Registration Form

---

Children’s Camp Kid’s Mission Adventure Kamp June 27-30th, 2016 completed 3rd-4th-5th grade

Sign up NOW - Call for more details $125.00 (partial scholarship help available - please apply) Cost Includes: T-shirt, meals, lodging, $10.00 concession card, insurance, church group picture, all crafts and activities, KMAK DVD, almost everything! Activities include: Bible study, worship, missions, swimming, water slide, paddle boats, canoeing, fishing, archery, drama, arts & crafts, soccer, basketball, frisbee golf, driving range, miniature golf, ropes course, climbing wall, softball, sand volleyball, and more. First Baptist Church 200 S Elm St., Sapulpa, OK 74066 918-224-4100

Camper Packet - Table of Contents Cover Page………………………………………………Summary of the fun! T.O.C.…………………………………………..………….Organizing the Info Registration Form……………………………..…Fill one out for each camper Medication Authorization*…..……………….….For each child as applicable Serious Medical Form*.…………………………For each child as applicable Tips to get ready for camp…………………………In weakness He is strong What to pack……………….……………..………..Invitation to Family Camp! Scholarship Request Form……………….………We want every child to go! Scholarship Gift Form………………………………Please help us send kids to camp by donating or sharing this scholarship form with someone who could help

Parent Camper Meeting - Sunday, June 26th @ 12 pm Worship Center All Scholarship applications are due by June 22nd

*For detail medical questions, leave a message at the church office for David Keiffer

Cabin _________________________________ Church ________________________________________________________

First Last

Kamper Name ________________________________________________

________________________________________________

Registration Form 2016 Kids Mission Adventure Kamp KMAK 2—June 27-30 (T-shirt size Circle One)

Youth: Y-Med, Y-Large

Adult size: S

M

L

XL

XXL

XXXL

Name of person attending camp: ______________________________________________________ School Grade Completed_________ Gender (circle one) M F Age________ Birth date_____________ Parent or Guardian (of minor) ___________________________________Phone: __________________ Address___________________________________ City___________________ St______ Zip________ e-mail: _____________________________________________________________________________ In case of emergency notify: ______________________________ Relationship__________________ Emergency phone numbers: Day_________________ Night______________ Cell _________________

First Baptist Church of Sapulpa Sponsoring Church: __________________________________________________________________ Participation Waiver:

I, for myself and on behalf of my attending student agree to release FBCS (First Baptist Church of Sapulpa), its officers, directors, and agents and anyone connected or associated with the church, from any liability for injuries to the student arising out of his/her participation, including during their transportation to and from the event as applicable. I also authorize FBCS to publish the photographs taken of me and/or the undersigned minor student and our names for any lawful purpose, including illustrations, advertising and web content. I release all claims against FBCS with respect to ownership and confirm that I am the parent or legal guardian of the minor student and have the authority to authorize use. Notice; FBCS will not be held liable for the loss of money or other personal items that may be lost or missing. Any damages or losses caused by my student, individually or with a group, shall become my responsibility. On all of our events, we have certain expectations of civil behavior which will insure that we all have a great experience. If, during this event, the student is unwilling to maintain these expectations, please understand that parents will be notified. Further, should it be necessary for the student to return home due to disciplinary action or otherwise, parents will assume all transportation costs.

initial here

AUTHORIZATION FOR MEDICAL INFORMATION RELEASE I hereby authorize the hospital to release the following information contained in its hospital records to the representative of the Tulakogee Conference Center concerning diagnosis, prognosis for the above named minor. initial here MEDICAL INFORMATION & AUTHORIZATION FOR EMERGENCY CARE TO A MINOR Physician’s Name____________________________________________ Phone____________________ Imperative if your child has allergies

