Southland Summit Scholarship Camp
July 9 - 16, 2005
Brad and Margie Iverson / Jon and Christine MillsCamp Directors / Camp Coordinators
951-927-0997 / 951-679-3738
Dear Awana Family,
Summer 2005 will be quickly upon us and before you know it many of us will be gathering at Pine Summit for another week of Awana Scholarship Camp. I know it is hard to believe but it is true. Don’t YOU be left OUT! Enclosed, is your camper application for 2005. Turn it in EARLY since the space is limited!!
This is a week you will not want to miss!!
What is Scholarship Camp all about you say? It is 7 days of intense spiritual growth, exciting fun, great food, fabulous friends, dedicated counselors, and adventures. You will be s-t-r-e-t-c-h-e-d in every way – it is God that will be molding you into His spiritual soldier. You will be memorizing a passage in God’s Word, involved in daily Bible lessons, participating in Bible Quiz, taking part in evening devotions with your cabin mates, learning how to develop a personal quiet time each day with the Lord, and competing with your team in some crazy activities!
Clubbers who are entering sixth grade or higher and have earned an Excellence, Timothy, Meritorious or Citation Award or completed two years of program requirements are eligible for camp. Campers must be at least 10 years old by the first day of camp. High School aged campers must be at least 13 years old by the first day of camp. Returning campers must complete one additional handbook/manual in the current handbook progression. All work must be completed before camp begins.
The cost of camp this year will be $340.00 per camper.
You will receive 7 full days of camp, a camp shirt, lesson books, award plaque, and a camp picture. For your application to be accepted it must be accompanied by a $140.00 non-refundable registration fee. To avoid a late fee of $10.00 your application must be post marked by March 15, 2005. After this date any open slots that are left will be opened up to campers from outside the Orange County / Inland Empire area, so don’t wait until the last minute!
The balance of your camper fees ($200) must be postmarked by May 25, 2005. Not doing so will cost you another late fee of $10.00 and your spot at camp could be given to campers on the waiting list. All campers that are accepted to attend camp are expected to participate in camp for the entire week.
A check from your church should be made out to Southland Summit Scholarship Camp and mailed to Jon Mills, 27893 Wild Sage Ct., Sun City, CA 92585.
Much prayer has already gone into this week of camp and we are confident that the Lord will do great things in the lives of all who attend. Expect God to teach you, humble you, stretch you, squeeze you, challenge you, convict you, and reward you.
Will you be a mound of clay in the Master’s hands this year at camp?
AWANA CLUBS INTERNATIONALOne East Bode Road, Streamwood, IL 60107
Dear Parents of Campers:
At Awana Clubs International, we care about kids! Our hope and prayer is that all children and youth throughout the world will come to know, love and serve the Lord Jesus Christ.
Volunteers for Awana camps are chosen carefully. They are screened by the Awana missionary and Awana Clubs International headquarters office. Our goal is that all volunteers will have a positive spiritual impact on youth attending camp.
Should you have any concerns regarding anything that occurred at camp, you may contact the Awana Missionary for your area or the Awana Headquarters office and speak to anyone in the Child Protection department. The contact information is at the end of this letter.
We encourage you to talk to your son or daughter and encourage them to talk to you about their camp experience. Also, let your son or daughter know they can feel free to talk with a camp counselor or the camp director should there be something he or she is not comfortable with at camp.
We desire camp to be a positive experience for all youth; a time of spiritual growth and a time they look back on with fond memories. We covet your prayers as Awana works to bring spiritual enrichment to the young people that are entrusted to us at camp.
Blessings to you!
The Child Protection Team
Awana Missionary – Brad Iverson – 951-927-0997
Lyn Loven, Executive Child Protection - 630-540-4513
Edna Jordan, Director Child Protection - 630-540-4515
Arlene Johnson - Risk Manager - 630-540-4639
Craig Mulligan - Risk Manager - 630-540-4536
KEEP THIS PAGE FOR FUTURE REFERENCE
GET YOUR APPLICATION IN EARLY:
February and March are the best months to complete your application. Our camps will fill up very quickly, often by the March 15 deadline for some of the age groups. Your AWANA church will mail in all applications from their clubs as a “package”. You will want to do your part to help them meet the deadlines which will help to ensure you a “spot”. The following items make up a COMPLETE APPLICATION:
· Application filled out completely, legibly, and properly signed
· Parental Consent and Release of Liability Form filled out and properly signed
· ONE copy (on 8½” X 11” paper) of your insurance card *
· Application Fee of $140.00
Incomplete applications will be returned to your church for corrections, thus delaying securing a “spot”.
