Camp McDowell - Amazon Simple Storage Service (S3)
Summer of 2011
Camp McDowell
Summer Camp Application to the Camp and Conference Center for the Episcopal Diocese of Alabama Camp McDowell ...The Heart of the Diocese!
ABOUT SUMMER CAMP Since 1948, Camp McDowell has been a vital gathering spot for the Diocese of Alabama. It is on the banks of Clear Creek, nestled in beautiful woodlands adjacent to the Bankhead National Forest. Former campers will tell you that Camp McDowell is a supportive Christian community where young people learn to be themselves, and where they develop an abiding respect for the integrity and individuality of all living things. Camp is fun, too! A unique feature of each summer session is the program theme. Camp Directors and their staffs design daily age-appropriate programs and activities incorporating skits, songs, art, and a healthy dose of humor. These programs encourage learning based on scripture and the traditional teachings of the Church, and how they relate to contemporary and personal issues. Intended to make the camp experience more than fun in the summer sun, the themes range from the environment and relationships to decision-making and dicipleship. One thing is always certain: campers come away with a deeper understanding of themselves and God in the world around them. In addition to nurturing spiritual, social, and creative growth, Camp McDowell offers hiking, canoeing, soccer, basketball, arts & crafts, a playground, a ropes and group action course, and an olympic-size swimming pool. Camp McDowell 105 DeLong Road Nauvoo, AL 35578 205.387.1806 www.campmcdowell.com The Right Reverend Henry N. Parsley,
Bishop of the Diocese of Alabama
The Right Reverend John McKee Sloan,
Bishop Suffragan
The Reverend Mark Johnston,
Executive Director of Camp McDowell
Susanna Whitsett, [email protected]
Summer Camp Coordinator
Anna Bryant, [email protected]
Summer Camp Registrar
INSIDE: Summer Camp Schedule…………………….………..2 Registration Form…………...………………….……...3 Registration checklist…………...…………….……….4 Over-the-counter Medication Requirements…….….4 Summer Camp Health Form……………………….....5 Prescription & OTC Medication Form…...……….….6 Camp Information and Policies ………………….…...7 Directions to camp………………………………….….8
Summer Camp Schedule SESSION ONE - Primary I: May 27-29 For entering 1st & 2nd graders, plus one parent per child……………………………………………....……...……$110.00 per camper Both child and adult must send in an application and health form Director: The Rev. Charles Youngson, St. Thomas, Birmingham SESSION TWO - Elementary I: May 31-June 3 For entering 3rd and 4th graders...…………………….…………………………..……………...…………………………..…….…$215.00 Director: The Rev. Stephen Hood, Church of the Ascension, Birmingham SESSION THREE - Senior Camp: June 6-15 For entering 10th, 11th, and 12th graders..…….………………………………………….…..…………………….………………..$475.00 Director: The Rev. Rob Iler, St. Columba in the Cove, Huntsville SESSION FOUR - Junior High I: June 20-25 For entering 6th and 7th graders…………………………………………………………………………………………………….....$310.00 Director: The Rev. Rebecca DeBow, St. Luke’s, Birmingham SESSION FIVE- Special Session: June 30-July 5 For physically and mentally challenge………………..………….………………………………………………………….…..…….$285.00 Staff: entering 11th grade and older: June 28-July 5.....…….………………..…...…………………………………..……..……$155.00 Director: The Rt. Rev. John McKee Sloan To apply to be on staff you must fill out the Special Session Application and Health Form found on our website SESSION SIX– Sophomore: July 6-13 For entering 8th and 9th graders……………….………………….……………………………………………………….................$410.00 Director: The Rev. Thomas Joyner, Holy Comforter, Montgomery SESSION SEVEN - Middler Camp: July 15-20 For entering 5th and 6th graders…………………………………………………………………………………………...…...…......$310.00 Director: The Rev. Andy Keyse, Trinity, Florence SESSION EIGHT - Junior High II: July 22-29 For entering 7th and 8th graders…………...............................................................................................................................$410.00 Director: The Rev. Mark Waldo, St. Michael and All Angels, Millbrook SESSION NINE—Elementary II: July 31-August 4 For entering 4th and 5th graders……………………………………….………………….............................................................$260.00 Director: The Rev. Susan Sloan SESSION TEN- Primary II: August 5-7 For entering 1st, 2nd and 3rd graders, plus one parent per child………….……….............................................$110.00 per camper Both child and adult must send in an application and Health Form Director: The Rev. Tim Murphy, St. Mary’s, Jasper
PLEASE HELP WITH THE BLACK BELT BOOK PROGRAM We ask all campers to please bring at least one new or gently used book to camp each summer for the Black Belt Book Program. Your donation will be distributed through the public school system to the children of the Black Belt. Last summer we collected 1791 books! THANK YOU! 2
Camp McDowell Summer 2011 Registration Form A $50.00 deposit is required for all registrations. For Primary I & II, $25 for each camper (child & adult) is required. Balance and all forms are due 10 days prior to Camp Session. For Primary I and II both parent and child must have separate registration forms. To participate in the Ropes Course (applies to Jr High I & II, Sophomore & Sr Camp only), a separate waiver must be signed & submitted. You may complete on-line at www.campmcdowell.com or download for mailing. You may also register, complete all forms & pay online at www.campmcdowell.com FOR QUESTIONS ABOUT REGISTRATION, CONTACT THE SUMMER CAMP REGISTRAR, ANNA BRYANT [email protected] or 205.387.1806 FOR OTHER QUESTIONS ABOUT SUMMER CAMP, CONTACT THE SUMMER CAMP COORDINATOR, SUSANNA WHITSETT AT [email protected] or 205.387.1806 PLEASE TYPE OR PRINT CLEARLY
