5pm) Florida Poison Center: (800) 222-1222 Florida Child Abuse and Neglect Hotline: (800) 96ABUSE Florida State Police (Emergency): 911

Florida State Highway Patrol (Highway traffic problems i.e. crashes, disabled vehicles, suspected substance-impaired drivers, and reckless and aggressive drivers): *FHP

FLORIDA 4-H PARTICIPATION FORM

Each camper (adult and youth) must have a Florida 4-H Participation Form while at any of the State 4-H camps.

The Participation Form can be found in Appendix A or on the website at www.florida4h.org on the ‘Events’ link. The Florida 4-H Participation Form gives signed permission for medical staff to provide routine health care, administer prescribed medications, administer prescribed medications, provide over-the–counter medications as needed, and seek emergency medical treatment for the 4-H camp participant. It also includes publicity release, survey and evaluation releases as well as the 4-H Youth/Adult Code of Conduct.

A parent or guardian for each minor age camper must sign the Florida 4-H Participation Form. Failure to complete and present this form may result in delay or refusal of medical care by a doctor or hospital in the event of an emergency. A copy of the Participation Form should be available to all authorized camp personnel.

HEALTH EXAM PRIOR TO 4-H CAMP It is recommended, but not required, that each 4-H agent obtain written verification from licensed medical personnel that each 4-H camp participant (under age 18) has had a health examination within the past 24 months.

INJURY/ILLNESS INSURANCE Injury/illness coverage is included in the camper’s fee. The company is:

American Income Life Insurance Co. Special Risks Division

PO Box 50158 Indianapolis, IN 46250

The event’s insurance will only cover a portion of the medical costs and the participants insurance, may be responsible for the remaining expenses.

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This partial coverage policy does not include: 1. Pre-existing conditions 2. Preventive medicine 3. Vaccines for prevention of disease 4. Certain exclusions 5. Crutches 6. Dental coverage is limited to injury to sound natural teeth and to $350.00

maximum.

This policy pays: 1. To a maximum of $2,500.00 for each accident. 2. To a maximum of $1,000.00 for each illness.

The policy covers each insured person 24 hours a day. Since all campers in attendance are partially insured, travel time is automatically covered providing it takes place on one of the insured days of the camping period. Copies of the insurance form and the claim number will be sent to each county before they leave for camp.

COST AND HANDLING METHOD The cost of insurance for camping is included in the camp fee. Paying for the insurance at time of registration may insure those not paying the camp fee. Only those campers listed on the 4-H Camp Registration Form will be considered covered by insurance. Be sure this form is accurate. County Extension Agents are covered by their own County insurance and should not take out this insurance.

INSTRUCTIONS FOR HANDLING INSURANCE CLAIMS In case of accident or illness at camp, the camper or volunteer will be given necessary treatment by a doctor, dentist, hospital or clinic. Even if no treatment is necessary, an Accident/Incident Report Form should be completed (see Appendix A).

The State 4-H Camping Office will serve as a clearing-house for all claims. Please follow the instructions listed below to insure early payment of claims.

SPECIAL NOTE: Neither the State 4-H Camping Office nor the 4-H camping facility is liable for costs above and beyond stated policy amounts.

1. PRIOR TO LEAVING CAMP

If an accident requires a hospital, doctor, dentist or clinic treatment, make sure the Camp Nurse, Camp Coordinator, and Resident Director are notified.

2. FOR HOSPITAL, DOCTOR, DENTIST OR CLINIC TREATMENT

Complete two American Income Life (AIL) (see Appendix A) insurance forms and an Accident/Incident Report Form (see Appendix A) for any person requiring treatment. Both of these forms will be available from the Resident Director. All sections of these forms should be completed except the section designate “Assignment Form”.

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a. Return a copy of the insurance form and the Accident/Incident Report Form immediately to the Resident Director so that it can be sent to the State office.

b. Leave one claim form at the hospital, doctor’s office or clinic and ask that they complete it

and return it TO THE STATE OFFICE, not the 4-H centers, along with any bills. The State Office will be responsible for submitting claim forms and bills to the Insurance Company. Be sure that a return envelope addressed to the State 4-H Office is attached to the claim form you leave with the hospital, doctor etc.

If a camper’s family receives a bill for radiology, ambulance service, etc. please instruct them to forward it to the State Office to expedite payment.

2. FOR MEDICATION

If medication must be purchased, use one of the following two procedures: a. If the pharmacy is willing to bill the insurance company, have them give you a bill

at the time you pick up the medication. Forward the bill and copy of the prescription to the State Office to submit for reimbursement direct to the pharmacy.

b. If the pharmacy will not bill the insurance company and you must

pay cash, purchase the medication and send a receipt and copy of the prescription to the State Office with instructions for reimbursement (name, address etc.)

Should treatment be required after camp, the camper’s Extension Agent is responsible for

facilitating the claim.

Please send all bills directly to the State Office, not to the Insurance Company, in order to avoid confusion and to facilitate timely payment of claims.

Failure to follow these procedures may result in delay of payment and the patient/family being billed.

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HEALTH AND SAFETY COORDINATOR (CAMP NURSE) 4-H County Faculty will be responsible for providing a Health and Safety Coordinator during their respective camps. The person who accepts this responsibility must have the ability to respond and relate to all youth and adult camper health and safety needs. Position Requirements: Current Certifications in First Aid and CPR (EMT suggested) Job Responsibilities

1. Collect and review all health forms – identify any special health-related needs. 2. Collect and dispense all prescribed medication. 3. Accept responsibility to be at a designated location and remain on camp facility at all

times in order to respond to camper health needs. 4. Fill out all injury and incident reports.

For a detailed job description please see Appendix B Special Note: under no circumstances should the legal guardian administer any non- prescription drug to a camper without prior written or verbal approval.

FIRST AID

a. All 4-H camp centers will provide the following personal protection equipment in a kit. These kits are located in the dining hall, waterfront area, camp office, and any other multi-purpose use area. All instructional camp staff should carry a minimal first aid kit. If you would like to purchase extra items that are listed below can be obtained from your local grocery or pharmacy. You may want to consult with your local safety-supply company for the latex gloves and hand cleaners.

i. Disposable latex gloves ii. Band-aides, iii. Waterless medicated hand cleaner such as a germicidal hand wash, iv. Tweezers v. Gauze dressing vi. Antibiotic Ointment/Insect sting reliever vii. Pain reliever

b. Disposable latex gloves shall be worn in all first-aid situations.

