Camp Brosend

Rules for Camp LifeIt is our desire that Camp Brosend maintain anatmosphere where each camper has the opportunity to acceptChrist as his/her personal Savior; to have fun; and to learnand grow spiritually, physically, and mentally. Campers andstaff are expected to conduct themselves in a manner thatencourages these objectives:1. Campers and staff members will be under the directsupervision of the program assistant and are expected toabide by the schedule unless excused.2. Every person is expected to conduct himself in aChristian manner at all times.3. Campers and staff members can only leave the campwith the program assistant’s permission. Leaving the campgrounds without written permission warrants immediatedismissal from the camp.4. The possession and use of tobacco, alcohol, illegaldrugs, weapons, or fireworks in any form are prohibited on thecamp grounds.5. Sickness or injury must be reported to the camp nurseimmediately. All medications are to be turned in to the campnurse in their original containers with their original prescriptionupon arrival (including Tylenol, Ibuprofen, etc.).6. Radios, cell phones, beepers, mp3 players/iPods, CDplayers, TVs, video games, pets, shaving cream, silly string,super soakers/water cannons, candy, and gum are to be leftat home.7. Public display of affection is discouraged. Hand-holdingis permitted.8. Clothing: Modesty and decency must prevail. Shortsshall approach the knee in length. Bare midriffs, spaghettistraps, or revealing clothing is prohibited. One pieceswimsuits (no cut-outs) or two-piece (no bare midriff) areto be worn with cover-ups to and from the swimmingarea. Shirts and shoes must be worn at all times whileoutside the cabins.9. The telephone may only be used with the programassistant’s permission.10. Campers are permitted near the lake or in the woods onlywith counselor supervision.11. Campers and their parents/guardians will be heldresponsible for any unnecessary damage to camp property.Destruction of camp property warrants immediate dismissalfrom the camp.12. All campers and staff members will wear a PFD (lifejacket) while boating. All campers in 2nd grade or lower willwear a PFD while swimming.Check In & Check OutCheck In:• Parents will sign in each camper at drop off in the DayCamp program room on a daily basis.• Drive back to the gate the way you came in instead ofdriving all the way around the circle. This pattern willbe safer for all of our campers.Check Out:• Our staff will check your photo ID against theauthorized pick up list.• Sign out the camper on a daily basis.• Please notify us if you will be picking up your childearly so we can be prepared.Please Note: Leaving the camp grounds without writtenpermission warrants immediate dismissal from the camp.Credit/Debit Card PaymentsIf you intend to make payments by credit/debit card,please include all your card information on your signedregistration form. Deposit fees will be charged immediatelyand the balance of the camp fee will be charged onMonday of each week your child is registered to attend. Topay your deposit online visit our website, click on SummerCamps, choose Day Camp, and click Register. Onlydeposit payments will be available online. Please note, inorder to complete the registration process a signedregistration form must be submitted to the office.Financial AssistanceFinancial assistance is available for campers whosefamily qualifies for free or reduced lunch. Assistance isgenerally 25% of fees.Please contact the camp office for a Program FeeAssistance Form to determine qualification and amount ofassistance. Assistance form should be returned withregistration form to the camp office.Anyone not willing to abide by these ruleswill be asked to leave the camp.Camp Brosend – 7599 Brosend Rd – Newburgh IN 47630 – 812.853.3466info@campbrosend.org – www.campbrosend.org