OFFICE USE ONLY Session #: _______ Circle: Child / Adult Male / Female __Deposit __Balance ______Canteen Camper Last Name ________________________________________ __Health __OTC ___ Ropes Waiver __Pic CD __T-Shirt ___H2O Bottle Camper First Name ________________________________________ __T-Shirt Pal Prefer to be called _________________________________________ Grade next fall: _______ Date of Birth: / / Age: _____ School Name:_____________________________ Have you ever been to Camp McDowell before? YES NO If yes, when? __________________________________ Summer Camp Environmental Camp Parish/Youth Retreat Other________________________________ Parent Name________________________________________________________________________________________ Email Address_________________________________________________ Parent cell phone_______________________ Street Address______________________________________ City________________________ State ____ Zip_______ Parent Home Phone_____________ Father’s Work Phone_________________ Mother’s Work Phone________________ EMERGENCY CONTACTS: Name_____________________________________ Hm Ph___________ Cell Ph__________ Relationship ___________ Name_____________________________________ Hm Ph___________ Cell Ph__________ Relationship ___________ Are you Episcopalian? Y / N Which parish? _______________________ If not, what religious affiliation?_______________ CAMPERS: Please read and sign the following statement. By signing this statement you are agreeing to participate fully in the program and activities offered by Camp. If accepted, I will participate in the Camp program and follow all the rules. I understand that the use or possession of tobacco, illegal drugs, and/or alcohol will result in my immediate dismissal from camp. I will not bring a cell phone or other communication device. Camper’s Signature____________________________________ Date ___/_____/_________ PARENTS: Please read and sign the following statement: In case of emergency, I give permission for the staff of Camp McDowell to select a physician and seek medical treatment for my child. I give permission for my child to receive over the counter medication from the camp nurse following physician guidelines. I give permission for photographs of my child to be used for promotional purposes by Camp McDowell. I understand that I am financially responsible for property damages caused by my child’s behavior. Parent’s Signature:_____________________________________ Date ____/_____/_________ CABIN MATE REQUEST POLICY Campers may request one (only) cabin mate. Both campers must request one-another on forms. Requests must be received 10 days prior to session. No assignments will be changed on opening day. Thank you! My cabin mate request is: ______________________________________ 3
Registration Checklist $50 Deposit enclosed ($25 for each camper for Primary I &II) Balance enclosed Balance will be submitted 10 days prior to session Forms Completed: Health Form, OTC Form, Ropes Course Liability Waiver (for Jr I, Jr II, Sophomore & Sr Camps) Canteen money amount _________ COMING THIS SUMMER...NEW ADDITIONS IN CANTEEN! Photo CD for $10 T-Shirt for $15 Water Bottle for $10 T-Shirt Pal for $15 ______ TOTAL AMOUNT SUBMITTED
Camp McDowell Scholarship Fund Please donate my child’s leftover canteen money to the Camp McDowell Scholarship Fund: Yes No Your contributions enable campers in need to attend summer camp. For information on scholarships, please contact Susanna Whitsett ([email protected]) or Anna Bryant ([email protected], 205-387-1806). Please note the financial assistance policy on page 7. Thank you.
Updated 01/2010 CMCD
Over-the-Counter Medication Requirements Dear Parent/Guardians, Due to requirements from the AL State Board of Nursing a few years ago, the Camp McDowell nurse will no longer be able to offer Over-the-Counter (OTC) medicines from Camp stock medicines. These requirements are probably similar to what your school requires regarding OTC medicines given during school. Please take note of the new Summer Camp Health form. In addition to providing current prescription information there is now room to provide information about OTC medicines you will be providing for your child while they are at camp. Please Note: All OTC medicines will be given following manufacturer’s recommendations. If your child is younger than 12 and the medicine sent is not recommended for children younger than 12, a signed statement from the child’s physician or health care provider authorizing administration of the OTC medicine will be necessary. Suggested over-the-counter medicines: something for pain/fever [ex. Children’s Tylenol or Ibuprofen], something for allergy relief [ex. Benadryl], and something for upset stomach [ex. Tums]. You may wish to consult with your child’s physician or health care provider regarding what medicine[s] to send. If your child is bringing nasal sprays or inhalers and you wish your child to keep and self-administer them then written authorization must be received from your child’s physician. If you have any questions regarding this new policy please contact me at (205)387-1806 or [email protected]. Parents may also want to contact their child’s primary physician, or health care provider, and ask the physician to inform the Camp Nurse of any health or medical restrictions for your child. Respectfully, Nancy Evans, R.N., Camp McDowell
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Camp McDowell Summer Camp Health Form (All information is confidential—PLEASE PRINT) ALL SUMMER CAMP APPLICANTS MUST FILL OUT THIS FORM. FOR SUMMER CAMP HEALTH QUESTIONS OR SPECIAL NEEDS PLEASE CONTACT THE CAMP NURSE @ 205-387-1806 or [email protected] CAMPER NAME: _________________________________________________________ _________________________ (Last) (First) (Middle) Prefers to be called Primary Physician: _________________________________ Physician Phone # : ( ) _________________________ Parent/Guardian: Name: _______________________________________________ Camper: Sex: M F Age: ______ ( ____) ________________________ ( ____) ___________________________ ( ____) ___________________________ Primary Phone Number (i.e. Home) Secondary Phone Number (i.e. Cell) Alternate Phone Number (i.e. Work) Emergency Contact: _________________________________________________________________________________ NAME Relationship to camper Day Phone Evening Phone Student Info: Birth Date: ________ Tetanus: ______ Height: ______ Weight: _____ Does camper wear contacts? Yes/No Month/Day/Year Year Any Known ALLERGIES to: Insects NO / YES Food NO / YES Plants NO / YES Animals NO / YES Medicines NO / YES Other NO / YES
Type Treatment _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
HEALTH CONCERNS: Is camper on a special diet? N / Y Please explain what CAN they eat as well as what they CANNOT: __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ Health Problems: ____________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________
Statement of emotional and mental health from parents: Please share with us any information about your child’s emotional or mental health that might aid us in caring for him or her while at camp. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ If things are not fine at home, please talk to the Camp Program Director or Camp Coordinator in confidence. The stress that your child may be suffering can be greatly minimized by an informed staff. Thank you. ACCIDENT INSURANCE COVERAGE: Accident Insurance costs are covered in the program fee and protect all campers throughout the program. The maximum benefits are: Sickness, $1000; Accidents, $2500; and Loss of Life, $2500. Parents or guardians are responsible for expenses in excess of these amounts.
