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Transcript of Riro Fc Pio Ccc2014
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SUMMER 2014 PARENT INFORMATION
Camper Health Forms & Waivers are due by MAY 1, 2014*
Helpful Notes for Submitting Health Forms: A new health form is required for each year your child registers for camp. A physical exam within the last 24 months must be validated on the health form with a physicians
signature or a physician-signed copy of the exam.
Please include immunization dates. Please keep a copy of the health form and any program waivers for your files. Per guidelines of the American Camp Association, this form will be reviewed by our health care staff prior
to your child arriving at camp. We are unable to readily access physical exams from previous years, however you may attach a copy of last
years physical if it is dated within 24 months of this years camp week.
Campers cannot be admitted on opening day without a completed and signed 2014 health form.*If registering after May 1, 2014, please submit your childs healthform & waivers
at least two weeks prior to his/her camper week.
Where to find a health form: Visitwww.novusway.com.
o Look on the tabs along the top of the NovusWay website and click Our Programs.o A dropdown list will appearclick Registration Information.o Find the health form on the list of downloadable documents on the right side of the page.
Or contact the Registration Office [email protected] or call 828-209-6329 to request a form.Which programs require an activity waiver(s): If your child is registered for one of the programs below, asigned waiver(s) is required for participation in each of the activities.
Lutheridge Programs Lutherock ProgramsCave & Wave Ride & Slide Rock n RollersCrossTraining Rock & Raft Ultimate LeadershipFire & Water Explorers Saddle &Paddle Whitewater/BackpackingHigh in the Sky Surf & TurfPaddlers Week Waveriders
Where to find a waiver for your childs program: Visitwww.novusway.com,click on Our Programs, then Summer.
o Find the link at the bottom of each online program listing for required waivers. Or contact the Registration Office [email protected] or call 828-209-6329 to request a form.
How to submit your childs health form & waivers: Scan and email to: [email protected] Fax to: 828-684-5196 Or mail to: NovusWay Registration, 28 Spruce Drive, Arden, NC 28704
Camp Lutheridge www.novusway.com Camp Lutherock2049 Upper Laurel Dr. NovusWay Registration 84 Camp Luther Rd.
Arden, NC 28704 28 Spruce Drive, Arden, NC 28704 Newland, NC 28657Office 828-684-2361 828-209-6329 Office 828-733-5868
Fax 828-684-5196 [email protected] Fax 828-733-5864
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Transportation
Transportation to and from Camp:For information about our transportation services or to schedule a shuttleor to pickup or drop off your child at the airport, please contact the Registration Office [email protected] 828-684-2361.
Lutheridge Lutherock Shuttle: For a nominal fee, shuttle service (about a 1-1/2 hour drive) isprovided on opening and closing days between our two camps.
Airport Shuttle: The Asheville Regional Airport is just a few miles from Lutheridgewhere we can pickup or drop off your child if he/she is flying to camp.
Transportation of Campers during Camp: During the camp week, most campers have an off-site outing. (Allactivities for First Camp Adventure and Lutheridge Pioneers are on site.) Transportation will be in a NovusWayowned or leased vehicle with a trained driver, and safety/emergency equipment is on board at all times. Per theAmerican Camp Association (ACA) guidelines, we have listed below the vehicle safety rules and ask that youreview them with your child prior to his/her camp week. We will also review the safety rules with campersbefore off-site activities.
1. Each passenger traveling in a NovusWay owned or leased vehicle (except buses) must wear a seat belt.2. Each passenger must have a seat in the vehicle, and the number of campers riding will not exceed the
manufacturers suggested seating capacity.3. When the vehicle is moving, each passenger must stay in their seat, and disruptive behavior is not allowed.4. Campers are not permitted to extend any part of their bodies out of the vehicles windows.
Mail & Communication
Campers LOVE getting mail! Our camp mailing addresses are at the top of the first page. Pleaseinclude the campers full name on the envelope, and post mail to your child early in the week(definitely before Wednesday) to ensure its likely delivery. The best mail is cheerful and newsy.Please dont send gum, candy, or food.