SPECIAL DIETARY NEEDS Many 4-H camp participants have special dietary needs. This includes children who have diagnosed food allergies (e.g., cow’s milk products, eggs, peanuts, fish and shellfish, soybeans, soy milk, soy flour, wheat, and some berries), religious exceptions and vegetarians. This does not include “picky” eaters, peanut butter and jelly is available at every meal. Although the Participation Form gives 4-H camp participants (or the parent/guardians of 4-H camp participants) the opportunity to identify special dietary needs, agents need to use the “Special Dietary Needs Form’” found in Appendices C. Please fax this form to the Resident Director at least two weeks prior to your week so that arrangements can be made for your camper.

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IMPACTS OF THE HEALTH INFORMATION PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) ON 4-H CAMPING The University of Florida 4-H Camps do not fall under, and are not bound by HIPPA for three reasons:

1. Camps are not health insurance insurers, 2. Camps do not provide health services for a fee, and 3. Camps do not act as a clearinghouse for health programs, insurers, or programs.

However, HIPPA has some important implications for how medical information is shared at camps. Such information is considered “Protected Health Information” which many states and lawyers are adopting as a standard of practice. Information provided on health forms is private and protected information. Therefore, 4-H Resident Directors must take specific and reasonable precautions to make sure: Only authorized individuals (as necessary to safeguard the individual) should have access to this information.

4-H Participation Forms, medication forms, and related health documentation and information records must be secured (locked away) in such a fashion to prevent unauthorized access. Training must be provided to all 4-H camp staff and volunteers regarding the importance of protecting and respecting the privacy of health information. (This health information is privileged and may be considered very sensitive.)

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OVERVIEW OF BLOOD-BOURNE PATHOGENS GUIDELINES 1. Purpose

a. The purpose of this plan is to educate 4-H staff and volunteers about the risks

associated with “exposures” to infectious substances and to inform them about the procedures to follow if they are exposed.

2. Definition of “Blood-Bourne Pathogens”

a. Microorganisms that can be present in human blood and are capable of

producing disease in humans. Some examples of blood-bourne pathogens are: a. Malaria,

b. Syphilis,

c. Hepatitis B virus (HBV), and d. Human immunodeficiency virus (HIV)

3. Definition of Exposure

a. An “exposure” is contact with any potentially infectious substance (i.e., blood, urine,

semen, vaginal secretions, saliva, and sweat), through inhalation, needles, contact with an open wound, non-intact skin, or eyes or other mucus membrane.

b. Please note that contact of blood or bodily fluids onto intact skin does not signify an

exposure and should be disinfected as outlined below.

4. Job Classifications at 4-H Camp that Hold a High Occupational Risk of Exposure

a. EMT/Nurse/Medical Staff; b. Lifeguards; c. Maintenance staff; and d. any summer camp staff member required to have first aid and CPR certification.

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5. Primary Responders

a. Each 4-H center must identify “primary responders,” those individuals who can respond to situations involving potentially infectious substances because of training, vaccinations, etc.

1. Residential camping groups must prior to encampment identify a primary

responder who meets the following criteria: a. When access to the emergency medical system (EMS) is 20 minutes or

less, certification by a nationally-recognized provider of training in first aid and CPR.

b. When access to EMS is 20-60 minutes, certification by nationally- recognized provider of training in second level first aid and CPR

c. When access to EMS is more than one hour, certification from a nationally-recognized provider of training in wilderness first aid and CPR.

b. For 4-H camps conducted at the unit level, there should be someone who can serve as the “primary responder.”

6. What To Do if You Are Exposed

a. If a potentially infectious agent comes into contact with an open wound, broken skin,

or mucous membrane, you have been exposed. b. If exposed, you must contact the office listed below to get instructions on how to

proceed.

i. Nurses Station/Infirmary ii. Resident Director’s Office

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

7. Personal Protection

a. All 4-H camp centers are responsible for assembling and providing the following personal protection equipment in a kit. If any part of a kit is used, the entire kit must be disposed of. Most items that are needed can be obtained from your local grocery or pharmacy. You may want to consult with your local safety-supply company for the latex gloves and hand cleaners.

i. Disposable towels, ii. Disposable latex gloves, iii. Waterless medicated hand cleaner such as a germicidal hand wash, iv. Small, equal size bottles of water and chlorine bleach, and v. Small plastic bag

b. Disposable latex gloves shall be worn in all first-aid situations.

c. Personnel (staff and volunteers) shall wash their hands and any other exposed skin as

soon as possible after the removal of gloves. If personnel are away from a facility, these body areas shall be cleaned with a waterless, germicidal hand cleaner. As soon as feasible, whether at the station or medical facility, personnel shall wash these body areas with appropriate hand-washing agents, followed by soap and water.

d. Personnel shall wash as listed above, or flush eyes or other mucus membranes with

water immediately or as soon as possible following contact of these body areas with blood or other potentially infectious materials. If you have an exposure, refer to 6. above.

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

CAMPING FACILITIES FACILITY CHECK Upon arrival, the Camp Coordinator or his/her designee and the Resident Director should inspect the facility for the current condition. Prior to departing camp, the Camp Coordinator or their designee and the Resident Director should again check the facility for any damages, which may have occurred during the encampment. Any damages found will be assessed against the camping unit. Charges are levied at the current prevailing rate. The Camp Coordinator is responsible for making assessments against an individual or group of campers. Payment for damages is payable before departing the camp facility or added to the invoice. See Appendices A for the Camp Inspection Report.

MAINTENANCE AND REPAIRS The Resident Director or his/her representative will make daily checks of the facilities for repairs, hazards and destruction of property. Any problems related to the upkeep of the facility should be promptly reported to the Resident Director. All camp centers have a maintenance board to report maintenance problems, ask the Resident Director where the board is located.

DINING HALL Meal service will be available on the following approximate schedule:

Breakfast 8:00 a.m. Lunch 12:00 p.m. Dinner 5:30 p.m.

**Meal times may deviate by ½ hour either way to fit into your schedule.

If the program or arrival/departure time requires a deviation from this schedule, it should be discussed with the Food Service Supervisor or Resident Director prior to the encampment. Efforts should be made to keep the program on schedule so that meals are served on time. Unless a special medical or illness situation exists, only that food offered will be available. Campers with special food needs should be brought to the attention of the Resident Director at least two weeks prior to arrival. Please fill out a Special Dietary Needs Form, found in Appendices C. Sufficient time must be allowed in order for the Food Service Supervisor to evaluate the menu request.

Campers and volunteers should be informed that all kitchen coolers, including the ice machine, are off limits unless permission has been given by the Resident Director or the Food Service Manager. Cups, plates, flatware, and cooking tools must remain in the dining hall.

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

MEAL SERVING About five minutes before each meal, campers should line up outside the dining hall or designated area. Campers should not enter the dining hall until instructed to do so by camp staff.

Each group should have one adult designated to assist with all clean-up crews. Each clean-up crew should consist of at least four campers. The Program Coordinator or Resident Director will meet with the adult crew leader for the first meal and explain the procedure and provide assistance. If problems develop during the week or there are questions, the Food Service Supervisor or Resident Director should be contacted.