Trading PostCampers can purchase items at the Trading post onTuesdays and Thursdays.Campers will place their spending money in the “Bank”in the morning upon arrival. Any change will be returnedback on their last day of camp for the summer.Recycling Credit: Bring a full plastic grocery bag of rinsed,squashed, aluminum cans and receive a $2.00 TradingPost credit (max. 1 bag/camper/5 weeks).Things to BringClothing:• Appropriate clothing, beach towel, & swimsuit w/coverup (see #8 under Rules for Camp Life)• Shoes—tennis shoes for recreation and extra shoesfor water games and walking to/from swimmingFood:• Sack lunch and drink (refrigeration provided)Other:• Water bottle—these are also available from the tradingpost.• Spray sunscreen—our staff will only apply spraysunscreen on your child.• Medications in original containers for nurse• Spending money for the trading post (Tuesdays andThursdays—money will be banked)Please be sure to label ALL items withcamper’s first and last name.Please leave the following items at home: toys, electronicdevices, gum, candy, or inappropriate clothing (see #4, 7,& 8 under Rules for Camp Life).Payment PolicyPayment is due in full at the first drop off of each newweek of camp. Any payments made after the first pick upof the week will be assessed a $10 late fee per child. Allchecks should be made payable to Camp Brosend. Youare responsible for payment in full for all sessionsregistered.In order to change, cancel, or alter the number ofdays in a week for one or more weeks of camp, we requirethat a written notice be submitted to the camp office atleast 2 weeks prior to the session for which you areregistered. Failure to submit this notice at least 2 weeksprior will result in you being billed for the full program fee ofthe week for which you were registered.Trading Post Items*Soft Drink, Water, & Icees $.50Snacks $.50Fruit snacks & Twizzlers $.50Klondike $.75Candy Bars $1.00Frisbee $2.50Water Bottle $3.00Sunglasses $3.00Notebooks $4.00Hat $5.00Lanyard $5.00Backpack $8.00Stuffed Animal $8.00Mini LED Flashlight $8.00T-shirts (add $1for XXL) $11.00Blankets $15.00Hoodies $24.00*Prices subject to change.Summer Camp Bunk NotesWant to send your camper a letter while he/she is atcamp? Click the “photos & email” link on our web site tosee how to email your camper. Send all emails prior to9:00 a.m. on the last day of each camp.Create an encouraging message for your camperusing the guidelines for preventing homesickness listedabove.Emails may / will be screened for the child’s safety.There is a fee for sending Bunk Notes emails. Check thelink for prices.You will use your same username and login from theregistration link.Summer Camp PhotosWant to see what is going on at camp? Want to take astroll down memory lane after camp? Click the “photos &email” link on our web site to see our camp gallery ofphotos. You will use your same username and login fromthe registration link. Viewing photos is free.Camp Brosend – 7599 Brosend Rd – Newburgh IN 47630 – 812.853.3466info@campbrosend.org – www.campbrosend.org

T-Shirt Pre-Order FormSize availability will only be guaranteed for orders received by 4/30/13. Return to Camp Brosend, 7599 BrosendRoad, Newburgh IN 47630 with check made payable to Camp Brosend. Prices include sales tax. Pleaseindicate shirt size quantity in the table below. *limited quantities – 1 st come, 1 st serveCamper’s Name______________________________ Total______________First Week to attend Day Camp – Wk #__________New 2013 KiwiFree T-shirt provided for each day camper by our sponsors!Youth S Youth M Youth L S M L XL XXL2010 Metro Blue N/A *$9 $9 *$9 *$9 $9 *$9 *$102011 Military N/A $9 N/A $9 $9 $9 *$9 *$10Green2012 Orange $10 $10 $10 $10 $10 *$10 $10 $11Red Hoodies N/A N/A N/A *$24 *$24 N/A N/A N/ACamp Brosend7599 Brosend RdNewburgh IN 47630-2881ADDRESS SERVICE REQUESTEDNon-ProfitOrgUS PostagePAIDNewburgh INPermit 3Gaige Barrettc/o Dale & Becky Barrett8333 Yorkridge DrNewburgh IN 47630-2712Counselor-in-Training (CIT)If you are age 13 - 20, you can be a CIT andhelp at day camp this summer!Learn valuable skills including leadership,counseling, and teamwork. You will also help in avariety of support areas of the camp which are allneeded in order to make a complete camp program.For more information or a staff application,please contact the camp office at 812-853-3466 orinfo@campbrosend.org.Day Camp ActivitiesCampers will enjoy a fun-filled week of age appropriateprogramming including:• archery, swimming, boating• tetherball, basketball, kickball, soccer, volleyball,whiffle ball• Bible lessons, singing, memory verses• miniature golf, inflatable water slide, obstacle course,and moon bounce• nature activities, outdoor living skills• crafts, trading post/free time• fantastic group gamesPlease note activities will vary weekly. All the aboveactivities may not be offered in any one given week.Camp Brosend – 7599 Brosend Rd – Newburgh IN 47630 – 812.853.3466info@campbrosend.org – www.campbrosend.org

