8/3/2019 Windy Gap Flyer 2011

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WINDY GAP

December 9-11

When: Friday, Dec. 9 (3:00pm) through Sunday, Dec. 11 (7:00pm)

Where: Windy Gap - 120 Coles Cove Rd., Weaverville, NC 28787

Who: 150 high school students from Wayne County, 300 more

from around NC, and your Young Life Leaders!

How much? $195 (non-refundable)

Parental Consent for Medical Treatmentn the event the your child becomes ill or injured while attending Young Lifes Windy Gap fall retreat, we request that Young Life be given permission to take your child to the nearest medical fac

healthcare provider and have the necessary treatment administered. Your signature verifies your child is in good health and capable of participating in strenuous activities. Your signature wilacknowledge your acceptance and understanding of Young Lifes role in the medical treatment of your child. In case of emergency, I understand that every effort will be made to contact me. cannot be reached, I hereby give Young Life the permission to act in my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary by Young L

hereby give permission to the medical personnel selected by Young Life to order x-rays, routine tests, treatment; maintain and/or releases any medical records necessary for insurance purposoutlined under the hipaa regulations. *I absolve Young Life from liability in acting on my behalf in this regard. * Young Life is compliant with Health Insurance Portability and Accountability Ac

HIPAA)> To obtain a copy of Young Lifes Notice of Privacy Practice, log onto www.younglife.org or call 719-381-1950.. I hereby grant Young Life the right to use, reproduce, distribute photogfilms, video tapes and sound recording of my child without compensation or approval rights.

Name of Child __________________________________ Gender ____ School __________________________ Grade ___Parents or Guardians __________________________________________

Address __________________________________________ City _______________________ St. ______ Zip ___________Phone _____________________ Cell ______________________ *Parent email ___________________________________

Parents Signature ____________________________________________ T-Shirt Size: ________________________

Emer. Contact Name ____________________________________________ Emer. Contact Phone _____________________

Parent

s Insurance Co ________________________________________ Insurance Policy Number ____________________nsurance Address ________________________________________________________________________

Further Information:

Windy Gap: Windy Gap is one of Young Lifes 20 premier camping facilities in North America.Young Life camping involves high adventure, lots of fun, great food and excellent speakers whounderstand and respect high school students. www.windygap.younglife.org

Travel/Transportation: We will be departing from JC Penney parking lot at 3:15pm on Friday,

Dec. 9 and returning in the evening (7:00pm) on Sunday, Dec. 11. We will travel viaprofessionally driven Charter Buses. Please let us know if you/your child needs special travelarrangements.

Fee: Camp fee includes: transportation, insurance, lodging, meals at camp, t-shirt, and allactivities at camp. We are committed to not let money be a reason not to go to camp, pleasecommunicate with us early if this is an obstacle.

What to Bring: Sleeping bag, pillow, towel, clothes to get messy, WARM clothes, shoes that canget muddy/wet, swimsuit (hot tub), toiletries, spending money for snack bar, camp store, and 2meals on the way (fast food).

How to register:

Complete the registration form below, attach $1(cash or check made out to Young Life with yo

childs name and school in the memo line), andturn both in to a Young Life leader or mail your

money and form to our office at:

Wayne County Young Life

PO Box 1702

Goldsboro NC 27533

For more information, please contact Ben Johnson atjohnsonbenk@gmail.com or the YL office at 919.583.8474

young life winter weekend:

the best weekend of your life

http://www.younglife.org/http://www.windygap.younglife.org/http://www.windygap.younglife.org/http://www.younglife.org/http://www.younglife.org/