Adults and campers assigned to clean-up crews should plan on staying an additional ten to twenty minutes after the meal is complete.

Responsibilities of Clean-Up Crew: (at least four campers per crew)

1. Upon arrival (before eating), depending on which camp you are at, get instructions from

Kitchen Supervisor of needs. 2. The adult will assign each person to a task and explain the procedure. 3. The adult and cleanup crew should be the first served and once finished eating, are to

report to their clean-up duty. MOTOR VEHICLES All vehicles in camp are assigned to a designated area. Vehicles should only be driven on established roadways and parked in designated areas. Driving across the campgrounds, up to cabins, or other buildings where roadways do not exist is not allowed.

CAMP VANS/BUSES There is a charge to use the camp vans and buses to go on trips, this money is put into a maintenance fund for the vans and busses.

Bus Fee: $40/day plus $1.00 per mile Van Fee: $25/day plus $.50 per mile

MAIL All mail addressed to campers, volunteers, or county staff will be picked up by the Resident Director and given to the Camp Coordinator for distribution. Individuals who send mail to camp participants should be advised to post their letters a full week before the camp starting date. Mail received after a camper has left will be returned to sender.

Outgoing mail should be deposited in the designated drop box by the time designated on the outgoing mail box (see Resident Director for box location). Mail deposited later in the day may not go out until the following morning.

TELEPHONES County faculty will determine if and when campers are allowed phone access. Camp office phones are to be used for EMERGENCY situations only. Any long distance calls placed from camp office phones will require a credit card or calling card.

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FLORIDA 4-H CAMPING: BUILDING LIFE SKILLS THROUGH OUTDOOR ED-VENTURES

KEEPING THE CAMP CLEAN Depending on the camp you are attending, the group is expected to clean cabins, bathhouses, auditorium, pavilion, and grounds each day. Your Resident Director will give you specific instructions. Cleaning materials and equipment will be supplied. It is highly recommended that an adult supervisor be assigned to each area to be sure it is appropriately cleaned each day and at the end of your camping experience.

On the day of departure from camp, special care should be taken to see that the necessary tasks are completed. Check with Resident Director/Program Coordinator for specific details, all of the following may apply depending on your site.

1. Cabins - Remove all baggage and personal items. Sweep floor thoroughly and pick up

grounds around cabin. Wood shutters should be left open, and glass windows should be closed.

2. Bathrooms - Sweep the floor and make sure all items are removed from shower. 3. Auditorium, Pavilion or Gym - Return all chairs and/or benches to original position or

as directed by Resident Director. Remove all program materials and trash. Sweep the stage and floor.

4. Grounds - the entire campground including swimming and parking areas should be inspected and cleaned of litter. Any program materials used on the grounds should be dismantled and disposed of or returned to the appropriate person.

5. Workshops or other facilities used - Must be thoroughly swept, tables wiped, and the area otherwise cleaned as necessary.

DAMAGE/CLEAN-UP POLICY

DAMAGE POLICY

4-H Camping Centers have established a policy concerning damage to the facilities. This policy has been discussed and accepted at the 4-H Camp Advisory Board level and read as follows. “The purposeful destruction of camp property will result in a minimum $25.00 charge to the 4-H county camping program. The county or camp cluster (two or more counties camping together) will then be responsible for collection of monies from campers involved. This fee will be included in the check to be written at the end of the camping week.” Purposeful destruction will be defined as any act that is deemed to be done on purpose or as a result of unacceptable behavior. The Resident Director will have the final determination over any disputed cost or discrepancies. This policy is in effect for all user groups.

CLEAN-UP POLICY Each group is responsible for sweeping for their cabins, disposing of the trash and picking up any trash on the grounds before leaving the facilities. If equipment (ex. Canoes, recreational, etc.) is used during the visit, it must also be put back in its original place. A minimum $25.00 charge will be added to the bill if this policy is not followed. The Resident Director will have the final determination over disputed cost or discrepancies.

If the above information has been read, understood and agreed to by the representatives of the user group. A policy to be signed is in Appendix A and turned into the Resident Director on the day of arrival to camp.

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References American Camp Association. (1998). Accreditation Standards for Camp Programs and Services. American Camp Association. Martinsville, Ind.

Culen, G. R. (1997). Florida 4-H Camp Operating Guidelines. University of Florida Cooperative Extension Service. University of Florida, Gainesville, Fl.

Faul, T. D. (2004). 4-H Camp Handbook. Louisiana State University Ag Center Research & Extension. Louisiana State University, Pollock, Louisiana.

Fox, D. M. (2003). 4-H Camp Handbook. Kentucky Cooperative Extension Service. University of Kentucky, Lexington, Ky.

Garst, B. A. (2005). Virginia 4-H Camping Handbook. Virginia Cooperative Extension Publication 388-562. Virginia Tech, Blacksburg, Va.

Hendricks, P. (1999). Targeting Life Skills Model. Iowa State University Extension.

Page 52: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive
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Essential Elements Walk Around

for the Camp Delivery System

Belonging 1. A Positive relationship with a caring adult: Trained counselors; adults

know responsibilities; outlined hierarchy of responsibilities at camp

2. In inclusive environment (affirming, belonging) cabin identity;

welcoming cabin; names tags, cabin spirit, responsibility of cabins to

special tasks, Flag raising; campfires; ice breakers, and games;

songs

3. A physically and emotionally safe environment: written or posted

programs, orientation prior to arrival; welcoming orientation the first

day; daily announcements

Mastery 4. Engagement in Learning: active participation in planned educational

opportunities in the form of classes, workshops, demonstrations, and

skill building activities. Adult or counselor guided experiential

learning activities that included “do, reflect, and apply” aspects for

development of life skills.

5. Opportunity for Mastery: exploration of new, developing, or continued

knowledge building in one or more specific disciplines over time, with

sequential learning activities that were age appropriate such as

outdoor ed / EE skills, self assessment of learning

Independence 6. Opportunity to see oneself as an active participant in the future:

campfires; opening and closing ceremonies;

7. Opportunity for Self-Determination – selection of sleeping location,

clothing care, cabin clean-up, use of bathhouse, loss of personal

articles, managing their personal items, managing time, working

within established times, dealing with homesickness

Generosity 8. Opportunity to value and practice service for other: service to others in

the dining room, cabin or grounds clean-up, sharing equipment,

looking out for others during water sports, buddy systems. Cabin

supervision of younger youth by trained teen counselors. Special

service project, service project for camp - prior or during. Care for the

lake, grounds, animals, etc., recycling of materials at camp,

Page 54: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive
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2007 SUMMER T-SHIRT DESIGN CONTEST

Got an idea? Well here’s your chance to come up with your own design for

the back of our 2007 Summer Camp T-Shirts. If your design is chosen to

be used on the T-Shirt, you will WIN:

A FULL CAMP SCHOLARSHIP

Good for one week during the Summer of 2007

at the 4-H Camp of your choice!!!!!

