New Pics at www.xanga.com/kennethbuck

well, it has been quite a time here the first day an a half....  approxomatly half of our group has been sick and throwing up...  we think it is a 24 hour type, but we are waiting for tests to see....  I am in the club and I am expecting to begin to regain energy by tomorrow....  on a positive note, the other leaders have been great at stepping up and helping the sick and keeping the rest on task....

the speakers (I hear) are doing a great job and I will have more on that later....  but other than sickness, the camp seems to be going well...  two wonderful letter this year:  AC.   we have AC which is really nice as it has been unseasonably hot....

we don't have any pics for you yet, but i hope to by tomorrow.....  feel free to chackout the camp's blog at www.velocitycamp.org

you can also chack out my friend's site who isn't sick and is posting about the camp...

www.davekurt.com

BRING

• Bible, small notebook, pens
• Sleeping bag or sheets and pillow (twin sized)
• Small fan
• Alarm clock (one per room)
• Swim suite
• T shirts (10-12)
• Shorts (4-6)
• Proper Under Attire & Socks
• Toiletries

o       Tooth paste / brush

o       Deodorant

o       Soap / Shampoo

o       Towel

• Games
• Rain Coat
• Two pair of sneakers or comfortable active shoes
• Spending monies

 

DO NOT BRING

• Illegal items (alcohol, etc…)
• Pranking materials (shaving cream, water balloons, etc)
• Computers, Video game systems, or anything valuable
• Fireworks
• ENERGY DRINKS
• Bad Attitudes

________________________   Church Affiliation

Student Health Form

 

______________________________________Age _______ Sex ________ Birth date ________________

_{Last Name                              First Name                              MI}

 

______________________________________       ___________________________________________

_{Address                                                                                                                                 City                                                                       State                                  Zip}                    

 

______________________________________

_{Youth Leader}

 

Immunization Record:

_{Please indicate date of immunizations of the following}

 

Tetanus/Diphtheria:           Polio:                     Measles:                Rubella:                                Hepatitis B:

DPT/TD                                 OPV/IPV               

_________                           ________             ________             ________             ________

_________                           ________             ________             ________             ________

_________                           ________                                                                             ________

_________                           ________

_________

 

Health History:

_{Check if these apply to your child:}                                                                          Allergies

________Rheumatic Fever                                                                Aspirin ________

________Asthma                                                                                               Penicillin______

________Epilepsy                                                                              Other Drugs _________________________

________Diabetes                                                                              Foods ______________________________

________Behavior _{(please describe- e.g. nosebleeds, bedwetting, headaches, sleepwalking, etc.)}

 

______________________________________________________________________________________

 

Precautions to be observed: _______________________________________________________________

Operations or injuries: ___________________________________________________________________

 

Medications:

Drug                                                             Purpose                                                Dosage

__________                                            __________                                     __________

__________                                            __________                                     __________

__________                                            __________                                     __________

 

In the event my child should have minor complaints of uncomplicated/simple headache, stuffy nose, cough, or diarrhea, I give permission for the registered nurse to administer over the counter medications to help alleviate the symptoms.

 

Please initial one:

                                               

                  ________ Yes, I give permission for the nurse to administer over the counter medications.

                                               

                  ________ No, I do not give permission for the nurse to administer over the counter medications.

 

 

I hereby certify that the above health record is, as of this date, accurate and complete.

 

________________________________                                            __________________

_{Signature of Parent or Guardian                                                                                                                              Date Completed}      

Medical Release

 

We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care, to be rendered to the minor under the general or specific supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or medical center, whether such diagnosis or treatment is rendered at the office of said physician and said hospital or medical center.

                The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to this authorization.  Should it be necessary for our/my child to return home due to medical reasons or otherwise, the undersigned shall assume all transportation costs.

 

Participant Signature________________________________________________Date_________

Parent/Gaurdian Signature___________________________________________ Date_________

Phone Number____________________Birth Date__________________________Age________

Name of Parent(s) or Legal Gaurdians(s)_____________________________________________

Secondary Phone Number (in case of emergency)______________________________________

Insurance Company and Number ___________________________________________________

Please attach a photocopy of your current insurance card  (front and back)

 

Liability Agreement:

            In consideration for permission and support by Evangelical Youth Fellowship and all participating churches for me to participate in and receive accommodation for Velocity 2007, June 25-30, 2007, I, the undersigned, for myself, my heirs, executors, administrators and assigns do hereby release, hold harmless, indemnify, waive and discharge Evangelical Youth Fellowship and all participating churches, staff members, and their agents (whether paid or volunteer) from and against any and all claims, demands, actions, or causes of action arising from any injuries or damages I may suffer or sustain by my participation in Velocity 2007.  Furthermore, in full recognition and appreciation of the potential dangers and hazards inherent in travel to and participation in Velocity 2007, I do hereby agree to assume all the risks and responsibilities surrounding my participation in this activity or any other activities undertaken in addition thereto.  I authorize my child to participate in the following special activities:  _________Canoeing ________ Paintball ______ Camping _______ Golf _______ Hiking _______Swimming

           

Photo Release

 

            I certify that photographs or videotape pictures of my child participating in Evangelical Youth Fellowship programs may be reproduced and utilized in promotional materials for the conference.

 

The undersigned acknowledges having read and understood the foregoing informed consent form.  In witness whereof, I have caused this release to be executed this ________ day of ______________, 2007.

 

Participant’s Signature___________________________________________________________

Participant’s Printed Name________________________________________________________

Parent/Guardian Signature________________________________________________________

Address ______________________________________________________________________

Phone:  Work (    )___________________  Home (    )_________________________