Unity of the Brethren (DOC) by yaohongm


									                 Unity of the Brethren
            2011 Summer Camping Program
                                         Information and
                                         Registration Form

                                          2011 Schedule
       Alpha Camp (ages 9&10)                       Discovery Conference (ages 13&14)
June 12-14 (Sunday 3 PM to Tuesday 3PM)             June 26-July 1 (Sun 4 PM to Fri 3 PM)
Deadline / Registration Fee                         Deadline / Registration Fee
By 4/15 - $200; By 5/1 - $250; By 5/15 - $275       By 4/15 - $300; By 5/1 - $350; By 5/15 - $375
Directors: John Paul & Jennifer Chervenka            Directors: Todd & Amy Snelgrove
           Mike & Danna Dowling                               Mark Olsen
           Brett & Becky Norris                               Steve Gleinser

  Pioneer Conference (ages 11&12)                   Challenger Conference (ages 15&16)
June 19-24 (Sun 4 PM to Fri 3 PM)                   July 10-15 (Sun 4 PM to Fri 3 PM)
Deadline / Registration Fee                         Deadline / Registration Fee
By 4/15 - $300; By 5/1 - $350; By 5/15 - $375       By 4/15 - $300; By 5/1 - $350; By 5/15 - $375
 Directors: Don and Laurie Bagby                     Directors: Rev. Whitney Amos
             Arnold Motl                                        Jennifer Chervenka
            Jennifer Chervenka

       Send All Registration                                                Registrations must
                                           Glenn Fojtasek                     be postmarked
       Forms and Fees to:                 2 Guinevere Place                by deadline date!!!!
                                      The Woodlands, TX 77384
                                             The Hus School Encampment
is a facility operated and supported by The Unity of the Brethren. The primary purpose of this facility is the advancement
of the Kingdom of God on earth according to the commandment of Jesus Christ. The programs offered by the
Encampment seek to challenge young people to respond positively to the good news of God's redeeming love; teach and
encourage young people to become Christian leaders; and to provide a place of wholesome Christian recreation.

Importance of Registration - It is important that all young people send in their registration forms as early as possible so
that programming plans may be completed. Registration deadlines are 3-tiered this year – Early Bird – April 15;
Regular - May 1; Late - May 15. Completed Medical Release, Registration forms, fees, and copies of insurance cards
should be sent to:
                                                       Glenn Fojtasek
                                                      2 Guinevere Place
                                                The Woodlands, TX 77384

Checks should be made payable to: Hus School Food & Activity Account. If cancellation is made by the deadline, this
fee will be refunded. If, however, cancellation is made after the deadline, or if campers simply do not come to the
activity, the fee will not be returned.

                                                      Medical Release Form
Medical Services are available in Caldwell, four miles from the Encampment. We hope there is no need to use those
services; but, in case it becomes necessary, the Medical Release form on the back of the Registration Form is a must.
Please complete it in its entirety, and sign it, in order to ensure that medical services can be secured should they be
required. Please also include a copy of your insurance card.

                                                 Camp Discipline Procedures
We hope all campers come with the right intentions, but every now and then an issue may arise that requires some
disciplinary action on the part of the staff. Please be aware that the camp’s policy is as follows: 1st offense: conference
with camper, write out agreement for rest of stay; 2nd offense: conference with camper and parents, review agreement
from 1st conference, write out agreement for rest of stay; 3rd offense: conference with student reviewing actions and
previous agreements, call parents to pick up camper, conference with parents.

                                                      Cell Phone Policy
Campers are asked to leave ALL electronic devices (radios, IPods, cell phones, etc.) at home. We realize some parents
may prefer that their child have his/her cell phone in transit. Therefore, when phones are brought to the encampment they
will be collected at check-in by the directors, locked up for the week, and returned to the camper at dismissal.

                                                  What to Bring to Camp
Bedding: 2 or 3 sheets, a blanket, a pillow, a pillow case, and an old rug or quilt to sit on outdoors.
Personal Items: Toilet articles, towels, wash cloths
Clothes: Regular "school type" clothes and sports wear such as jeans and shorts (modest), swim wear, if requested,
should be one-piece or covered.
Other Items: Bible, notebook, pencils, flashlight, raincoat or umbrella.
Please Note: (1) All items brought to the camp should be clearly marked with the camper's name, and (2) No
radios, CD/Tape players, Gameboys, DS, IPods, cell phones or other electronic devices will be allowed.