Rules:

1) Designs MUST be drawn on a standard (82 x 11) sheet of paper. One

design is used for all four camps, so the theme of your design must be

relative to all four camps. (Remember, if you use the 4-H Cloverleaf in

your design, you cannot superimpose anything over the Cloverleaf.)

2) Designs must be submitted no later than 11/15/06 to:

University of Florida 4-H

Att: Kim Gumbiner

PO Box 110225

Gainesville, FL 32611-0225

2005 Design

Ask your Camp Director or your Summer Program Coordinator for a copy of

this flyer if you are interested in participating in this contest.

HAVE FUN DRAWING!!

Page 56: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive
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4-H Camp Evaluations: Faculty/Staff

I am: County Faculty Program Assistant Other

County Staff Not specified

I attended Camp: Cherry Lake Cloverleaf Ocala

Timpoochee

Choose the appropriate response for items #1-3

1. Approximately how many summers have you been participating in the 4- H camping program?

1-3 4-6 7-10 10+

2. Approximately what percentage of your county 4-H members participate in the camping program?

1-5% 6-10% 11-20% 21-30%

30%+

3. Did you conduct an evaluation of the camping experience with campers at camp or subsequent to the camp week?

Yes No

If "Yes," Please describe your procedures (e.g., written, verbal, parental feedback) and how the results might be used.

Choose the one that best describes your

position.

To No Extent

X

X

Moderate Extent

X

X

To a Great Extent

X

4. To what extent does the camping program play a role in my overall county 4-H program?

5. The county faculty and/or volunteers participate (in a teaching capacity) in the activities during camp programs.

6. The county faculty and/or volunteers participate in the preparation of the weekly

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schedule prior to the camp week.

7. The summer program director and/or resident manager is/are helpful in the preparation of the weekly camp schedule.

8. Florida 4-H Curricula were utilized when planning and implementing camp activities.

9. The "Florida 4-H Camp Operating Guidelines" were helpful in preparing for my camp session.

COMMENTS:

The following questions apply to the campers and your perception of their

experience.

To No Extent

X

X

Moderate Extent

X

X

To a Great Extent

X

10. To what extent do you believe your campers gained an awareness of the environment or environmental knowledge?

11. To what extent do you believe your campers learned new skills related to communication?

12. To what extent do you believe your campers improved their teamwork skills?

13. To what extent do you believe your campers experienced adventure and challenge not usually found in daily home life?

14. To what extent do you believe your campers thought that the camp program was an enjoyable experience?

15. To what extent do you believe the camping experience improved/enhanced camper social skills?

16. To what extent do you believe your campers improved on their self- responsibility during their stay at camp?

17. To what extent do you believe your

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campers are more accepting of differences as a result of the camping experience?

COMMENTS:

Please choose the one that best

describes your perception of 4-H state camp staff.

Strongly Disagree

Disagree

So- So

Agree

Strongly Agree

18. The summer camp staff appeared well-trained and prepared for the activities they conducted

19. The summer camp staff were appropriate role models for this camping experience.

20. The summer camp staff were punctual and attentive when conducting activities.

21. The summer camp staff were prepared for various minor first aid emergencies.

22. The summer camp staff were enthusiastic when performing their duties.

23. The summer camp staff were viewed as trusted adults during the camp experience.

24. The level of staff involvement and comradery with campers was appropriate.

25. The summer program director demonstrated appropriate leadership for staff and participants.

26. The summer program director and/or staff used appropriate discipline measures when necessary.

27. The resident manager demonstrated appropriate leadership for staff and participants.

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COMMENTS:

Facilities/Service Component. Strongly Disagree

Disagree So- So

Agree Strongly

Agree

28. The quality of the food was appropriate for this type of camping experience.

29. The amount of food was appropriate for this type of camping experience.

30. The food service staff was courteous and helpful.

31. Requests for facilities maintenance were performed in a timely manner.

32. Cabin cleanliness and upkeep were appropriate for this type of facility.

33. Improvements in grounds and facilities are needed.

COMMENTS:

Please rate your experience.

Weak X

X

Good X

X

Excellent X

34. From your years of experience at camp, please provide an overall rating for this year's staff.

35. If applicable, please provide a rating relative to your interactions with/assistance from state camping staff.

36. Last, but not least, provide an overall rating of your camp experience this summer.

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Additional Comments:

Information provided here is confidential. Results of these evaluations will be distributed to the Camp Advisory Committees. Any comments used in these reports will be anonymous.

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4-H Camp Evaluations: 4-H Volunteers

Now that your county camping program is over, please take this opportunity to reflect on the experiences you had at the camp during the summer of 2005. Individual responses will remain confidential. The information from the items below will be tabulated and used for evaluation of

the summer 4-H programs by the State Camping Office and the Camp Advisory Committee. This information will be shared with each individual camp manager and when appropriate with the

summer camp staff. This information will also be made available to DEDs and other administrators. Any and all comments are welcome and will remain confidential.

I attended Camp: Cherry Lake Cloverleaf Ocala

Timpoochee

Choose the appropriate response for items #1-3

1. Approximately how many summers have you been participating as a volunteer in the 4-H camping program?

First Experience 2-3 4-6 7-10

10+

2. Approximately how many years have you been a 4-H volunteer?

1-3 4-6 7-10 10+

Choose the one that best describes your

position.

To No Extent

X

X

Moderate Extent

X

X

To a Great Extent

X

3. To what extent do county faculty and/or volunteers participate (in a teaching capacity) in the activities during camp programs?

4. To what extent do county faculty and/or volunteers participate in the preparation of the weekly schedule prior to the camp week?

COMMENTS:

The following questions apply to the campers and your perception of their

experience.

To No Extent

X

X

Moderate Extent

X

X

To a Great Extent

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X

5. To what extent do you believe your campers gained an awareness of the environment or environmental knowledge?

6. To what extent do you believe your campers learned new skills related to communication?

7. To what extent do you believe your campers improved their teamwork skills?

8. To what extent do you believe your campers experienced adventure and challenge not usually found in daily home life?

9. To what extent do you believe your campers thought that the camp program was an enjoyable experience?

10. To what extent do you believe the camping experience improved/enhanced camper social skills?

11. To what extent do you believe your campers improved on on their self- responsibility during their stay at camp?

12. To what extent do you believe your campers are more accepting of differences as a result of the camping experience?

COMMENTS:

Please choose the one that best

describes your perception of 4-H state camp staff.

