one heckuva night campout all-forms

8/9/2019 One Heckuva Night Campout ALL-Forms

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June 4th-5th,

2010

Some of the perks:

Flushing outhouse

Working showers

Best view of the night sky

in JoCo

Tornado shelter (hoping

not to be needing this)

Barn the size of your house

Most impressive talent show

in the Midwest

Fireside worship

Frisbee, yard games

Fellowship with area teensWho: Any high school teen

What: Overnight camp-out

Where: Rantoul, KS

Why: Summertime fellowshipSponsored by the JoCo YMs

Hosted by Sacred Heart YM

COST ONLY $5!!!

(Each parish must supply own chaperones)

(Sign up with your local YM)


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one heckuva night

Directions to The Farm:

The Farm is 160 acres just south of Rantoul Kansas (@40 minutessouth of Olathe). Take I-35 South to the Wellsville exit. Turn left(highway 33 South) and go to the first stop sign. Turn right (highway 68West) 1 mile. Turn left (South) on the road to Rantoul. Once yourethrough the traffic of Rantoul(thats a joke), continue heading South 3 miles. Turn left (you cant turn right here) on Hamilton road (notHamilton Terr.). If you reach the stop sign (John Brown MemorialHighway) you missed Hamilton road. Were at the top of the hill on theleft side of the road. You cant miss us.

What to expect: Outhouse, thats right Flushing Outhouse Working showers Best view of the night sky in JoCo Tornado Shelterjust in case A Barn the size of your house Fireside worship Kickball, Frisbee, horseshoes, volleyball, fishing, tractor rides,

maybe some golf Fellowship with area teens

What to bring: TENT!!! Please let your youth minister how many it will sleep

(please note that there will be a distinct line where boys and girls cannot cross) Sleeping bag Drinks for your time there, we will have plenty of coolers Snacks for in between meals A change of clothes Lawn chairs Bug spray/sun screen Anything that can be used outside Musical Instruments


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Camp-Out

DRIVER INFORMATION SHEET

DriverName _________________________ Date of Birth ________________

Address _________________________ Home Phone ________________ _________________________ Cell Phone ________________

Drivers License # ____________________ Date of Expiration ________________Vehicle That Will Be UsedName of Owner __________________ Model of Vehicle ________________Address of Owner __________________ Make of Vehicle ________________

__________________ Year of Vehicle ________________License Plate # __________________ Date of Expiration ________________Registration Expiration Date____________

If more than one vehicle is to be used, the aforementioned information must be providedfor each vehicle.

Insurance InformationWhen using a privately-owned vehicle, the insurance coverage is the limit of theinsurance policy covering that specific vehicle.Insurance Company ________________ Policy # _____________________Date of Policy Expiration __________ Liability Limits of Policy* __________(*Please note: The minimal, acceptable liability limit for privately-owned vehicles is $100,000/$300,000)

In order to provide for the safety of our students or other members of the

parish/school and those we serve, we must ask each volunteer driver to list allaccidents or moving violations they have had in the past five years:_____________________________________________________________________________

_____________________________________________________________________________

Please be aware that as a volunteer driver, your insurance is primary. There is apolicy that would offer additional liability protection should a claim exceed thelimits of your policy.

Certification

I certify that the information given on this form is true and correct to the best of myknowledge. I understand that as a volunteer driver, I must be 21 years of age or older,possess a valid drivers license, have the proper and current license and vehicleregistration, and have the required insurance coverage in effect on any vehicle used totransport students. I agree that I will refrain from using a cell phone or any otherelectronic device while operating my vehicle.

____________________________________________ ___________________

Signature Date


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ADULT LIABILITY WAIVER

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

RELEASE OF LIABILITY

I, _________________________, agree on behalf of myself, my heirs, assigns,Full Name

executors, and personal representatives, to hold harmless and defend_Sacred Heart of Jesus______, _ArchDiocese of Kansas City, KS__, its officers,

Parish/School (Arch)Diocese

directors, agents, employees, or representatives associated with the field trip

from any and all liability claims, loss or damage arising from or in connection

with my participation in the field trip.

_______________________________ _________ __________________

Signature Date

_______________________________Print name


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one heckuva night campout all-forms

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