Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial...

19
2018 Registration Package Presents...

Transcript of Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial...

Page 1: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

2018 Registration Package

Presents...

Page 2: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

South Suburban Christian Center

Camp R.O.C.K. Registration Form

2018

CAMPER INFORMATION

Camper’s Name_____________________________________________________________

last first middle Address________________________________________ Phone_____________________

street city zip Age_______ Birth Date _______________ Sex_______ Grade to Enter ______________

FAMILY INFORMATION

Father’s or Male Guardian’s Name ___________________________________________

Father’s/Male Guardian Email________________________________________________

Mother’s or Female Guardian’s Name _________________________________________

Mother’s/Female Guardian Email_____________________________________________

Emergency Contact:______________________________ Phone ____________________

Emergency Contact:______________________________ Phone ___________________

Page 3: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

South Suburban Christian Center

Camp R.O.C.K. Financial Agreement-2018

Ages 3-12 Years

I/we understand that the cost for the program is: First child - $400.00 1st session (4 weeks)

Second child - $375.00 1st session (4 weeks)

Third child - $350.00 1st session (4 weeks)

Fourth child - FREE (4 weeks)

5th week optional for 2nd session

My Child will be attending:

Session 1(June 4th through June 29th) Session 2 (July 2nd through August 3rd-5th week optional)

Sessions 1 & 2 (June 4th through August 3rd)

I/we will pay (check one):

1st Session Payment: Due by Monday, May 28th

2nd Session Payment: Due by Monday, June 25th

Both 1st & 2nd Session Payments- Paid in Full

Both 1st & 2nd Session Payments– Paid in Two Installments Due May 28th and June 25th

* If payment is made after the due date, a $50.00 late fee will be applied.*

Before & After Camp Care Program

Yes, my child will be attending the South Suburban Before & After Camp Care

Program and I have completed the B.A.C.C. Hours Sheet.

No, my child will not be attending the South Suburban Before & After Camp Care

Program.

I/we understand that the cost of B.A.C.C. depends on the number of children and times in

which I/we need the program. I/we also understand that if I pay for B.A.C.C. in advance of

each session, I will not be refunded that money regardless of how many times I use B.A.C.C.

Financial Agreement Continues on following page….

Page 4: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

Financial Agreement Continued:

I will need the program:

M T W T F Before: # of Children

6-9am: $110.00 Per Session/Per Child (up to 3 children; 4th child FREE) ______

7-9am: $75.00 Per Session/Per Child (up to 3 children; 4th child FREE) ______

8-9am: $50.00 Per Session/Per Child (up to 3 children; 4th child FREE) ______

After:

3-4pm: $50.00 Per Session/Per Child (up to 3 children; 4th child FREE) ______

3-5pm: $75.00 Per Session/Per Child (up to 3 children; 4th child FREE) ______

3-6pm: $110.00 Per Session/Per Child (up to 3 children; 4th child FREE) ______

I/we will pay (check one):

1st Session B.A.C.C. Payment: Due by Monday, May 28th

2nd Session B.A.C.C. Payment: Due by Monday, June 25th

Both 1st & 2nd Session B.A.C.C. Payments– Paid in Full

Both 1st & 2nd Session B.A.C.C. Payments– Paid in Two Installments Due May 28th

& June 25th

These figures are based on a 4-week session. If you choose the 5th week for the 2nd session, the payment will be

due on Friday, June 27th.

If your child is dropped off/picked up outside the time slot that was paid for, B.A.C.C. will be billed at $3.50 per

hour per child.

AGREEMENT

I/we have read & understand the fees associated with the Before & After Camp Care Program. I/we also agree to

meet the financial obligations as outlined above and will submit to program requirements.

Father’s Signature Mother’s Signature

______________________________________ _______________________________________

Date Date

Legal Guardian _______________________________________

Date

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South Suburban Christian Center

Camp R.O.C.K. Medical History-2018

IT IS MANDATORY that pupils who show symptoms of communicable diseases be excluded from classes until readmission

is acceptable to academy authorities. Your cooperation will be greatly appreciated. Thank you.

___________________________________________________________________________________________________

General Information:

Camper’s Name: ___________________________ Sex: _____ Birth Place: __________________ Birth Date: _______

Father’s Name: ____________________________ Occupation: _____________________Health: Good/Bad/ Deceased

Mother’s Name: ___________________________ Occupation: _____________________ Health: Good/Bad/Deceased

Doctor’s Name: ___________________________ Address: ________________________ Phone: __________________

Past Diseases: (If your child has had any of the following, state age when he/she had them)

Asthma ____________________Discharging of ears or infection _________________ Pneumonia ___________________

Chicken pox ___________________ Hay fever _________________________ Polio ______________________________

Convolutions __________________ Heart disease _______________________ Phenumatic cough ___________________

Diabetes ______________________ Measles ___________________________ Scarlet fever ________________________

Diphtheria _____________________ Mumps ___________________________ Whooping cough ____________________

Recent Disabilities: (Please check all that apply)

4 or more colds yearly ___________________Fainting spells ___________________Hearing difficulty _______________

Frequent sore throat _____________________Abdominal pain __________________Tires easily ____________________

Poor vision ____________________________Frequent urination ________________ Breathing shortness _____________

Frequent leg pain _______________________ Allergies ________________________ Hernia (rupture) _______________

Dizziness _____________________________ Persistent coughs __________________ Ringworm ___________________

Frequent sties __________________________ Speech impediment ________________ Nose bleeds __________________

Dental defects __________________________ Crippling conditions _______________ Growing pains ________________

Immunization Record:

Copy of yellow immunization card or other documents indicating immunization information requirements.