WHAT IS THE COST?
The cost covers a full 7 day camp, an AWANA camp T-shirt, a lesson manual, a Scholarship Camp award plaque, and a camp picture. Most campers bring extra funds for crafts, shopping in the Bible book store, a missions offering, and free time activities.
All camp fees should be paid through your Awana church. The church will send the Camp Coordinator one check for the Application Fee (due March 15th) and another check for the balance due (by May 25th). Please note the following registration and fee deadlines:
ON TIME / LATEApplication Fee and COMPLETED Application (non-refundable) / MARCH 15TH / AFTER MARCH 15TH
$140.00 / $150.00
Balance Due / MAY 25TH / AFTER MAY 25TH
$200.00 / $210.00
TOTAL CAMP FEE: / $340.00 / $360.00
If a reservation is cancelled, the applicant forfeits the application fee. If he/she cancels after June 15th, no refund can be given. If a camper is not accepted, or if the camper cancels for medical reasons, all fees will be returned in full. All funds will be returned to applicants on “waiting lists” if no space becomes available.
Please understand that Southland Summit Scholarship Camp is not equipped to handle special physical, emotional, or educational needs. All such circumstances need to be discussed with the Camp Coordinator prior to applying.
WHAT TO EXPECT:
Campers are divided into separate camps: JV (6th – 8th Graders) and VARSITY (9th – Super Seniors). Each camp will have its own separate program –expect to make friends with other young people your age. Here’s more of what to expect:
· Daily Bible Lessons and Chapel Services / · Daily Quiet Time and Evening Devotions· Bible Memorization / · 4-Way Team Competition
· Free Time Activities / · Lots of Good Food!
THE PINE SUMMIT ADDRESS IS: 700 Wren Drive, Big Bear Lake, California 92315
* Perspective campers who do not have health insurance, please contact Jon Mills, Camp Coordinator (951/679-3738)
Southland Summit Scholarship Camp
July 9 – 19, 2005
CAMPER INFORMATION
Applicant’s Full Name: ______Date of Birth:______Age: ______
Name or nickname you prefer to be called (if different from above): ______Male Female (circle one)
Address: ______City: ______State: ______Zip:______
Home Phone: (_____) ______Family E-mail address: ______
(circle one) Grade next fall: 6 7 8 9 10 11 12 Graduate Adult Shirt Size: S M L XL XXL
If you have ONE roommate preference in your age/grade level, please give their full name ______
Every attempt will be made to honor your request.
SPONSOR INFORMATION
Camper is sponsored by: q Church q Parent q Clubber q Other
Sponsor’s Name ______Address ______
City ______State ______Zip ______
TO BE FILLED IN BY THE APPLICANT’S AWANA COMMANDER OR DIRECTOR
Church: ______Registration Number: ______
Church Address: ______City: ______State: _____ Zip: ______
Check awards earned: q Excellence q Timothy q Meritorious q Citation
Handbook/manual completed this year
q T&T Book 1 q Relay q Red AKX q Main Study One
q T&T Book 2 q Sprint q Blue AKX q Main Study Two
q T&T Book 3 q Marathon q Green AKX q Main Study Three
q T&T Book 4 q Yellow AKX q Main Study Four
Returning campers must complete one additional handbook/manual in the current progression this club year.
I confirm that this Applicant has met camp eligibility requirements and recommend her/him for Scholarship Camp. I further confirm that the Applicant and the Applicant’s family have completed this Application and have provided all necessary signatures and information, and that I have not signed on behalf of the Applicant or parents/guardians unless the Applicant is my child.
______
Signature (required for acceptance)
IF LEFT BLANK THE APPLICATION WILL NOT BE ACCEPTED & WILL BE RETURNED
______(_____) ______
Title (Commander or Director) Phone number (of signatory) E-mail address (of signatory)
REMEMBER TO REGISTER EARLY
We recommend that you keep a copy for your records.
For returning campers.