PLEASE READ & COMPLETE REVERSE SIDE REGARDING MEDICATIONS WHILE AT CAMP. 5
Updated 01/2010—Page 2
PRESCRIPTION MEDICATIONS:
The following section MUST BE COMPLETED BY Camper’s PARENT or LEGAL GUARDIAN. (All medication is dispensed by licensed nurse )
* If your child is bringing an Epi-Pen you MUST talk to the Nurse before your visit: (205) 387-1806 or [email protected] List all prescription medications you plan to send with your child and the reasons s/he takes them (attach extra sheet if necessary) Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Your child’s medication MUST be in the correct pharmacy prescription bottle w/ administration directions on the pharmacy label. ** Please note: “Administer according to directions” is not acceptable. Prescription Medication LABEL must include: Your child’s name Strength of the medication Amount Given How often it is to be given Expiration date of the medication
If your child’s prescription medication is not in its original container and labeled properly the Camp McDowell Nurse cannot administer it. If you have further questions please contact the Nurse at (205)387-1806 or [email protected]. Thank You!
NOTE: ALL OVER-THE-COUNTER (OTC) MEDICINES MUST BE PROVIDED BY THE PARENTS OR LEGAL GUARDIAN OF THE CAMPER.
OVER THE COUNTER (OTC) MEDICATIONS: ** A Parent or Legal Guardian MUST provide Camp with OTC medications. Please list below the medications you plan to send for your child and the reason(s) why your child should take them. All medicine will be kept by the Camp Nurse. It must be in the original manufacturer’s container with the camper’s name written on the container. [**See Note Below] OTC medicines will be administered following manufacturer’s guidelines. Name of OTC Medicine Reason(s) for Giving Tylenol 160 mg___________________________According to manufacturer recommendations________________________________ (example) (example) ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Attach additional sheets if necessary DESCRIPTION OF ESSENTIAL FUNCTIONS OF A CAMPER: In order to participate in our summer camp programs, a child should be able to meet their personal needs, move independently from place to place, and cooperatively function in a group setting. Our professional staff is not trained to give individualized attention to children with special needs beyond these parameters. If you have questions or need further information, please contact Susanna Whitsett at [email protected] or 205.387.1806 Camp McDowell also offers one session specifically for people with disabilities, Special Session. The Special Session leadership can answer questions in regard to those eligible for this session. For further information please contact Gail Perna at [email protected]
“I authorize the Camp Nurse the task of assisting my child in taking the above medications. OTC medicines will be administered following manufacturer guidelines. ** I understand that if my child is younger than 12, a signed statement from the child’s physician or health care provider authorizing administration of the OTC medicine will be necessary if the medicine sent is not recommended for use in children younger than 12. I also authorize the Camp Nurse to talk with my child’s physician or pharmacist should a question come up about the medicine.‖ ___________________________________________________________________________________________________________ SIGNATURE OF PARENT or LEGAL GUARDIAN DATE EFFECTIVE DATES (Dates of Camp Session): __________________ Camper Name: ____________________________________ All health information is considered confidential and will be shared only on a need-to-know basis to ensure the safety of your child. ―This is to certify that the information provided on this form is accurate to the best of my knowledge.‖ 6
Summer Camp Information and Policies Parents: At Camp McDowell, the staff is committed to creating a safe, healthy, and happy environment for each camper. We are striving to achieve best practices in the camp setting. Please assist us with your support of the following policies & practices: People of all races and traditions are welcomed with love and joy at Camp McDowell. OPENING & CLOSING DAY AND SCHEDULING Campers are expected to be present for the entire session. Any exceptions must be approved by the Executive Director and Session Director. Contact the Summer Camp Coordinator to begin this process. Campers should arrive on opening day between 2-5 PM. Registration will not begin until 2 PM. Campers will not be able to enter Camp before 2 PM. Most sessions end with Holy Eucharist at 8:30 AM. Parents are invited to attend or to pick up no later than 9:30 am on closing day. If circumstances prevent your camper from attending, please call Camp immediately so that someone else can have your space. Episcopalians of other dioceses and campers of other denominations are encouraged to apply. These registrations will be held in order of their receipt and accepted on a “space available” basis after April 1. FINANCIAL INFO A non-refundable deposit of $50 ($25 each for Primary I and II) is due with your registration form. Makes checks payable to Camp McDowell. The balance is due no later than 10 days before the session begins. Financial assistance will be made available to those who are in need. No child will be denied the opportunity to come to Camp due to inadequate finances. Due to the amount of scholarships requested each year from Camp, it is now our policy to request the $50 deposit ($25 per camper for Primary I & II) if possible and/or a portion of the session fee. Families also may choose to contact their parish priest for assistance or camp may contact the parish on a family’s behalf. Insurance costs are covered in the session fee and protect all campers while traveling to and from camp and through out the session. The maximum benefits are:
Sickness, $1000; Accidents, $2500; and Loss of Life, $2500. Parents or guardians are responsible for expenses in excess of these amounts. Please consider a contribution to Camp McDowell’s Scholarship Fund when paying your fee. A Photo CD is available for your session for $10. Please note on form. Canteen money may be added registration fees. $2.50/day is suggested. You may pre-purchase a Camp McDowell T-shirt & water bottle. T-shirts will be also be available opening & closing day. Keep a friend in style...be a “T-Shirt Pal” ! Purchase a t-shirt for a camper in need. HEALTH & WELLNESS Your application is not complete until we have received your Health Form. Jr High I & II, Sophomore, & Sr Camps require a liability waiver (found on-line) to participate in the Ropes Course. Routine health care is provided by a registered nurse on staff. If additional care is needed, the camper will be taken to a medical facility. Parents will be contacted ASAP All medications (prescription and OTC) must be in their original containers and checked in by the medical staff at the time of registration on opening day. These will be kept in the Healt Hut and dispensed as needed by the medical staff. The physical, emotional, and mental health of campers are of concern to our staff. If things are not fine at home, please talk to the Camp McDowell Summer Camp Coordinator or Executive Director in confidence. An informed staff will be better equipped to care for your child. LIFE AT CAMP If accepted, campers are expected to participate fully in the Camp program and follow all the rules. The use or possession of tobacco, illegal drugs, or alcohol will result in immediate dismissal from camp. Inappropriate personal contact or exposure will result in dismissal from camp. Energy drinks are not allowed. 7
One-piece bathing suits or Tankinis ONLY. Please DO NOT BRING two-piece bathing suits for girls. Cell phones are not allowed. These will be taken up by a staff member and kept until the end of the session. Camp is a place to do things that your child cannot do at home. To that end, we like for campers to get “unplugged” at camp. We discourage the use of electronic devices such as Gameboys, Nintendos, etc. Portable DVD players, I-Pads, and cell phones are not allowed. Electronics detract from the “camp” experience and run the risk of being damaged or lost. CONTACTING CAMPERS AT CAMP Campers may receive emails at [email protected]. Put the cabin name in the subject line. Please limit to one email per sender, per day. We encourage regular mail by post, as well. Campers may make & receive telephone calls only in cases of emergency. Cell phones are not allowed. These will be taken up by a staff member and kept until the end of the session. Please do not mail or send candy or highsugar foods with your camper. Candy in the cabins can be messy, sticky, and may attract insects. Also, extra sugar is not helpful for campers or counselors. Small packs of cookies, crackers or chips are acceptable, as well as non-food items such as a writing journal, books, cards, and games. Mailed packages should be no larger than a regular shoe box. Please, only one package per camper, per session. CABIN ASSIGNMENTS Cabin Mate Request Policy: Campers may request 1 other camper to be in their cabin. Multiple requests will not be accepted. Campers must request one another on forms to be processed. Cabin requests will be received up to 10 days prior to a session. No assignments will be changed on opening day. As camp is a time to meet new friends, we will limit the number of campers from the same parish in a cabin. LOST/LEFT ITEMS Items lost/left at camp will be mailed for a fee of $5/ small package & $10/large.
Directions to Camp McDowell From Birmingham and Montgomery - Take I-65 North in Birmingham. Take exit 264 and turn left onto Daniel Payne Drive going west. Go approx. 1 mile and then turn right on Coalburg Road. Then go 2 miles and turn left onto I-22/78 (Corridor X) towards Jasper. Take Exit 63 and turn right onto 269 North into Jasper. Turn right at second light onto 18th St. and an immediate left onto 9th Ave. which will turn into HWY 195. Take HWY 195 approx. 15 miles to mile marker 13 and turn right into Camp McDowell. From Huntsville - Take I-65 South to Cullman; Take U.S. 278 West to Double Springs. Take Highway 195 South to Camp McDowell, about 10 miles (at the 13 mile marker). From The Shoals - Take Highway 43 South from Florence to Russellville; Take 243 from Russellville until that road ends then take Highway 195 South to Double Springs; continue on Highway 195 South, about 10 miles to Camp McDowell (13 mile marker). From Tuscaloosa - Take Highway 69 North to Jasper. Take Highway 195 North to Camp McDowell, about 15 miles (13 mile marker). Non-Profit Organization
U.S. POSTAGE
PAID Permit No. 103 Nauvoo, Alabama
Camp McDowell 105 DeLong Road Nauvoo, AL 35578 205-387-1806 Return Service Requested
Please recycle! 8
Camp McDowell
Summer Camp Application to the Camp and Conference Center for the Episcopal Diocese of Alabama Camp McDowell ...The Heart of the Diocese!