How to Register for Day Camp:Step 1 – Detach Registration Form from “Camper Health-Care Recommendations by Licensed MedicalPersonnel Form 2”.Step 2 – Submit your completed Registration Form with the weeks/days marked that you intend for your childto attend Day Camp. (You may register for additional weeks at a later date if space continues to be available.)Submission Options:1. Mail to the camp2. Scan and e-mail to info@campbrosend.org3. Fax to 812-853-3466 (call first)Step 3 – Submit your $15 per week, per child deposit OR the total weekly camp fee for the week(s) you areregistering for.Payment Options:1. Mail a check with your Registration Form2. Include your credit card information on the registration form.3. Pay online at www.campbrosend.orgStep 4 –Have your health care provider complete the “Camper Health-Care Recommendations by LicensedMedical Personnel Form 2” and then return it to Camp Brosend by the first day of the camp session.**Admission to camp will be denied without this current health record.**Your registration is not complete until we have received bothpayment and registration form at Camp Brosend.Don’t Forget! Register three weeks prior to the week of camp you choose to attend and get a$10/week discount off your Day Camp fee!Example: For Week #1, register by Monday, May 6th to guarantee your $10 discount.Camp Brosend, 7599 Brosend Rd, Newburgh IN 47630-2881812-853-3466 info@campbrosend.org www.campbrosend.org

Camp Camp Brosend’s Brosend’s 20072013 Day Day Camp Camp Registration FormReturn completed form along with deposit (non-refundable/non-transferable) $15/wkReturn to: Camp Brosend, 7599 Camp Brosend Rd, Newburgh IN 47630 812-853-3466Indicate with a X which weeks to enroll this camper: __1-2 days __ 3 days __4-5 days __M __T __W __R __F__ #1 5/28/13– 5/31/13 (no camp 5/27) __ #4 6/17/13 – 6/21/13 __ #7 7/8/13 – 7/12/13 __ #10 7/29/13 – 8/2/13__ #2 6/3/13 - 6/7/13 __ #5 6/24/13 – 6/28/13 __ #8 7/15/13 – 7/19/13 __ #11 8/5/13 – 8/9/13__ #3 6/10/13 – 6/14/13 __ #6 7/1/13 – 7/5/13 (no camp 7/4) __ #9 7/22/13 – 7/26/13Please type or print the following information:Camper’s Name________________________________________Boy_____Girl_____Age_____Birth Date___________Home Address_______________________________________________________Grade in fall 2013________________City_____________________________State______ZIP_____________Home Phone_____________________________Spring 2013 School_________________________________________School Corporation_________________________Camper’s T-shirt Size (circle one): Youth S Youth M Youth L Adult S Adult MMother’s Name__________________________________Cellular__________________Work Phone________________Father’s Name__________________________________Cellular__________________Work Phone_________________Parents’ Email Address______________________________@_______________________________________________Church Name__________________________________Pastor's Name___________________Church Phone___________Parents who live separately can use this line to provide the information for (circle): Mother FatherAddress_________________________________________________________Preferred Phone__________________The Emergency Contact should be someone other than a parent in case they cannot be reached.Emergency Contact Name______________________________Relationship______________Phone_________________Authorized people to pick up my child (ID required)__________________________________________________________________________________________________________________________________________________________If parents are divorced, who is custodial parent____________________________________________________________Person responsible for payment________________________________________________________________________Payment Information: ____ weeks X $15 deposit per week = $________Cash__ Check #____ Visa__ MC__ Disc__For Credit Card Payments: ____ Deposit Only ____Deposit & Weekly Fee (Monday of each week)__/__ ECf __/__ LCf __sig__ EC __$ __CHCR __ImCard # ______-______-______-______ Exp Date ____/____ Cardholders’ Signature____________________________Further Comments (use extra paper if needed)_______________________________________________________________________________________________________________________________________________________________As the parent or legal guardian of the above child and by signing this form:Please initial each line• I hereby consent for my child to attend and participate in all activities provided by Camp Brosend. ________• I certify the accuracy of all statements and the information provided on this form. ________• I give my permission to provide routine health care, dispense medications, and seek emergency medical treatment for the camper. ________• I understand that I am financially responsible for any expenses incurred through emergency medical treatment given to this camper. ________• I give my permission for my child to be photographed for publicity purposes and optional photo purchasing. ________• I understand that payment is due in full upon drop off on the first visit of each week of camp and that payments made after this time mustinclude a $10 late fee per child. I understand that I am responsible for payment in full for all sessions registered.________• I understand that in order to change, cancel, or alter the number of days in a week for one or more weeks of camp, written notice must besubmitted to the camp office at least 2 weeks prior to the session. If I fail to submit this notice within 2 weeks prior, I understand that I will bebilled for the full program fee for the week.________MUST BE SIGNED BY PARENT OR LEGAL GUARDIANParent/Guardian Signature____________________________Printed Name________________________Date___/___/13Required Health Info on Reverse Side