Strongly Disagree

Disagree

So- So

Agree

Strongly Agree

13. The summer camp staff appeared well-trained and prepared for the activities they conducted

14. The summer camp staff were appropriate role models for this camping experience.

15. The summer camp staff were punctual and attentive when conducting activities.

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16. The summer camp staff were prepared for various minor first aid emergencies.

17. The summer camp staff were enthusiastic when performing their duties.

18. The summer camp staff were viewed as trusted adults during the camp experience.

19. The level of staff involvement and comradery with campers was appropriate.

20. The summer program director demonstrated appropriate leadership for staff and participants.

21. The summer program director and/or staff used appropriate discipline measures when necessary.

COMMENTS:

Facilities/Service Component. Strongly Disagree

Disagree So- So

Agree Strongly

Agree

22. The quality of the food was appropriate for this type of camping experience.

23. The amount of food was appropriate for this type of camping experience.

24. The food service staff was courteous and helpful.

25. Requests for facilities maintenance were performed in a timely manner.

26. Cabin cleanliness and upkeep were appropriate for this type of facility.

27. Improvements in grounds and facilities are needed.

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COMMENTS:

Please rate your experience.

Weak X

X

Good X

X

Excellent X

28. From your years of experience at camp, please provide an overall rating for this year's staff.

29. Last, but not least, provide an overall rating of your camp experience this summer.

Additional Comments:

Page 67: FLORIDAflorida4h.org/camps/files/camp_handbook.pdfChad Meyers, Resident Director, Camp Ocala 4-H Center Produced from Florida 4-H EDIC Grant State 4-H Headquarters 2142 Shealy Drive
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Florida 4-H Camp Counselor Survey 2005

Please complete and return. Remember your responses are important to the camp program so please respond to all items and be fair.

1. Age 2. County

ENTER AN X NEXT TO YOUR RESPONSE

3. Gender: Male Female

4. Have you been a 4-H counselor before? Yes If yes, how many times?

No

5. Did you attend a counselor training session before you came to camp? Yes No

6. If you responded “yes” to questions 5, do you believe attending a training session helped you to be a better counselor?

Not at all Somewhat Absolutely

7. Do you believe that you had a leadership role in the overall camp program? Not at all Somewhat Absolutely

8. Do you believe that you had a leadership role in the overall camp program? Not at all Somewhat Absolutely

9. Did you participate or assist as an instructor for any activity session? Not at all Somewhat Absolutely

10. Did you learn about the environment during your stay at camp? Not at all Somewhat Absolutely

11. How would you rate the camp staff? (Not your county 4-H agent, but the individuals who served as lifeguards and presented activities)

Terrible Good Excellent

12. How would you rate the food at camp? Terrible Good Excellent

13. How would you rate your overall experience during the past week at camp? Terrible Good Excellent

14. What did you like best about your week at camp?

Please turn over and answer questions on the back.

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15. What did you like least about your week at camp?

16. What would you change?

17. Would you like to be a counselor again? Yes No

Additional comments:

Thank you!

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Florida 4-H Camper Survey 2005

1. Age 2. County you are camping with

3. Have you ever been to camp before? Yes No If yes, how many times?

Please place an X next to the response that best describes your experience at camp.

4. The camp staff (lifeguards, nature, arts & crafts instructors) were … Not so good Good Great

5. My cabin counselor was … Not so good

Good

Great

6. The camp food was … Not so good

Good

Great

7. Overall, my week at camp was … Not so good Good Great

8. Rate the following activities: (Rate only those activities you were involved with)

Swimming Not so good Arts & Crafts Not so good Canoeing Not so good Nature Not so good Archery Not so good Sport Fishing Not so good Evening Programs Not so good Campfire Not so good Dance Not so good

Good Good Good Good Good Good Good Good Good

Great Great Great Great Great Great Great Great Great

9. What did you like the best at camp?

10. What did you like least at camp?

11. What would you change about camp?

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Permission to Use Personal Vehicle

1. The 4-H center grants permission to to use his/her personal vehicle, license plate # , registered in the State of , to provide transportation for 4-H youth, registered teen and adult volunteers, and Extrension/4-H center staff to obtain emergency medical care during the 4-H events titled , which is scheduled on -.

2. The owner verified that this vehicle is licensed and is insured.

3. The owner grants permission, if he/she is personally unavailable, for any pre- approved individual to drive the vehicle described above. The owner of this vehicle assumes all liability for any damages or injuries occurring due to accident.

Owner’s Signature Date

4-H Resident Director Date

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University of Florida

Camp Ocala 4-H Center

MEMORANDUM OF AGREEMENT

The following agreement is made for use of Camp Ocala 4-H Center operated by the University of Florida 4-H Youth De

and the Florida 4-H Foundation:

Group Name:

Mailing Address:

Date/Time of Arrival:

Date/Time of Departure:

First Meal:

Last Meal:

Number of Guests:

Number of Days in Camp:

Number of Nights in Camp:

Camp Coordinator: Phone Number:

All groups MUST have insurance coverage. Insurance provided by: (check appropriate one)

UF ($1.00/day/person) Maximum Coverage: $2,500 Accident, $1,000 Illness

User Group, Signature of authorized group representative

The enclosed information has been read, understood and agreed to by the representatives of the user group. The user gro

to release the University of Florida and the Florida 4-H Foundation from any legal responsibility for accidents or injuries

from the use of the above named camp site and/or facilities.

Based on estimated attendance X = $0.00

Special Conditions: User group must provide a certified lifeguard for all waterfront activities. NO PETS.

BY: DATE:

Authorized Representative of User Group

BY: DATE:

Representative of University of Florida 4-H

A ten (10) percent non-refundable deposit in the amount of $ is required with this agreement. If

circumstances necessitate a change of date, a written request must be submitted to the camp manager as soon

as possible. In certain situations, rescheduling of the event will be permitted and the deposit can be applied to

these new dates. Additional expenses will be paid prior to departure from camp.

Send all correspondence to: Camp Director

Cherry Lake 4-H Center

3861 NE Cherry Lake Circle

Madison, FL 32340

(850) 929-4429

Cloverleaf 4-H Center Ocala 4-H Center Timpoochee 4-H Center

126 Cloverleaf Road 18533 NFS 535 4750 Timpoochee Lane

Lake Placid, FL 33852 Altoona, FL 32702 Niceville, FL 32578

(863) 465-4884 (352) 759-2288 (850) 897-2224

Make check payable to: Florida 4-H Foundation

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velopment

+10

up agrees

arising

Total

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Target Life Skills Wheel

Iowa State University Extension

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VISITOR RECORD LOG

The Resident Director is required to keep a log of all visitors that come to camp. This is the form to record all of the visitors and reason for visiting.