                                                    Financial Assistance
Financial assistance is available on a limited basis to those that would like to attend a conference or Hus School and
would be unable to do so without financial aid. Please contact Glenn Fojtasek (address & telephone number listed) for
further information.

                                     Directions to the Hus School Encampment
From the intersection of U.S. Hwy. 21 and Texas Hwy. 36 in Caldwell, Texas, go south on Texas 36 approximately ½
mile. Turn east (left) on Farm Road 166. Stay on Farm Road 166 for 2 miles. Turn north (left) on County Road 225.
Follow 225 approximately 0.8 miles to New Tabor Brethren Church, then past the church approximately 0.2 miles. Turn
left at the Hus School Encampment directional sign (across the road from the SPJST Lodge Hall). Continue another 1
mile to the Hus School Encampment.
                     Hus School Encampment Registration Form – 2011

                            All Registration Fees are Due with This Form

       Please fill in both pages of this form, detach and mail to Glenn Fojtasek, 2 Guinevere Place, The
     Woodlands, TX 77384. A check made out to “Hus School Food & Activity Account” is required for all

    Name of camper                                            Telephone #
    Home Address
                                                                     (city)             (State) (zip)
    Parents’ Names: ______________________________________________________________
    Parents’ Email                                        Camper’s e-mail
    Age as of September 1, 2011                      School grade completed as of June 1, 2011
    Date of Birth:                                   Sex: Male                Female
    Name of Home Church: _______________________Name of Pastor: _____________________

    I plan to attend: (Check one) [age is by start of school/Sept. 1 after camp – ie: summer birthdays count]

            Alpha Camp (ages 9&10)                            Pioneer Conference (ages 11&12)
           June 12-14 (Sunday - Tuesday)                      June 19-24

            Discovery Conference (ages 13&14)                    Challenger Conference (ages 15&16)
            June 26-July 1                                       July 10-15

    Have you previously attended any of the camps/conferences at the Hus School Encampment?
           Yes              No     If yes, please list the camp and the year. _____________________

    T-shirt size (sometimes required for art/craft activities)
    Youth sizes:     Medium       Large    Adult sizes:    Small      Medium           Large     Extra Lg

    I ( ) do, ( ) do not give my permission for my child’s contact information to be included in a camp roster
    that will go home with each camper.
    I ( ) do, ( ) do not give my permission for my child’s photo to be published on the Unity website, in the
    Brethren Journal, on a take home CD, camp scrapbook, etc.

    Parents’ signature _________________________________________ Date ____________

Please include a copy of the camper’s medical insurance card and the entire registration fee with this form.
                     Hus School Encampment Health and Medical Release Form

    Name of camper
    Date of Birth:                               Age:              Sex: Male             Female
    Name of parent or guardian
    Home Address
                                                          (city)            (state)     (zip)     (telephone number)
    Business Address
                                                  (city)           (state) (zip) (telephone number)
    Mother’s Cell _________________________________ Father’s Cell ______________________________

    If person named above is not available in the event of an emergency, notify:
    Name                                 Relationship                       Telephone
    Name                                 Relationship                       Telephone
    Name of personal physician                                              Telephone
    Personal health insurance carrier                                       Policy No.

    List medications to be taken during camp:
    List allergies to: Medications:
    List any physical or behavioral conditions that may affect or limit full participation in Hus School Encampment

    Immunizations:          (last year given)                      vaccinated      or   had disease
              Tetanus                            Mumps
              Diphtheria                         Rubella
              Polio                              Pertussis
                                                 Chicken Pox

    I give permission for full participation in the Hus School Encampment Program, subject to limitations noted herein
    including my child’s inclusion in a group conference photo and I grant my permission for the group photo to be posted
    on the Unity of the Brethren’s website. In case of emergency, I understand every effort will be made to contact me. In
    the event I cannot be reached, I hereby give my permission to the directors or other adult leaders of the Hus School
    Encampment to secure the services of a licensed physician to provide proper treatment, including hospitalization,
    anesthesia, surgery, or injections of medication for my child.

    Date                                 Signature of parent/guardian

Please include a copy of the camper’s medical insurance card and the entire registration fee with this form.

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