Camper’s Name ______________________________________________Staff Use Only: Health Screen IntakeTp ____ Ob ____ HH ____ Md ____Please return a completed “Camper Health-Care Recommendations by Licensed Medical Personnel Form 2”.Admission to camp will be denied without this current health record.Family Doctor__________________________________________________Phone_______________________________Medical Insurance Carrier_________________________________________________ID No.______________________Member's Name______________________________Other Info:______________________________________________Known Drug Allergies_______________________________________________________________________________Other Allergies_____________________________________________________________________________________Current physical, mental, or psychological conditions requiring medication, treatment, or special restrictions orconsiderations while at camp (e.g. asthma, diabetes, ADHD)___________________________________________________________________________________________________________________________________________________Immunization Record: Date of Last Tetanus Shot/Booster__________ Polio _______MMR _______ Hep B _______Hospital Preferred (circle one) Deaconess St Mary’sAny camp activities which camper should be exempted for health reasons ________________________________________________________________________________________________________________________________________Recent major medical treatment (past 6 months) _____________________________________________________________________________________________________________________________________________________________If this camper has had a significant life event that continues to affect his/her life (death of a loved one, family change,adoption, new sibling, survived a disaster, etc.), please provide written information about the event, its impact upon yourchild’s life, and care tips for your child’s camp counseling staff on a separate sheet of paper.Current Medications Dosage Dosage Time(s)___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________StateLawALL medications (including over the counter drugs such as Aspirin/Tylenol)are to be given to the camp nurse in their original container when registering.I (parent/guardian), hereby give permission for Camp Brosend to administer the following over-the-counter medications ifthe nurse deems it necessary. Dosages will be administered according to directions on the bottle unless a physician directsotherwise (please initial all that apply).____ Acetaminophen or Ibuprofen (as needed for headache,____ Emetrol for upset stomachfever, cramps, muscle aches/pains)____ Anti-diarrheal for diarrhea as directed____ Cough syrup as directed for cough____ Calamine lotion or similar topical preparation for poison oak or ivy____ Antihistamine or decongestant as needed for itching or allergy reliefMUST BE SIGNED BY PARENT OR LEGAL GUARDIANParent/Guardian Signature____________________________Printed Name________________________Date___/___/13Camp Brosend, 7599 Brosend Rd, Newburgh IN 47630-2881812-853-3466 info@campbrosend.org www.campbrosend.org

Camp Brosend, 7599 Brosend Rd, Newburgh IN 47630-2881812-853-3466 info@campbrosend.org www.campbrosend.org