Date Time Name of Visitor Reason for visit Who visiting

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CAMP INSPECTION REPORT

Camp:

Group:

Dates: Arrival: Departure:

The Resident Camp Director and the Person-in-Charge of the group should inspect the camp for damage, cleanliness, safety hazards and proper equipment on the group’s arrival. Another inspection should be made at the end of the camp session. Damage charges will be assessed to reflect cost of repair and/or replacement (Labor & Materials) to any damages not of a routine nature or the result of normal wear and tear.

Pre-Camp Inspection Hazards/Damage Bldg. No./Area

Other Comments:

Resident Manager: Date:

Person in Charge of Group: Date:

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Post-Camp Inspection Hazards/Damage Bldg. No./Area

Other Comments:

Resident Manager: Date:

Person in Charge of Group: Date:

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Camp Registered Nurse/Health Care Worker

Desired Qualifications

Licensed as a registered nurse (RN) or other health care worker approved by the Resident Manager.

Experience with children and young adults is preferred.

Ability to originate, update and/or monitor health care, maintain records, and implement the health care plan.

Current CPR and First Aid Certifications required.

Desire and ability to work in a camp setting

Customer friendly persona

Must pass criminal background check Responsible to Resident Director

►Specific Responsibilities:

Supervise health and cleanliness standards Help provide adequate physical health conditions for staff

and campers. Maintain record system of camper and staff

health participation forms for out-of-camp trips. Be prepared with all supplies necessary for basic first aid and

CPR. Establish and follow appropriate medical routines

including recordkeeping in the daily medical log, disposal of medical waste, managing and safeguarding medications, and utilizing approved standing orders.

Give campers a specific time and location to take their medication daily.

Be available to camp staff to meet the needs of first aid that their first aid kits do not contain.

Keep accident/incident reports that can be used for risk- management assessment.

Prepare a summary and evaluation of the camp experience and make recommendations for the next year that create a more healthful condition for the camp.

Some duties may be reassigned and additional duties may also be assigned as required.

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Food Service Manager (Kitchen Supervisor)

Desired Qualifications

Experience in a camp or institutional food-service setting

Supervisory skills

Ability to relate and work well with others

Desire and ability to work in a camp setting

Customer friendly persona

Must pass criminal background check Must have certification from Food Safety class

Responsible to Resident Director

►Specific Responsibilities:

Supervise and coordinate activities of cooks and food-service personnel.

Supervise dish-washing procedures. Plan menus and utilize leftovers wisely. Train staff. Maintain time and payroll records to report to the

Resident Director. Supervise pantry and storeroom. Supervise and assist in preparation of food. Supervise kitchen safety. Approve orders, help receive and store food and

other supplies. Meet with staff as needed to address specific concerns. Some duties may be reassigned and additional duties

may also be assigned as required.

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Food Service Assistant (Kitchen Worker)

Desired Qualifications

Desire to work in the food service area.

Ability to read menus, weights, and measures.

Ability to work well with others and have a customer friendly persona.

Ability to accept supervision.

Must pass criminal background check.

Responsible to Food Service Manager

►Specific Responsibilities: Assist in preparing foods by performing any

combination of the following tasks: o Wash, peel and prepare vegetables. o Prepare poultry and meats o Prepare breads o Stir and strain soups and vegetables o Weigh and measure foods o Carry pans, pots, etc o Store food o Clean utensils and area o Distribute food and supplies

Assist in any area of kitchen or dining room as requested by

the Food Service Manager or Resident Director. Food service assistants may be asked to share

responsibilities of other food service staff. Help unload and store supplies. Help move supplies around the kitchen area. These are not the only duties to be performed. Some

duties may be reassigned and additional duties may also be assigned as required.

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Maintenance Personnel

Desired Qualifications

Mature, capable, mechanically-oriented person

Skilled in various trades (i.e. electrical, plumbing, painting, construction, etc)

Ability to accept guidance from the Resident Manager as well as supervision

Ability to work well with others.

Desire to work in a camping community Self-starter and organizer

Must pass criminal background check

Preferred: current CPR and First-Aid certifications

Responsible to Resident Director

►Specific Responsibilities: Maintain grounds and facilities of the camp by

doing the following tasks: o Maintain facilities for trash collection, gas and electric

companies. o Assist in moving materials and supplies to appropriate

areas around the camp as needed. o Maintain inventory of maintenance supplies and

equipment. o Inform the Resident Director of materials that need to

be ordered. o With permission, purchase supplies that are necessary

for current projects. o Be available or have arrangements made to have

maintenance staff available all times when campers are present for emergencies.

o Be knowledgeable of community fire, police and emergency service departments and requirements.

o Prepare any facility needing outside work for easy access by contractor.

o Keep, maintain and perform minor repairs to all camp vehicles and equipment.

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o Maintain grounds to reduce risk of danger to campers, staff or personnel.

o Monitor all sewer systems. o Maintain grounds during off-season as the Resident

Director requests. o Perform annual jobs as follows:

Inspect and repair dining room chairs and tables. Prepare all vehicles for in-season use. Repair and/or rebuild docks. Inspect and make necessary repairs on all doors,

windows, floors, plumbing, porches, roofs, etc. Inspect all buildings and paint when necessary. Inspect camp for trees that may need thinning,

trimmed, or limbs that need removed. Repair and adjust all small motors (i.e. mowers,

blowers, cutters, etc) Maintain inventory of beds and mattresses. Repair items recommended by staff (i.e. boats,

canoes, kayaks, etc.) Split wood for camp fires for in-season use.

o Communicate with the Resident Manager on a daily basis to set up a productive maintenance schedule and to be updated on new requests.

o Complete reports annually of projects completed for review by the Resident Director and the Business Manager of the Camping Program.

These are not the only duties to be performed. Some duties may be reassigned and additional duties may also be assigned as required.

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Summer Waterfront Coordinator

Desired Qualifications

Training and experience in waterfront activities and management.

Current lifeguard certification

Current CPR and First-Aid certification Desire and ability to work with children outdoors

Ability to accept guidance and supervision

Enthusiasm, sense of humor, patience, and self-control

19 years of age or out of high school for at least one full year Responsible to Program Coordinator

►Specific Responsibilities:

Set up lake or waterfront area during staff training. Assist in teaching waterfront staff their responsibilities

for activities during staff training. Assist in training and monitoring staff of proper

use of equipment. Conduct initial and end-of-summer inventory and

store equipment for safety. Check equipment for needed repairs. If necessary,

inform Program Coordinator. Ensure that the canoe shed is clean and secured when groups

leave. Prepare and gather supplies (or assign someone)

for all waterfront activities including water games. Evaluate summer and make suggestions for the next

summer waterfront activities. Run scheduled in-service trainings. These are not the only duties to be performed. Some

duties may be reassigned and additional duties may also be assigned as required.

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Summer Waterfront Staff

Desired Qualifications Training and experience in waterfront activities.