Phone Calls: Please understand that your camper will NOT be calling you. Calls home can be disruptive for acabin group and can take away from the true camp experience. Cell phones are not allowed. If it is important foryou to speak with your camper during the camp week or if you have questions about this policy, a programdirector will be happy to make a plan with you and your camper.
Lost & Found
Lutheridge and Lutherock are not responsible for a campers lost or damaged personal items. (Please read theguidelines in the Packing List. Do not bring clothing or items that are expensive or irreplaceable.) Our counselorsare attentive that proper care is given to all camper belongings. However, if you find something missing, please call828-606-5684 at Lutheridgeand 828-733-5868 Lutherockand give any details that will help locate the missingitems. If your item is found, we will ship to you via USPS. Any items unclaimed by September 1stwill be donated to
local charities.
Spending Money
The registration fee includes lodging, meals, evening canteen snacks, study materials, craft supplies andprogram costs. However, campers may want money to use at the snack bar (open to campers once weekly) andfor the Camp Store. Items range in price from $5-$35 at Lutheridge, and $15-$40 at Lutherock. The CampStore stocks t-shirts, jackets, basic toiletries, souvenirs, postcards & stamps, etc. Parents are welcome to visitthe Camp Store during the weekend.
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Packing List Sleeping bag & pillow 2-3 towels & washcloths Soap, shampoo, brush, comb Toothpaste & toothbrush Warm coat/sweatshirt (Rock evenings) Light jacket/sweatshirt (Ridge evenings) Raincoat or poncho (& head cover) Shoes2 pairs: sneakers with treads or
closed-toe shoes that can get wet are best.Shoes will likely get dirty!
Shower shoes or flip flops
Sturdy clothes that can get dirty or wet Swimsuits (2) Cards, book, etc. for rest times Bible, notebook, pen or pencil Flashlight Water bottle (refillable) Insect repellent & sun block Plastic trash bag (for wet/damp clothing,
towels)
Camera (optional)
.
Outdoor Adventure Programs (OAP) Require a Few Additional Items:
Horseback Riding
Jeans or long pants Enclosed shoes, such as athletic shoes
Backpacking
Light weight, packable sleeping bag Thin sleeping pad (optional) Sturdy, broken in hiking shoes (either
boots or sneakers with treads)Rafting & Canoeing
Quick-dry shorts Water shows or sandals that have a
heel strap
Rock Climbing & Tower Climbing
Sturdy, comfortable shorts (not too short) Sturdy shoes for climbing (specialized
climbing shoes are not necessary; runningshoes/hiking boots work fine)
Caving Long pants Long-sleeved shirt & t-shirt w/ sweatshirt
*You will probably get dirtier than you have ever been inyour life! The clothes you wear caving may never come clean,so choose clothes wisely. Please note: caves are cool & wet!
What Not to Bring
Alcoholic beverages, tobacco, and drugs (that are not prescribed by a physician). Violation of this policyresults in immediate dismissal. Transportation home will be at the expense of the parent/guardian. Donot bring CELL PHONES, food (snacks, gum, candy, or drinks), knives, firecrackers, or similar items tocamp. Leave hair dryers, curling irons, radios, iPods, MP3 or CD players and other electronic items athome. Weapons of any kind are not allowed!
Do not bring clothing, jewelry or valuables that you would feel badly about if they were damaged or lost.NovusWay is not responsible for loss or damage of personal items.
Helpful Packing Hints:
Please do not over-pack! Storage space in camper housing is limited. Write your childs name on each article of clothing, towels, hats, etc.
Please make certain clothes are in good taste. Shorts should not be too short, and T-shirts should not contain inappropriate language ors mbols. Swimsuits must be modest. Cam ers ma be asked to chan e/cover u i clothin is deemed ina ro riate.