What team were you on last year? Red Blue Green Yellow
AWANA SCHOLARSHIP CAMP
Parental Consent and Release of Liability
Please Print and Provide All Information Requested
IMPORTANT: THIS DOCUMENT CONTAINS A RELEASE OF LIABILITY. YOU ARE ADVISED TO REVIEW IT CAREFULLY.
Name of Camper ______Camper’s Date of Birth______
Camp Location Pine Summit Christian Conference Center, Big Bear Lake, CA Dates Camper Will Attend Camp July 9 – 16, 2005
I understand and agree that participation in the Awana Scholarship Camp (“Camp”) is a privilege to which my minor child named above (“Camper”) is not otherwise entitled. In consideration for that privilege, I am signing this Parental Consent and Release of Liability.
Consent to Attend Camp
I hereby give permission for Camper to attend and participate in the Camp.
Consent to Medical Treatment
If Camper experiences an injury or illness, or has other medical needs, I authorize the Camp’s employees, volunteers, and agents to make such arrangements for Camper’s health and safety, including but not limited to first aid, emergency medical care, ambulance or other transportation to a hospital, medical office, or clinic, testing and examination, and hospital care, and other medical care and treatment (including dental care) as they feel are appropriate in the circumstances. I further agree that I am fully responsible to pay all charges and expenses relating to such care, transportation and treatment and I hereby fully release ACI, Pine Summit and their directors, officers, employees, volunteers and agents from any claims, including claims for medical charges, prescription costs and other expense, I might have as a result of such care, transportation and treatment. My signature below also serves to indicate my willingness for my Health Insurance Company (please provide details in the Medical Information section) to be billed for any and all medical fees and services should they be needed. I agree that I will pay all charges and expenses not covered by insurance.
Medical Information
Medical Insurance Co. ______Policy Number ______
(Please attach a copy of your insurance card)
Address ______
Phone ( ) - Insured’s Name ______
Doctor’s Name ______Phone (_____) -______
Date of last tetanus ______Date of last physical ______
List any medical or food allergies of Camper (please write “None” if applicable): ______
Will Camper be under any medication* while at camp? Yes No If yes, please provide details: ______
*All medications are to be in original containers with prescription attached and given to the camp nurse.
The camp nurse has our (my) permission to provide Camper with non-prescription medicines as deemed
necessary. Yes No Please list any over-the-counter medicines that should not be given to Camper. ______
Does Camper have any physical condition or limitations that would restrict participation in any camp activities?
Yes No If yes, please provide details: ______
Release of Liability
Prior to Camper’s participation in Camp activities, I acknowledge that involvement of Camper in the Camp may involve risk of property damage and of personal injury, illness or even death of Camper, including but not limited to the risks arising from transportation–related activities, recreational activities, accidents in the outdoors and rustic facilities, adverse weather conditions, and injuries and illness as a result of food-borne illnesses and allergic reactions. In addition, I understand that there may be other risks inherent in Camp activities of which I may not be presently aware.
By signing this Parental Consent and Release of Liability, I warrant that Camper is fully capable of safely participating in all Camp activities, and I expressly assume all risks of Camper’s participation, whether such risks are known or unknown to me at this time. I further generally release Awana Clubs International (“ACI”), Pine Summit, and their directors, officers, employees, volunteers, and agents, and other campers at the Camp, from any and all claims that I or Camper may have against any of them as a result of property damage or personal injury, illness or death of Camper as a result of participation in Camp activities, whether on or off Camp grounds. I agree that this release includes the ordinary, special and inherent risks described above, and other risks that I may not foresee or be aware of at this time. This Release of Liability is given on behalf of myself, Camper, and the heirs, family, estate, administrators, executors, personal representatives and assigns of me and Camper.
Other Releases and Acknowledgements
I acknowledge receipt of the Child Protection and Safety letter provided in the Scholarship Camp registration packet.
I understand that, while Camper is participating in Camp activities, photographs, film, audio recordings and videotape of Camper may be taken for use in brochures, videos, releases to the press, and various ACI publications and other work product. I do hereby irrevocably grant ACI permission to record, display and/or reproduce my child’s name, likeness and voice on audio and/or video tape, film or other media, to edit and otherwise modify such media at its discretion, to incorporate the media into any work product, and to use or authorize the use of such media or any portion thereof in any manner or media or by any means, methods or technologies now known or hereafter to be known.