Current lifeguard certification and/or

Current CPR and First-Aid certification

Current canoe instructor certification

Desire and ability to work with children outdoors

Ability to accept guidance and supervision

Enthusiasm, sense of humor, patience, and self-control

19 years of age or out of high school for at least one full year Responsible to Waterfront Coordinator

►Specific Responsibilities:

Assist in checking equipment and requesting repairs. Assist in conducting initial and the end-of-summer

inventory, storing and maintaining good condition of supplies and equipment.

Write lesson plans that foster the participants’ water skills. Conduct daily check of equipment in the area for

safety, cleanliness and good repair. Submit orders for equipment and supplies when needed to

the program coordinator. Teach and monitor proper use of equipment. Assist in packing all materials and supplies at the end

of the summer. Evaluate summer activities and make suggestions for

next summer. These are not the only duties to be performed. Some duties

may be reassigned and additional duties may also be assigned as required.

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Summer Program Coordinator

Desired Qualifications Previous camp staff experience

Current CPR and First Aid Certifications

Desire and ability to work with children and adults in a camp setting

Ability to creatively schedule programs, use of facilities and staff schedules

Ability and experience in supervising staff and campers

At least 21 years of age Responsible to Resident Manager

►Specific Responsibilities:

Assist in training staff in their responsibilities. Meet or talk with agents no less than 2 weeks prior to

camp about their camping schedule. Formulate a schedule at least one week prior for each

week to give the staff members. Supervise staff and the programs. Teach the staff the “ways of the road” and make sure

everyone is on the same page. Model the attire and behavior that is expected from every

staff member. Conduct or delegate responsibility for inspection of cabins,

facilities and other areas. Assist in executing the evening programs. Correct and guide staff (preferably in private) about

issues that are putting the staff or campers’ health or safety at risk or of situations that should not be occurring.

In the event that a staff member is ill or cannot be present, fill

in for the staff member temporarily for the activity. These are not the only duties to be performed. Some

duties may be reassigned and additional duties may also be assigned as required.

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Summer Staff Member

Desired Qualifications Current CPR and First Aid Certifications

Good character, integrity and adaptability

Enthusiasm, sense of humor, patience, and self-control

Desire and ability to work with children and adults in a camp setting

Ability to assist in teaching an activity

Ability to accept supervision and guidance 19 years of age or out of high school for at least one full year

Responsible to Program Coordinator

►Specific Responsibilities:

Actively participate in staff training. Set a good example for campers and others including

cleanliness, punctuality, language, sportsmanship and table manners.

Follow camp rules and regulations including those of attire (clothes and shoes), smoking and use of alcohol and drugs.

Encourage and practice respect of personal property, camp equipment and facilities.

Develop lesson plans for each activity and class that is assigned.

Gather own materials and supplies for classes. Make sure you

are prepared! Perform nightly duties or make sure that it is done

before going to bed. Work as a team with the other staff members to make

sure that all weekly duties are accomplished. These are not the only duties to be performed. Some duties

may be reassigned and additional duties may also be assigned as required.

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Housekeeping

Desired Qualifications Good character, integrity and adaptability

Desire and ability to work with in a hospitality environment.

Ability to accept supervision and guidance

Knowledge of principles and processes for providing customer and personal services

Ability to use abdominal and lower back muscles to support the body continuously over time without 'giving out' or fatiguing.

Responsible to Resident Director

►Specific Responsibilities:

Clean floors, hallways, and bathrooms of the cabins so

that health standards are met. Empty trashcans and transport other trash and

waste to disposal areas. Sweep, using brooms, mops, and/or powered

scrubbing machines. Keep storage areas and carts well-stocked, clean, and tidy. Wash, dry, fold and sort clean linens, and store them in

linen areas. Inform maintenance if repair services are needed. Hang curtains. Dust and clean windows periodically. Move and arrange furniture, and turn mattresses at the

end of the summer. Care for housekeeping property and be responsible

for the upkeep of the equipment. These are not the only duties to be performed. Some

duties may be reassigned and additional duties may also be assigned as required.

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Date Time Name of Individual Contacted Reason for Contact Result of Contact Contact Made By

COMMUNICATION RECORD LOG

The Health Service Supervisor (Camp Nurse) is required to keep a log of all communications that is conducted about patients. This is the form to record all of that communication.

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4-H Educational Center Medication Form

This form is adapted from the Virginia 4-H Camping Handbook.

Camper’s Name:

Phone: (Day) (Evening):

INSTRUCTIONS: Please complete this form for all medication(s) your child will be taking as needed at camp including over-the-counter medications for headaches or cold, inhalers, etc. NOTE: This form must accompany your child to 4-H camp only if he/she is taking any medication. Please read the following information related to the “Medication Policy” at the University of Florida 4-H Centers.

Medication Policy All medication submitted at 4-H camp registration must be in the

ORIGINAL CONTAINER with the camper’s (or teen’s) name printed on the bottle.

Campers (teens under 18 years old) will not be allowed to keep ANY

medicines with them. Zip-lock bags, other bottles printed with someone else’s name, or

any other type of container besides the original, will not be accepted.

Actual dosage listed on the bottle must be followed unless there is a

written note from the prescribing doctor outlining different indications. There will be no exceptions to this policy.

Parent/Guardian Signature Parent/Guardian Name (Please Print)

The following should be filled out for each medication that your child MAY need to take at camp or AS NEEDED ONLY, including over-the-counter medications such as Tylenol or cold medicine. Prescription medications taken daily should be listed on the BACK of this form.

1) Medication Name: Dosage: Special Instructions:

AS NEEDED

MEDICATIONS

2) Medication Name: Dosage: Special Instructions:

3) Medication Name: Dosage:

Special Instructions:

4) Medication Name: Dosage: Special Instructions:

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1) Medication Name: Dosage: Special Instructions:

2) Medication Name: Dosage:

DINN

R Special Instructions:

3) Medication Name: Dosage:

Special Instructions:

4) Medication Name: Dosage: Special Instructions:

1) Medication Name: Special Instructions:

Dosage:

BREAKF

AST

2) Medication Name: Special Instructions:

3) Medication Name:

Dosage:

Dosage: Special Instructions:

4) Medication Name:

Special Instructions:

Dosage:

1) Medication Name: Dosage: Special Instructions:

2) Medication Name: Dosage:

LUNC

H Special Instructions:

3) Medication Name: Dosage:

Special Instructions:

4) Medication Name: Dosage: Special Instructions:

E

1) Medication Name: Dosage: Special Instructions:

2) Medication Name: Dosage:

BEDTI

ME

Special Instructions:

3) Medication Name: Dosage: Special Instructions:

4) Medication Name: Dosage:

Special Instructions:

Medication Release: (Do not sign this line until you pick your child up from camp.) My signature below indicates that I have picked up all medications from the 4-H Center medical staff person following the completion of 4-H camp. Parent/Guardian Signature: Date:

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ACCIOentllnCIOent Heport t-orm FM 01

Developed by the American Camping Association® (Fill out 1 on each incident or person)

Camp Name -------------------------Date _

Address -------------- ---------- ----- ----- street & Number City State ZIP

Name of person involved -,- ----;:::--.,----------,=:-- Age Sex Last First Middle

0 Camper 0 Staff 0 Visitor

Address _ ------ ----- ---- ---Phone ---- srreer & Number City State Zip Area/Number

Name of Parent/Guardian (if minor) ------------------------------- Address_ ------- ---------, ---- ---Phone

---

Street & Number City State Zip Area/Numoer

Name/Addresses of Wimesses (You may wish to attach signed statements.)