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DIRECTIONS toLutheridge and Lutherock
From I-40, Eastern North Carolina(Greensboro, Hickory) and I-40, Tennessee(Knoxville)
Take I-40 West to Exit #51 (Hwy 25A/Sweeten Creek Rd) Take Sweeten Creek Road South (left at the end of the ramp) Go about 6 miles to Hwy 25/Hendersonville Rd (major intersection with Walgreens on corner across the
street)
Turn left onto Hendersonville Rd Lutheridge entrance is just a very short distance on the right
From I-26, South Carolina(Spartanburg, Columbia)
Take I-26 West to exit 40 (the Asheville Airport Exit) Take a right at the end of the exit onto Airport Rd Travel approximately 2 miles to US-25 (Hendersonville Rd) Turn right onto US-25 Lutheridge entrance is just a very short distance on the right
From I-40, Western North Carolina(Asheville)
Travel I-40 East to exit #72 (Old Fort, US-70) Travel US-70 approximately 11 miles - left on US-221 North (at the red light just past Wal-Mart, McDonalds) Just over 32 miles on 221 North you will come to stop sign at a T intersection. Turn left towards Newland on
Highway 181.
At about 2.5 miles, turn onto Wes Brewer Road if the road becomes four lanes, you have gone too far-alsolook for the Welcome to Newland sign on the right.
Travel Wes Brewer Road 2.2 miles to the fork take left onto Sugar Mountain Road. Travel on Sugar Mountain Road 8/10 mile to left on Camp Luther Road (sign on road for Camp Lutherock). This is the Lutherock drive follow the drive over the creek then follow the signs to designated areas.From I-40, Central North Carolina (Hickory)
Travel US-321 North (to Boone, NC) (approximately 40 miles to right) As you pass Blowing Rock, take the Blue Ridge Parkway South toward Linville. After crossing the Linn Cove
Viaduct, exit onto 221 toward Grandfather Mountain. Pass the entrance to Grandfather. Cross Hwy. 105thisis still 221. When 221 turns left towards Marion/Pineola, continue straight on NC-181.
Travel on NC-181 2.5 miles, turn onto Wes Brewer Road if the road becomes four lanes, you have gone toofar.
Travel Wes Brewer Road 2.2 miles to the fork take left onto Sugar Mountain Road. Travel on Sugar Mountain Road 8/10 mile to left on Camp Luther Road (sign on road for Camp Lutherock). This is the Lutherock drive follow the drive over the creek then follow the signs to designated areas.
Directions to LUTHEROCK in Newland, NC
Directions to LUTHERIDGE inArden, NC GPS Address for Lutheridge:2511 Hendersonville Road, Arden, NC
The GPS Address for Lutherockis unreliable. Please use these directions.
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From I-40/I-85,Eastern North Carolina (Winston-Salem, Raleigh)
Travel US-421 North (toward Wilkesboro) (off of I-40) Travel US-421 approximately 48 miles to US-421 BYP and travel approximately 5 miles US-421 BYP will intersect with US-421 once again and travel approximately 31 miles Turn left on NC-105 Ext, US-221 and go approximately 0.8 miles Continue on NC-105 for approximately 17 miles Turn right on Newland Highway, US-221 and travel approximately 0.7 miles Travel on NC-181 2.5 miles, turn onto Wes Brewer Road if the road becomes four lanes, you have gone too
far.
Travel Wes Brewer Road 2.2 miles to the fork take left onto Sugar Mountain Road. Travel on Sugar Mountain Road 8/10 mile to left on Camp Luther Road (sign on road for Camp Lutherock). This is the Lutherock drive follow the drive over the creek then follow the signs to designated areas.FromSouth Carolina (Columbia)
Follow I-26 West (to Spartanburg) Exit to I-85 North (to Charlotte) Exit onto US-221 North Travel US-221 - On 221 North you will come to stop sign at a T intersection. Turn left towards Newland on
Highway 181.
Travel on NC-181 2.5 miles, turn onto Wes Brewer Road if the road becomes four lanes, you have gone toofar.
Travel Wes Brewer Road 2.2 miles to the fork take left onto Sugar Mountain Road. Travel on Sugar Mountain Road 8/10 mile to left on Camp Luther Road (sign on road for Camp Lutherock). This is the Lutherock drive follow the drive over the creek then follow the signs to designated areas.From I-81 in Eastern Tennesseeor Western Virginia
Exit I-81 (at Bristol, TN) onto I-381 to 11E near Bristol, Tennessee Take 11E to 19E, following 19E until it becomes Highway 194 (taking you into Newland) In Newland, turn left on NC-181 Travel on NC-181 (approximately 1.5 miles) to left on Wes Brewer Road (right after the road changes from 4
lanes to 2). Travel Wes Brewer Road 2.2 miles to the fork take left onto Sugar Mountain Road. Travel on Sugar Mountain Road 8/10 mile to left on Camp Luther Road (sign on road for Camp Lutherock). This is the Lutherock drive follow the drive over the creek then follow the signs to designated areas.From I-40 Knoxville, Tennessee
Travel I-40 East to I-81 to I-181 (US-23) Follow I-181 to US-321 Follow US-321 to US-19E (to the rights) Following 19E until it becomes Highway 194 (taking you into Newland) In Newland, turn left on NC-181 Travel on NC-181 (approximately 1.5 miles) to left on Wes Brewer Road (right after the road changes from 4
lanes to 2).
Travel Wes Brewer Road 2.2 miles to the fork take left onto Sugar Mountain Road. Travel on Sugar Mountain Road 8/10 mile to left on Camp Luther Road (sign on road for Camp Lutherock). This is the Lutherock drive follow the drive over the creek then follow the signs to designated areas.
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2014 CAMPER HEALTH FORMLutheridgeLutherockLutheranch
Each camper MUST complete a 2014 health form. A physical exam within the last 24 months of the campers first day at camp must bevalidated on the health form with a physicians signature or a physician-signed copy of the exam.
Complete all 4 PAGES. Must have a PHYSICIANS SIGNATURE plus PARENT SIGNATURES in
3 SIGNATURE LOCATIONS. Submit by MAY 1, 2014. Make a copy for your records before sending.
For those registering after May 1st, please make every effort to complete and submit this form
at least 4 weeks priorto camp to help us best prepare for your childs camp week.
Name ________________________________________________________________________________________________________ Last First (Name Used) MI
Birth Date_____________________________________ Age_________________ Male Female
Parent/Guardian Names(s) ____________________________________________________ Relationship ________________________
Home Address ____________________________________________City ___________________State ________Zip_______________
Home Phone _____________________________ Work Phone_________________________ Cell Phone ________________________
Email___________________________________________________________
IF PARENT/GUARDIAN IS NOT AVAILABLE IN AN EMERGENCY, PLEASE NOTIFY:
Emergency Contact #1 ___________________________________________________________ Relationship____________________
Home Phone _____________________________ Work Phone _________________________ Cell Phone ________________________
Emergency Contact #2___________________________________________________________ Relationship____________________
Home Phone _____________________________ Work Phone _________________________ Cell Phone ________________________
Physician name__________________________________________________________ Phone _______________________________
Health Insurance InformationNovusWay has secondary
Carrier Name __________________________________________________________________________________________________
accident insurance. The parent/legal guardians primary insurance is responsible for charges associated with an accident or illness.
Carrier Address ________________________________________________________________________________________________
Policy # _________________________________________________________ Phone _______________________________________
Policy Holders Name ___________________________________________________________________________________________
Policy Holders Date of Birth___________________________________
If you have an Rx card Bin # _________________________ ID # _______________________ Group # _________________________
Signature Required for Participationif camper is under 18 years old.
Week ________________________ Program Name ____________________________ RIDGE ROCKIf attending a second week:
Week ________________________ Program Name ____________________________ RIDGE ROCK
Last Name, FI _________________THIS IS NOT A REGISTRATION FORM
MEDICAL RELEASE AND AUTHORIZATION FOR TREATMENTThe undersigned, as a parent/legal guardian of the camper, authorizes NovusWay Ministries, its delegated leaders, directors, and the medic
personnel they have selected to consent to any medical/hospital care deemed necessary. I consent to the release of this health history and
examination form to the emergency room, hospital, or doctors office providing care. NovusWay, Inc. will endeavor, but is not required, t
communicate with me prior to treatment. The undersigned releases NovusWay, Inc. and its designated leaders and directors from any liabil
and clames arising from any consent given in good faith in connections with diagnosis or treatment. The undersigned certifies he/she has f
authority to sign this Release and Authorization. This completed form may be photocopied for trips off camp.
Printed Name _________________________________ Signature _______________________________ Date ______________
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PHYSICIANS EXAM
: Physician must either complete this section of the health form or a copy of a signedcompleted physical or sports physical from the last 24 months must be attached to this form. Copies of heal
forms/physicals for campers from previous summers are archived and cannot be readily accessed. This informatiomust be kept on file by the parent/guardian and resubmitted each year.
Date of last exam(must be within past 24 months of camp week) ___________________________
Any physical condition requiring restriction(s) on participation in the camp program and a description of that restriction(please describe in detail attach further documentation if needed)
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Any current or on-going treatment or medications to be administered at camp (name, dosage, frequency) _____________________________________
_________________________________________________________________________________________________________________________
Any modified nutritional /meal plan: ________________________________________________________________________________
Yes No This applicant canparticipate in a camp program of high activity including backpacking, rock climbing and rafting.
Yes No This applicant canparticipate in a weeklong resident camp program.
Licensed physicians signature ____________________________________________________________________ Date ______________________
Phone ___________________ Address _________________________________________ City _________________ State _____ Zip ___________
PAST MEDICAL TREATMENT & HEALTH HISTORYHas/does the participant: Yes No Yes NHad any recent injury, illness or infectious disease. Ever had high blood pressure..
Have a chronic or recurring illness/condition.. Ever had back problems..
Have frequent headaches.. Ever had problems with joints (eg. knees, ankles).
Ever had a head injury.. Have any skin problems..
Have frequent ear infections. Had mononucleosis in the past 12 months..
Ever passed out during or after exercise... Have problems with sleepwalking..
Ever had chest pain during or after exercise. Have a history of bed-wetting.
Ever had seizures . Ever had an eating disorder.
Ever had an operation.. Been diagnosed as ADD or ADHD.
Please explain any yes responses: ____________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Describe any current physical or psychological conditions requiring medication, treatment, or special restrictions or considerations while at camp.
_____________________________________________________________________________________________________________________
Describe any camp activities from which the camper should be exempted for health reasons.
_________________________________________________________________________________________________________________________
Allergies: Hay Fever Poison Ivy Insect Stings Food ________________________ Other_________________
Asthma: Severe Moderate Mild Triggers?_________________________________________________________
Nutritional/dietary restrictions:_______________________________________ Diabetic? No Yes Vegetarian?No Yes
Does camper have any medication allergies?Yes No If yes, list medication(s)______________________________________________
Has the camper had any of the following: Measles Chicken Pox MumpsGerman measles
Please attach immunization record or indicate the date(MM/YY) of the last immunizations/booster for:
DTP__________ MMR__________ Hepatitis B__________ HIB__________
Does the camper know how to swim? Yes No
Is camper currently taking any prescribed or over-the-counter medicine? Yes No
If yes, what medications? __________________________________________________________________________________________________
Which of these medications will the camper bring to camp? _________________________________________________________________________
ANY MEDICATIONS TO BE TAKEN AT CAMP MUST BE IN CLOSED VIALS WITH ORIGINAL PHARMACY LABELS INTACT.PLEASE COMPLETE THE MEDICATION FORM FOUND ON THE FORMS PAGE OF OUR WEBSITE AND BRING IT TO CHECK-IN
Last name, FI _________________
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NORTH CAROLINA
Signatures Required for Participation
BUNCOMBE & AVERY COUNTYNovusWay, Inc.
PARTIAL WAIVER AND RELEASE OF LIABILITY AND PARENTAL CONSENT
READ CAREFULLY BEFORE SIGNING
In consideration of NovusWay, Inc. furnishing services and/or equipment to enable me/my child to participate in a variety of
outdoor and recreational activities, I agree as follows:I fully understand and acknowledge that outdoor recreational activities have: (a) inherent risks, dangers and hazards and such
exists in my use of outdoor recreational equipment, transportation to, and my participation in outdoor recreational activities; (b) my/my
childs participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to bodily
injury, disease, strains, fractures, partial and/or total paralysis, death, or other ailments that could cause serious disability; (c) these risks
and dangers may be caused by the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of
nature, or other causes. Risks and dangers may arise from foreseeable and unforeseeable causes including risks, hazards, and dangers tha
are integral to recreational activities that take place in a wilderness, outdoor, or recreational environment; and (d) by my/my childs
participation in these activities and/or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/o
damages.
I hereby agree and consent to my/my childs participation in each outdoor and recreational activity that is provided by or on
behalf of NovusWay, Inc. for the age group in question (which may include, among other things, camping, hiking, canoeing, challenge
tower activities, challenge course activities, rock climbing, spelunking, mountain biking, playground activities, and swimming). I, on
behalf of myself/my child, and my personal representatives hereby waive, release and discharge NovusWay, Inc. its agents andemployees, of any claim whatsoever that is not the direct result of active, foreseeable negligence on the part of NovusWay, Inc. and its
respective agents and employees. I further waive, release and discharge NovusWay, Inc. for any claim arising from participation in any
program, service, or other outdoor and recreational activities.
The sole proper venue of any dispute that may arise out of this Waiver or Release or otherwise between the parties to which
NovusWay, Inc., or its agents is a party shall be the General Court of Justice, Buncombe County, North Carolina. I understand and
acknowledge that this Waiver and Release and any claim arising herein shall be interpreted pursuant to the laws of the State of North
Carolina, which shall be controlling in all respects and at all times.
I HAVE READ THE ABOVE PARTIAL WAIVER AND RELEASE OF LIABILITY AND PARENTAL CONSENT AND BY
SIGNING IT AGREE THAT IT IS MY EXPRESS INTENT TO EXEMPT AND RELIEVE NOVUSWAY, INC., FROM LIABILITY
FOR PERSONAL INJURY, PERSONAL PROPERTY DAMAGE OR WRONGFUL DEATH OTHER THAN CLAIMS THAT ARISE
AS THE DIRECT RESULT OF ACTIVE FORESEEABLE NEGLIGENCE.
________________________________ _____________ _________________________________________PARTICIPANT NAME (PRINT) AGE IF MINOR PROGRAM/DATES
_____________________________________ __________________
CAMPER SIGNATURE (If 18 years of age or older) DATE
______________________________________ __________________
SIGNATURE OF CUSTODIAL PARENT/GUARDIAN* DATE
TRANSPORTATION AND PHOTOGRAPH PERMISSION
I hereby allow my child to be transported for off-site outings and photographed for possible inclusion inNovusWay publications or the NovusWay website.
______________________________________ __________________
SIGNATURE OF CUSTODIAL PARENT/GUARDIAN* DATE
*Signature of Custodial Parent or Guardian Required
Last name, FI _________________
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NovusWay, Inc. wants to provide the best possible camp experience, spiritually, physically
and socially for your child. Your responses below will help our staff best meet his/her needs
Campers Name______________________________________ Grade just completed _______
Camper is attending an overnight camp for the first time.
Camper has attended another overnight camp, but this is his/her first time at Lutheridge or Lutherock.
Camper has attended Lutheridge or Lutherock before. Number of years: _________
I have other children attending Lutheridge or Lutherock the same week.
Names/Grades _____________________________________________
______________________________________________
Describe campers feelings about attending camp (i.e. excited, hesitate, resistant, etc.).___________________________________________________________________________________________
___________________________________________________________________________________________
Use the following scale (put a mark) to let us know how the decision was made for this camper to attend camp.
Totally Voluntary Mutual Decision Totally Involuntary
Decision completely campers Camper made w/ encouragement Decision made for camper
Does camper tend to get homesick when spending the night away from home?
___________________________________________________________________________________________________
Are there any major events or significant situations of which we should be aware?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Has this camper had any negative camp experiences of which we should be aware?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Are there any concerns this camper is addressing that would be helpful for us to know?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
What camp activities do you think this camper will enjoy the most?
___________________________________________________________________________________________________
Anything else youd like us to know?___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Thank you for the information. Please know it will only be read by staff working directly with your child
We look forward to a successful and fun camp experience for your child!
Last name, FI _________________
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