ABOUT SUMMER CAMP Since 1948, Camp McDowell has been a vital gathering spot for the Diocese of Alabama. It is on the banks of Clear Creek, nestled in beautiful woodlands adjacent to the Bankhead National Forest. Former campers will tell you that Camp McDowell is a supportive Christian community where young people learn to be themselves, and where they develop an abiding respect for the integrity and individuality of all living things. Camp is fun, too! A unique feature of each summer session is the program theme. Camp Directors and their staffs design daily age-appropriate programs and activities incorporating skits, songs, art, and a healthy dose of humor. These programs encourage learning based on scripture and the traditional teachings of the Church, and how they relate to contemporary and personal issues. Intended to make the camp experience more than fun in the summer sun, the themes range from the environment and relationships to decision-making and dicipleship. One thing is always certain: campers come away with a deeper understanding of themselves and God in the world around them. In addition to nurturing spiritual, social, and creative growth, Camp McDowell offers hiking, canoeing, soccer, basketball, arts & crafts, a playground, a ropes and group action course, and an olympic-size swimming pool. Camp McDowell 105 DeLong Road Nauvoo, AL 35578 205.387.1806 www.campmcdowell.com The Right Reverend Henry N. Parsley,
Bishop of the Diocese of Alabama
The Right Reverend John McKee Sloan,
Bishop Suffragan
The Reverend Mark Johnston,
Executive Director of Camp McDowell
Susanna Whitsett, [email protected]
Summer Camp Coordinator
Anna Bryant, [email protected]
Summer Camp Registrar
INSIDE: Summer Camp Schedule…………………….………..2 Registration Form…………...………………….……...3 Registration checklist…………...…………….……….4 Over-the-counter Medication Requirements…….….4 Summer Camp Health Form……………………….....5 Prescription & OTC Medication Form…...……….….6 Camp Information and Policies ………………….…...7 Directions to camp………………………………….….8
Summer Camp Schedule SESSION ONE - Primary I: May 27-29 For entering 1st & 2nd graders, plus one parent per child……………………………………………....……...……$110.00 per camper Both child and adult must send in an application and health form Director: The Rev. Charles Youngson, St. Thomas, Birmingham SESSION TWO - Elementary I: May 31-June 3 For entering 3rd and 4th graders...…………………….…………………………..……………...…………………………..…….…$215.00 Director: The Rev. Stephen Hood, Church of the Ascension, Birmingham SESSION THREE - Senior Camp: June 6-15 For entering 10th, 11th, and 12th graders..…….………………………………………….…..…………………….………………..$475.00 Director: The Rev. Rob Iler, St. Columba in the Cove, Huntsville SESSION FOUR - Junior High I: June 20-25 For entering 6th and 7th graders…………………………………………………………………………………………………….....$310.00 Director: The Rev. Rebecca DeBow, St. Luke’s, Birmingham SESSION FIVE- Special Session: June 30-July 5 For physically and mentally challenge………………..………….………………………………………………………….…..…….$285.00 Staff: entering 11th grade and older: June 28-July 5.....…….………………..…...…………………………………..……..……$155.00 Director: The Rt. Rev. John McKee Sloan To apply to be on staff you must fill out the Special Session Application and Health Form found on our website SESSION SIX– Sophomore: July 6-13 For entering 8th and 9th graders……………….………………….……………………………………………………….................$410.00 Director: The Rev. Thomas Joyner, Holy Comforter, Montgomery SESSION SEVEN - Middler Camp: July 15-20 For entering 5th and 6th graders…………………………………………………………………………………………...…...…......$310.00 Director: The Rev. Andy Keyse, Trinity, Florence SESSION EIGHT - Junior High II: July 22-29 For entering 7th and 8th graders…………...............................................................................................................................$410.00 Director: The Rev. Mark Waldo, St. Michael and All Angels, Millbrook SESSION NINE—Elementary II: July 31-August 4 For entering 4th and 5th graders……………………………………….………………….............................................................$260.00 Director: The Rev. Susan Sloan SESSION TEN- Primary II: August 5-7 For entering 1st, 2nd and 3rd graders, plus one parent per child………….……….............................................$110.00 per camper Both child and adult must send in an application and Health Form Director: The Rev. Tim Murphy, St. Mary’s, Jasper
PLEASE HELP WITH THE BLACK BELT BOOK PROGRAM We ask all campers to please bring at least one new or gently used book to camp each summer for the Black Belt Book Program. Your donation will be distributed through the public school system to the children of the Black Belt. Last summer we collected 1791 books! THANK YOU! 2
Camp McDowell Summer 2011 Registration Form A $50.00 deposit is required for all registrations. For Primary I & II, $25 for each camper (child & adult) is required. Balance and all forms are due 10 days prior to Camp Session. For Primary I and II both parent and child must have separate registration forms. To participate in the Ropes Course (applies to Jr High I & II, Sophomore & Sr Camp only), a separate waiver must be signed & submitted. You may complete on-line at www.campmcdowell.com or download for mailing. You may also register, complete all forms & pay online at www.campmcdowell.com FOR QUESTIONS ABOUT REGISTRATION, CONTACT THE SUMMER CAMP REGISTRAR, ANNA BRYANT [email protected] or 205.387.1806 FOR OTHER QUESTIONS ABOUT SUMMER CAMP, CONTACT THE SUMMER CAMP COORDINATOR, SUSANNA WHITSETT AT [email protected] or 205.387.1806 PLEASE TYPE OR PRINT CLEARLY
OFFICE USE ONLY Session #: _______ Circle: Child / Adult Male / Female __Deposit __Balance ______Canteen Camper Last Name ________________________________________ __Health __OTC ___ Ropes Waiver __Pic CD __T-Shirt ___H2O Bottle Camper First Name ________________________________________ __T-Shirt Pal Prefer to be called _________________________________________ Grade next fall: _______ Date of Birth: / / Age: _____ School Name:_____________________________ Have you ever been to Camp McDowell before? YES NO If yes, when? __________________________________ Summer Camp Environmental Camp Parish/Youth Retreat Other________________________________ Parent Name________________________________________________________________________________________ Email Address_________________________________________________ Parent cell phone_______________________ Street Address______________________________________ City________________________ State ____ Zip_______ Parent Home Phone_____________ Father’s Work Phone_________________ Mother’s Work Phone________________ EMERGENCY CONTACTS: Name_____________________________________ Hm Ph___________ Cell Ph__________ Relationship ___________ Name_____________________________________ Hm Ph___________ Cell Ph__________ Relationship ___________ Are you Episcopalian? Y / N Which parish? _______________________ If not, what religious affiliation?_______________ CAMPERS: Please read and sign the following statement. By signing this statement you are agreeing to participate fully in the program and activities offered by Camp. If accepted, I will participate in the Camp program and follow all the rules. I understand that the use or possession of tobacco, illegal drugs, and/or alcohol will result in my immediate dismissal from camp. I will not bring a cell phone or other communication device. Camper’s Signature____________________________________ Date ___/_____/_________ PARENTS: Please read and sign the following statement: In case of emergency, I give permission for the staff of Camp McDowell to select a physician and seek medical treatment for my child. I give permission for my child to receive over the counter medication from the camp nurse following physician guidelines. I give permission for photographs of my child to be used for promotional purposes by Camp McDowell. I understand that I am financially responsible for property damages caused by my child’s behavior. Parent’s Signature:_____________________________________ Date ____/_____/_________ CABIN MATE REQUEST POLICY Campers may request one (only) cabin mate. Both campers must request one-another on forms. Requests must be received 10 days prior to session. No assignments will be changed on opening day. Thank you! My cabin mate request is: ______________________________________ 3
Registration Checklist $50 Deposit enclosed ($25 for each camper for Primary I &II) Balance enclosed Balance will be submitted 10 days prior to session Forms Completed: Health Form, OTC Form, Ropes Course Liability Waiver (for Jr I, Jr II, Sophomore & Sr Camps) Canteen money amount _________ COMING THIS SUMMER...NEW ADDITIONS IN CANTEEN! Photo CD for $10 T-Shirt for $15 Water Bottle for $10 T-Shirt Pal for $15 ______ TOTAL AMOUNT SUBMITTED
Camp McDowell Scholarship Fund Please donate my child’s leftover canteen money to the Camp McDowell Scholarship Fund: Yes No Your contributions enable campers in need to attend summer camp. For information on scholarships, please contact Susanna Whitsett ([email protected]) or Anna Bryant ([email protected], 205-387-1806). Please note the financial assistance policy on page 7. Thank you.
Updated 01/2010 CMCD
Over-the-Counter Medication Requirements Dear Parent/Guardians, Due to requirements from the AL State Board of Nursing a few years ago, the Camp McDowell nurse will no longer be able to offer Over-the-Counter (OTC) medicines from Camp stock medicines. These requirements are probably similar to what your school requires regarding OTC medicines given during school. Please take note of the new Summer Camp Health form. In addition to providing current prescription information there is now room to provide information about OTC medicines you will be providing for your child while they are at camp. Please Note: All OTC medicines will be given following manufacturer’s recommendations. If your child is younger than 12 and the medicine sent is not recommended for children younger than 12, a signed statement from the child’s physician or health care provider authorizing administration of the OTC medicine will be necessary. Suggested over-the-counter medicines: something for pain/fever [ex. Children’s Tylenol or Ibuprofen], something for allergy relief [ex. Benadryl], and something for upset stomach [ex. Tums]. You may wish to consult with your child’s physician or health care provider regarding what medicine[s] to send. If your child is bringing nasal sprays or inhalers and you wish your child to keep and self-administer them then written authorization must be received from your child’s physician. If you have any questions regarding this new policy please contact me at (205)387-1806 or [email protected]. Parents may also want to contact their child’s primary physician, or health care provider, and ask the physician to inform the Camp Nurse of any health or medical restrictions for your child. Respectfully, Nancy Evans, R.N., Camp McDowell
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Updated 01/2010 — Page 1
Camp McDowell Summer Camp Health Form (All information is confidential—PLEASE PRINT) ALL SUMMER CAMP APPLICANTS MUST FILL OUT THIS FORM. FOR SUMMER CAMP HEALTH QUESTIONS OR SPECIAL NEEDS PLEASE CONTACT THE CAMP NURSE @ 205-387-1806 or [email protected] CAMPER NAME: _________________________________________________________ _________________________ (Last) (First) (Middle) Prefers to be called Primary Physician: _________________________________ Physician Phone # : ( ) _________________________ Parent/Guardian: Name: _______________________________________________ Camper: Sex: M F Age: ______ ( ____) ________________________ ( ____) ___________________________ ( ____) ___________________________ Primary Phone Number (i.e. Home) Secondary Phone Number (i.e. Cell) Alternate Phone Number (i.e. Work) Emergency Contact: _________________________________________________________________________________ NAME Relationship to camper Day Phone Evening Phone Student Info: Birth Date: ________ Tetanus: ______ Height: ______ Weight: _____ Does camper wear contacts? Yes/No Month/Day/Year Year Any Known ALLERGIES to: Insects NO / YES Food NO / YES Plants NO / YES Animals NO / YES Medicines NO / YES Other NO / YES
Type Treatment _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
HEALTH CONCERNS: Is camper on a special diet? N / Y Please explain what CAN they eat as well as what they CANNOT: __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ Health Problems: ____________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________
Statement of emotional and mental health from parents: Please share with us any information about your child’s emotional or mental health that might aid us in caring for him or her while at camp. __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ If things are not fine at home, please talk to the Camp Program Director or Camp Coordinator in confidence. The stress that your child may be suffering can be greatly minimized by an informed staff. Thank you. ACCIDENT INSURANCE COVERAGE: Accident Insurance costs are covered in the program fee and protect all campers throughout the program. The maximum benefits are: Sickness, $1000; Accidents, $2500; and Loss of Life, $2500. Parents or guardians are responsible for expenses in excess of these amounts.