List any allergies to medications or any known allergies________________________________________ ____________________________________________________________________________________ Date of last tetanus immunization__________________________ List medications presently being taken: ____________________________________________________________________________________ ____________________________________________________________________________________ Medical Insurance Company__________________________ Insurance Policy #___________________ I/we the undersigned, parent(s) or legal guardian of the above named minor do hereby authorize any X-ray examination, anesthetic, dental, medical, or surgical diagnosis or treatment by any physician or dentist licensed by the State of Oklahoma and hospital service that may be rendered to said minor under the general, specific or special consent of: Camp Staff of First Baptist Church of Sapulpa It is understood that this consent is given in advance of any specific diagnosis or treatment being required, but is given to encourage those persons who have temporary custody of the minor, and said physician or dentist to exercise his/their best judgment as to the requirements of such diagnosis or medical or dental or surgical treatment. initial here

Parent /Guardian___________________________________________________________Date___________ parent / guardian sign here

Please make sure you have one (1) ORIGINAL FOR TULAKOGEE and one (1) copy FOR THE CHURCH

KMAK PAREN T A L A UT H ORI Z A TION T O A D M I N IST E R M E D I C A T I O N T his medication form must accompany A L L medication to be given at K M A K . A ll medications M UST be given to the C amp F irst A id person at the time of ar rival in the original container, whether it is a prescription or over the counter medication. I hereby give my permission to the C amp F irst A id person and to designated camp staff to administer medica tion to my child at K M A K. Name of Child ________________________________________________________________Age: ___________ Weight: _____________ Church name:____________________________________________________________ City:_____________________________________ I understand that the camp first aid person and/or the KMAK staff shall not be liable to the student, parent, or Guardian of the child for civil damages for any personal injuries to the student, which result from acts or omissions in administering any medication at KMAK. _______________________________________________ Signature of Parent or Legal Guardian

_________________________ Date

Name of medication(s): _____________________

MEDICATION MUST BE BROUGHT IN THE ORIGINAL CONTAINER

______________________________________________________________________________

Reason for medication to be given and/or comments: ____________________________________ Time(s) to administer medication at camp: ____________________________________________ Dates to administer medication at camp: ______________________________________________ Side effects to be reported to parents: ________________________________________________ ______________________________________________________________________________ Side effects requiring immediate medical attention: ______________________________________ List of medications: 2)______________________________________________________________________________________________________________ 3)_______________________________________________________________________________________________________________ 4)_______________________________________________________________________________________________________________

A.M. Breakfast

Noon Lunch

P.M. Dinner

Bed Time

Monday Tuesday Wednesday Thursday Notes from first aid person: ____________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________

Serious Life Threatening Policy Policy: Tulakogee Conference Center Tulakogee (KMAK) is prepared to administer first-aid for their campers. It is EXTREMELY important that the camp administration be made AWARE of ANY situation that requires medical attention beyond first-aid: Examples of but NOT exclusive are: 1. 2. 3. 4. 5. 6. 7. 8.

Leukemia – Cancer (under Rx) Diabetic Types I & II Severe Asthmatics (requiring emergency on person inhalers or nebulizers) Chemotherapy Heart condition Organ transplant recipient or on list Growth hormones Severe allergies to insects, food, etc. requiring epi-pen or other extreme meds

Tulakogee administration will evaluate each situation individually in determining what measures need to be taken to ensure the camper’s safety and wellbeing during their stay. Please complete this form and return to your church/organization administration prior to registering for camp. Organization ___________________________ Date ____________ Camp date _____________ Campers name __________________________ Age ___________ Condition:___________________________________________________________ ___________________________________________________________________ Who will be accompanying camper (signature/relation to camper): (spouse, parent, guardian) X__________________________________________________________________ This is accurate info (signature): X ______________________________________