1. __ _ _

2·---- -------------------------------------- 3.

Type of incident 0 Behavioral 0 Accident 0 Epidemic illness 0 Other (describe)

Date of Incident!Accident ---::::--=:-:-----;-;:-:-:::-----=-----;-;:-:--- oay of Week Month Day Year

Hour _ __ 0 a.m. 0 p.m.

Describe the sequence of activity in detail including what the (injured) person was doing at the time

Where occurred? (Specify location, including location of injured and witnesses. Use diagram to locate persons/ obj ects.)

Was injured participating in an activity at time of injury? 0 Yes 0 No If so, what activity? _ __

Any equipment involved in accident? 0 Yes 0 No If so, what kind? ----------------­

What could the injured have done to prevent injury? --------------------------

Emergency procedures followed at time of incident/accident

By whom? ___ _ _ _

Submitted by ---------------- Position

Phone number ___ _

Date

Copyright 1983 by American Camping Association, Inc. Revised 1990, 1992, 1999.

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Printed with permission of and under license of American Camping Association, Inc.

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Medical Report of Accident

Were parents notif ied? D Yes D No By D Writing D Phone D Other--------------­

By whom?-------------- Title ----------- When -----,,.---------==----

Time Dare

Parent's Response-------------------------------------

Where was treatment given (check and complete all that apply)?

D At Accident Site: Where? __ By whom? _ _ _

Treatment given ---- ----------------------- Date

0 Camp Health Service: By whom? Title _ __

Treatment given Date

Released to 0 Camp Activities 0 Home 0 Other -------------- Date _

0 Doctor's Office: By whom? _ _ Title _

Treatme nt given ---------------------------- Date

Released to D Camp Activities D Camp Health Service D Home D Other

0 Hospital: By whom? __ __ Title __

Was injured retained overnight in hospital? D Yes D No If so,which? _

Where? Date __ D Out-patient D In-patient

Name of physician in attendance

Date released hom hospHal _

Released to D Camp D Home D Other -------------------------- Comments _ _ __ _

Persons notified such as camp owner/sponsor, board of directors, etc.

Name Position Date

Describe any contact made with/by the media regarding this situation -------------------

I Signed _ _ Position

Date _

Insurance Notification

1. D Parent's Insurance

2. D Camp Health Insurance

3. D Worker's Compensation

··tv lnsuranc:P.

By D Parent D Camp

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Date

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CLAIM REPORT

To be completed by the Camp Director, Chaperone, or Group Leader of the Event.

American Income Life Insurance Co·. Special Risk Division

P.O. Box 50158

Indianapolis, IN 46250

800-849-4820

Medicare MUST be filed as primary carrier.

Policy# 314 7E

Serial # Dates Person Was Insured

Name of Camp/Club/Group _ Sponsoring Org nization Univer sity of Florida 4-H

For prompt seNice please attach Physician/Emergency Room Report and all itemized bills for seNices rendered (doctor, hospital and prescriptions).

Name of Patient -------------------- Age __ Sex M F Patient Is:

D Camper/Member

Home Address of Patient ------------------------- 0 Counselor/Instruct.

D Salaried Staff

City ------------------- State Zip._ _ Eligible Work Comp.

D Summer Staff

D Volunteer Leader

INJURY,REPORT

Date of Injury: Time:

ILLNESS REPORT

Date Insured First Noticed Symptoms:

Group Activity: Nature of Illness:

How and Where Injury Occurred (explain fully): Was this condition already present

before this person became insured? D Yes 0 No

If YES, please explain:

Describe injuries:

If there was no medical treatment during insured period, was injury or Illness reported to staff member? 0 Yes D No

Verification Signature - UNRELATED to patient

Ihereby certify that this was a supervised group activity sponsored by the organization covered under this policy.

I was the: 0 Camp Director 0 Chaperone 0 Group Leader 0 Other (define) --------------

Signed------------------------ Day Time Phone -----------

Title _ __ Name of Camp/Org. --------------

ASSIGNMENT FORM

Ihereby authorize the American Income Life Insurance Company to pay benefits on the above claim to:

0 Medical Provider(s) [Check is sent directly to the facility providing the medical services.}

(Payee Name) ------------------ is to be reimbursed since the bills have been paid.

Address

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Date Si ned

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disability

How to File a Claim

1. Written notice of claim or Claim Report mus·t be given to the company within twenty days of commencement of any loss covered by this policy or ·as soon as is reasonably possible.

2. All claim reports must be completed and signed by the camp director, chaperone,

or group leader who is UNRELATED TO THE PATIENT. Report the following:

A: Name of the disabled person (patient).

B: Date of the disability (for either an injury or an illness).

C: How . . . was sustained.

3. Please provide:

A: Complete medical diagnosis by the attending physician.

B: Itemized statements for services rendered by physician or hospital.

C: Prescription receipts complete with Rx number and price .

D: Proof of payment with an itemized bill if payment has been made.

Reimbursement is made directly to the medical provider unless otherwise indicated.

Pennsylvania Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information

concerning any fact material thereto commits a fraudulent insurance act.which is a crime and subjects such person to criminal and

civil penalties.

ALL correspondence will be directed to the policyholder .

American Income Life Insurance Company

Special Risk Division

P.O. Box 50158

Indianapolis, IN 46250

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OfU 4Q-4R?O

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SPECIAL DIETARY NEEDS FORM

INSTRUCTIONS: The purpose of this form is to communicate special dietary needs,

food allergies, etc. for any child, teen, or adult who will be attending 4-H camp.

Please complete this form and send it to your 4-H center (Attention: Resident Director and Food Service Supervisor) no less than 2 weeks prior to your camp.

Name:

County:

Check One:

Camper (5-13 years old) Counselor –in-Training

Teen Counselor (14-18 years old) Adult volunteer or

Extension faculty/staff

In the space provided below, please list all food allergies for the person listed above and any necessary precautions that should be taken:

In the space below, indicate and food restrictions (non-allergy) for the person listed above and food substitutes that may be considered: