APPALACHIAN WORK CAMP PROGRAM, INC

July 4-14, 2013 St. Therese/St. Max

July 6-14, 2013 St. Joan/Sacred Heart

REGISTRATION FORM

Complete this 2-page form and send to:

Carol Sherratt

15 Sunset Blvd #1301

Beaufort, SC 29907

OR

Scan the completed 2-page form and e-mail to:

Name______

Home Address______

City ______State ______Zip______

Cell Phone No. (______)______Date of Birth ______

or home phone if you do not have a cell

E-Mail Address ______

T-Shirt Size: S M L XL XXL

Explain any medical training you have:______

YOUTH: If you will be pursuing this kind of work in your everyday life, is there a specific skill you

would like to learn? (for example, electrical, carpentry, etc)______

APPALACHIAN WORK CAMP PROGRAM, INC.

STATEMENT OF UNDERSTANDING

The Appalachian Work Camp is a Christian-based group. One of the purposes of the Work Camp is to live the word of the Gospel. We live the Gospel by our travel to Kentucky to provide much needed service to those less fortunate than ourselves.

Consistency is important. So as NOT to confuse the situation, ALL young adults who participate in this trip will be traveling as a member of the Appalachian Work Camp under the direction of the work camp’s Youth Coordinator (even if their parent is also in attendance for this trip).

No one under the age of 18 may use tobacco products in any form.

No one under the age of 21 may possess or consume alcohol. No illegal drugs. Breaking either of these rules will result in a phone call to the parent. The parent will be expected to travel to the work camp for the purpose of transporting the child home at the parent’s expense.

Camp curfew for persons under the age of 21 is midnight.

Everyone is expected be on time and to “pull his/her weight” on the job site. No sleeping on the job.

No profanity.

Appropriate and modest clothing is expected on and off the job site for both males and females.

Certain areas of the camp will be deemed “off limits” after dark.

All tents will be “male only” or “female only” unless a parent/guardian is present.

No one may purchase or use fireworks. If the camp does have a fireworks presentation, it will be under the direction of a trained professional.

Only persons 25 years of age or older may drive Work Camp vehicles and transport others.

If one does not fulfill the behavioral expectations of this Work Camp, he/she will not be returning next year. Depending upon the severity of the infraction, the consequences may include being sent home immediately and prior to the end of the Work Camp. By acknowledging this form, the parent/guardian agrees to travel to the Work Camp for the purpose of transporting the participant home at the parent’s expense. Also, by acknowledging this form the participant and parent/guardian agree to a search of personal possessions for the purpose of finding alcohol, drugs, tobacco, fireworks, or any other illegal material.

I understand the Appalachian Work Camp Program, Inc. is not affiliated with Roman Catholic Diocese of Pittsburgh.

Camper’s Name: ______

Parent’s Name (if camper is a minor): ______

_____ Check here to agree with this Statement of Understanding. Date ______