Tips to get kids ready for Camp Camp is kind of like kids getting to experiment with a miniature life. They can grow up a lot in that week. Upon welcoming their kids home, most parents find their kids not only loved the experience, but have a new sense of confidence, new friends and have experienced Christ in a deeper way. Here are a few tips on preparing your child for camp. • Take your child shopping for camping items • Develop a shower kit and coverup. Have your child “practice” getting modestly to and from the shower stall. (Thankfully our backup plan? We swim every day) • Pack a favorite personal item for kids to take with them (i.e., T-shirt, hat, stuffed animal…not a family heirloom, things happen at camp) • Watch last years video, they should know some of the kids in it. Talk about the fun things they are looking forward to at camp. *We will post a list of activities soon. They will get a choice of three different sessions. (older kids do get priority on activities requested) www.fbcsapulpa.com/kmak • Share a story about your first time away from home (keep it positive) • Point out what your child does well and how that can be an asset at camp • Post a letter to your child a few days early so it will be waiting for them at camp the first day (Tulakogee Conference Center 34168 East 713th Way, Wagoner, OK 74467) It also helps to have a few conversations with your child, before he heads off to meet his new friends. Here are a few things you can say--not all at once, but a little over time in the week before he goes:

• Every camper is part of a group and as your parents, we expect you to cooperate and help out.

• If you are having a problem, your group leader is there to help you. Don't wait to tell us, you can tell your group leader. Be honest and ask for what you need.

• If your group leader doesn't help or is part of what makes you uncomfortable, talk to your Camp Pastor.

• Clean-up is part of camp; you do it everyday; we expect you to participate.

• There are many new things at camp, and you may not like them all or be as good at some as you are at others. We expect you to try!

• Go about making a new friend or two. If you are timid about meeting someone new, ask about what she/he likes and be a good listener.

• Not everyone has to be your friend, and you don't have to be everyone else's friend. If you have one or two good friends at camp, that's great!

• Have fun and tell us all about it when you get home!

KMAK: What to Pack Suggestions What to pack in my suitcase?

• A Bible and a pen/pencil for taking notes • Toiletries (toothbrush, toothpaste, soap, shampoo & conditioner) • Sleeping bag or sheets and blanket, and a pillow • Towels and washcloths for showers and pool • Clothes for 5 days • Walking shoes, shower shoes • Swimsuit • Sunscreen and bug-spray NEW THIS YEAR - KEEP THE EXPERIENCE GOING JOIN US FOR FAMILY CAMP! One of the favorite things each year for us counselors is to see the autonomy these kids relish as they take over their new “domain”. They get to choose classes, activities, friends, free time, snacks, and hopefully, Christ. This year we long for each parent to join us for Family Camp! As we wind down KMAK on Thursday at noon, we are inviting each parent to come as you are, join us for Family Camp Thursday and Friday night. We look forward to hanging out together around a campfire. After a week of experiencing camp, I KNOW your child will want to show you around their new kingdom. They will relish telling you how things work in their new little world and introducing you to their friends. As the kids finish up their classes and crafts on Friday morning there will be an awesome adult classes led by Dr. & Mrs. (Dee) Story. Pastor Smokey, Meagan and other staff members will be involved and available to answer any life questions your family may be facing. Then Friday afternoon we will join up as family teams. We plan to have some of the most fun ever. (i.e., a cross between kickball with slip-n-slide: Kick-N-Slide!) Meals will be provided by the excellent Tulakogen staff in their beautiful new Lakeview dining room. Accommodations will be your choice of bunking with your kids in the dorm (boys side / girls side) or for a slight up charge stay in one of the conference center hotel rooms right on sight. Saturday morning will be leisurely family time and you can leave as you get ready or stay a while and hangout with other families. There is an amazing pool and giant waterslide for family use and many other activities to enjoy. We have tried to make this as affordable as possible so please, please try and join us. Do not let finances keep you away from this meaningful weekend getaway. Come make some memories with us!

KMAK SCHOLARSHIP REQUEST FORM

Student Name: Age:

Grade Level:

Address:

Phone #: Email:

Event Name:

Dates:

KMAK - Children Camp

June 27-30, 2016

Cost:

$

Amount I am Able to Pay:

$

Amount of Scholarship Request (remainder):

$

125.00

Parent Name:

Parent Signature:

Date:

---------------------------------------------------------------------------------------------------------------------

For office use only Date Request Received:

Amount Granted: $

Signature: ________________________

Date Processed.:

Date of confirmation sent to requestor:

First Baptist Church 200 S Elm St., Sapulpa, OK 74066 918-224-4100