PLEASE READ & COMPLETE REVERSE SIDE REGARDING MEDICATIONS WHILE AT CAMP. 5
Updated 01/2010—Page 2
PRESCRIPTION MEDICATIONS:
The following section MUST BE COMPLETED BY Camper’s PARENT or LEGAL GUARDIAN. (All medication is dispensed by licensed nurse )
* If your child is bringing an Epi-Pen you MUST talk to the Nurse before your visit: (205) 387-1806 or [email protected] List all prescription medications you plan to send with your child and the reasons s/he takes them (attach extra sheet if necessary) Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Medication ____________________________ Dosage _____________ Time Given _____________ Reason ___________________ Your child’s medication MUST be in the correct pharmacy prescription bottle w/ administration directions on the pharmacy label. ** Please note: “Administer according to directions” is not acceptable. Prescription Medication LABEL must include: Your child’s name Strength of the medication Amount Given How often it is to be given Expiration date of the medication
If your child’s prescription medication is not in its original container and labeled properly the Camp McDowell Nurse cannot administer it. If you have further questions please contact the Nurse at (205)387-1806 or [email protected]. Thank You!
NOTE: ALL OVER-THE-COUNTER (OTC) MEDICINES MUST BE PROVIDED BY THE PARENTS OR LEGAL GUARDIAN OF THE CAMPER.
OVER THE COUNTER (OTC) MEDICATIONS: ** A Parent or Legal Guardian MUST provide Camp with OTC medications. Please list below the medications you plan to send for your child and the reason(s) why your child should take them. All medicine will be kept by the Camp Nurse. It must be in the original manufacturer’s container with the camper’s name written on the container. [**See Note Below] OTC medicines will be administered following manufacturer’s guidelines. Name of OTC Medicine Reason(s) for Giving Tylenol 160 mg___________________________According to manufacturer recommendations________________________________ (example) (example) ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Attach additional sheets if necessary DESCRIPTION OF ESSENTIAL FUNCTIONS OF A CAMPER: In order to participate in our summer camp programs, a child should be able to meet their personal needs, move independently from place to place, and cooperatively function in a group setting. Our professional staff is not trained to give individualized attention to children with special needs beyond these parameters. If you have questions or need further information, please contact Susanna Whitsett at [email protected] or 205.387.1806 Camp McDowell also offers one session specifically for people with disabilities, Special Session. The Special Session leadership can answer questions in regard to those eligible for this session. For further information please contact Gail Perna at [email protected]
“I authorize the Camp Nurse the task of assisting my child in taking the above medications. OTC medicines will be administered following manufacturer guidelines. ** I understand that if my child is younger than 12, a signed statement from the child’s physician or health care provider authorizing administration of the OTC medicine will be necessary if the medicine sent is not recommended for use in children younger than 12. I also authorize the Camp Nurse to talk with my child’s physician or pharmacist should a question come up about the medicine.‖ ___________________________________________________________________________________________________________ SIGNATURE OF PARENT or LEGAL GUARDIAN DATE EFFECTIVE DATES (Dates of Camp Session): __________________ Camper Name: ____________________________________ All health information is considered confidential and will be shared only on a need-to-know basis to ensure the safety of your child. ―This is to certify that the information provided on this form is accurate to the best of my knowledge.‖ 6
Summer Camp Information and Policies Parents: At Camp McDowell, the staff is committed to creating a safe, healthy, and happy environment for each camper. We are striving to achieve best practices in the camp setting. Please assist us with your support of the following policies & practices: People of all races and traditions are welcomed with love and joy at Camp McDowell. OPENING & CLOSING DAY AND SCHEDULING Campers are expected to be present for the entire session. Any exceptions must be approved by the Executive Director and Session Director. Contact the Summer Camp Coordinator to begin this process. Campers should arrive on opening day between 2-5 PM. Registration will not begin until 2 PM. Campers will not be able to enter Camp before 2 PM. Most sessions end with Holy Eucharist at 8:30 AM. Parents are invited to attend or to pick up no later than 9:30 am on closing day. If circumstances prevent your camper from attending, please call Camp immediately so that someone else can have your space. Episcopalians of other dioceses and campers of other denominations are encouraged to apply. These registrations will be held in order of their receipt and accepted on a “space available” basis after April 1. FINANCIAL INFO A non-refundable deposit of $50 ($25 each for Primary I and II) is due with your registration form. Makes checks payable to Camp McDowell. The balance is due no later than 10 days before the session begins. Financial assistance will be made available to those who are in need. No child will be denied the opportunity to come to Camp due to inadequate finances. Due to the amount of scholarships requested each year from Camp, it is now our policy to request the $50 deposit ($25 per camper for Primary I & II) if possible and/or a portion of the session fee. Families also may choose to contact their parish priest for assistance or camp may contact the parish on a family’s behalf. Insurance costs are covered in the session fee and protect all campers while traveling to and from camp and through out the session. The maximum benefits are:
Sickness, $1000; Accidents, $2500; and Loss of Life, $2500. Parents or guardians are responsible for expenses in excess of these amounts. Please consider a contribution to Camp McDowell’s Scholarship Fund when paying your fee. A Photo CD is available for your session for $10. Please note on form. Canteen money may be added registration fees. $2.50/day is suggested. You may pre-purchase a Camp McDowell T-shirt & water bottle. T-shirts will be also be available opening & closing day. Keep a friend in style...be a “T-Shirt Pal” ! Purchase a t-shirt for a camper in need. HEALTH & WELLNESS Your application is not complete until we have received your Health Form. Jr High I & II, Sophomore, & Sr Camps require a liability waiver (found on-line) to participate in the Ropes Course. Routine health care is provided by a registered nurse on staff. If additional care is needed, the camper will be taken to a medical facility. Parents will be contacted ASAP All medications (prescription and OTC) must be in their original containers and checked in by the medical staff at the time of registration on opening day. These will be kept in the Healt Hut and dispensed as needed by the medical staff. The physical, emotional, and mental health of campers are of concern to our staff. If things are not fine at home, please talk to the Camp McDowell Summer Camp Coordinator or Executive Director in confidence. An informed staff will be better equipped to care for your child. LIFE AT CAMP If accepted, campers are expected to participate fully in the Camp program and follow all the rules. The use or possession of tobacco, illegal drugs, or alcohol will result in immediate dismissal from camp. Inappropriate personal contact or exposure will result in dismissal from camp. Energy drinks are not allowed. 7
One-piece bathing suits or Tankinis ONLY. Please DO NOT BRING two-piece bathing suits for girls. Cell phones are not allowed. These will be taken up by a staff member and kept until the end of the session. Camp is a place to do things that your child cannot do at home. To that end, we like for campers to get “unplugged” at camp. We discourage the use of electronic devices such as Gameboys, Nintendos, etc. Portable DVD players, I-Pads, and cell phones are not allowed. Electronics detract from the “camp” experience and run the risk of being damaged or lost. CONTACTING CAMPERS AT CAMP Campers may receive emails at [email protected]. Put the cabin name in the subject line. Please limit to one email per sender, per day. We encourage regular mail by post, as well. Campers may make & receive telephone calls only in cases of emergency. Cell phones are not allowed. These will be taken up by a staff member and kept until the end of the session. Please do not mail or send candy or highsugar foods with your camper. Candy in the cabins can be messy, sticky, and may attract insects. Also, extra sugar is not helpful for campers or counselors. Small packs of cookies, crackers or chips are acceptable, as well as non-food items such as a writing journal, books, cards, and games. Mailed packages should be no larger than a regular shoe box. Please, only one package per camper, per session. CABIN ASSIGNMENTS Cabin Mate Request Policy: Campers may request 1 other camper to be in their cabin. Multiple requests will not be accepted. Campers must request one another on forms to be processed. Cabin requests will be received up to 10 days prior to a session. No assignments will be changed on opening day. As camp is a time to meet new friends, we will limit the number of campers from the same parish in a cabin. LOST/LEFT ITEMS Items lost/left at camp will be mailed for a fee of $5/ small package & $10/large.
Directions to Camp McDowell From Birmingham and Montgomery - Take I-65 North in Birmingham. Take exit 264 and turn left onto Daniel Payne Drive going west. Go approx. 1 mile and then turn right on Coalburg Road. Then go 2 miles and turn left onto I-22/78 (Corridor X) towards Jasper. Take Exit 63 and turn right onto 269 North into Jasper. Turn right at second light onto 18th St. and an immediate left onto 9th Ave. which will turn into HWY 195. Take HWY 195 approx. 15 miles to mile marker 13 and turn right into Camp McDowell. From Huntsville - Take I-65 South to Cullman; Take U.S. 278 West to Double Springs. Take Highway 195 South to Camp McDowell, about 10 miles (at the 13 mile marker). From The Shoals - Take Highway 43 South from Florence to Russellville; Take 243 from Russellville until that road ends then take Highway 195 South to Double Springs; continue on Highway 195 South, about 10 miles to Camp McDowell (13 mile marker). From Tuscaloosa - Take Highway 69 North to Jasper. Take Highway 195 North to Camp McDowell, about 15 miles (13 mile marker). Non-Profit Organization
U.S. POSTAGE
PAID Permit No. 103 Nauvoo, Alabama
Camp McDowell 105 DeLong Road Nauvoo, AL 35578 205-387-1806 Return Service Requested
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