Has your child had a skin test for tuberculosis? ____________________________________________________________

Has he/she been associated with tuberculosis patients? _______________________ When? ________________________

Personal Record: (Please answer the following)

Is he/she shy? _________ Over active? ___________ Bites fingernails? ___________ Sucks thumb? __________

Has excessive fears? _______________ Temper tantrums? ___________________ Likes school? _________________

Plays well with others? ____________ Eats breakfast? _____________________ He/she bedtime? ________________

When is he/she rising time? ____________________________________________________________________________

Potty trained?_____________

Notes: (Please note any other information the camp should be made aware of) ________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

________________________________________________ _________________________________________________

Parent’s Signature Date Legal Guardian’s Signature Date

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Allergies Child’s Name: ______________________________________ Does he/she have any allergies? (check one) ______Yes ______No If Yes, what are your child’s allergies? ______________________________________________________________________________________________________________________________________________________________________________________________

Special Medical Conditions We Need To Know

________________________________________________________________________________________________________________________________________________________ _________________________ ___________ Parent/Guardian’s Signature Date

Allergy & Special Medical Conditions Sheet-2018

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South Suburban Christian Center

Camp R.O.C.K. Identification and Emergency Information-2018

General Information

Camper’s Name: __________________________ Sex: _____ Birth Place: __________ Birth Date: ______

Father’s Name: ________________________________________ Day Phone: ________________________

Home Address: ________________________________________ Phone Number: _____________________

Mother’s Name: _______________________________________ Day Phone: _________________________

Home Address: ________________________________________ Phone Number: _____________________

Legal Guardian: _______________________________________ Day Phone: _________________________

Emergency Contacts

Name Day Phone Relationship

1. _______________________________________________________________________________________

2. _______________________________________________________________________________________

Medical Information

Physician’s Name: _____________________________________________ Phone Number: _______________________

Insurance Carrier: _____________________________________ Medical Plan Number: __________________________

Dentist’s Name: _______________________________________________ Phone Number: _______________________

Insurance Carrier: _____________________________________ Medical Plan Number: __________________________

If physician or dentist cannot be reached, what action should be taken by the camp? ____________________________

___________________________________________________________________________________________________

Father’s Signature: ___________________________________________ Date: _______________________

Mother’s Signature: __________________________________________ Date: _______________________

Legal Guardian’s Signature: ____________________________________ Date: _______________________

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South Suburban Christian Center

Camp R.O.C.K. Consent to Treat a Minor-2018

I/we the undersigned parents/legal guardians of ______________________________________

do hereby authorize the staff of Camp R.O.C.K. to act as agents for the undersigned to receive

any emergency treatment from paramedics or EMTs or to receive any x-ray, examination, anes-

thetic, medical or surgical diagnosis and treatment, or hospital care which is deemed advisable,

and is to be rendered under the general or special supervision of any physician and/or surgeon

under the provisions of the Medical Practice Act or the medical staff of a licensed hospital,

whether such diagnosis or treatment is rendered at the office of said physician or said hospital.

It is understood that this authorization is given in advance of any specific diagnosis, treatment, or

hospital care being required but is given to provide authority and power on the part of my/our

aforesaid agents to give specific consent to any and all such diagnosis, treatment, or hospital care

which the aforementioned physician in the exercise of his best judgment may deem advisable.

It is understood that a valid and conscientious effort will be made to notify me/us before such

action is taken. If I cannot be reached within a reasonable period of time, as determined by the

staff, I hereby authorize the staff to make emergency medical decisions for my child.

I do for myself and for my child, heirs and assigns, hereby irrevocably and unconditionally re-

lease, acquit and forever discharge Camp R.O.C.K. and its agents, employees, and volunteers

from any and all liability, actions, causes of actions, claim, expenses, obligations and damages of

any nature whatsoever, which I now have or which may arise in the future, including, but not

limited to, any injury to my child or property, even an injury resulting in death.

Father’s (Guardian’s Signature) _________________________________ Date: ____________

Mother’s (Guardian’s Signature) ________________________________ Date: ____________

Please specify if allergic to any medication, food, etc. _________________________________

____________________________________________________________________________

____________________________________________________________________________

If there are any physical problems or any special instructions, please comment: ____________

_____________________________________________________________________________

_____________________________________________________________________________

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South Suburban Christian Center

Camp R.O.C.K. Athletic Consent and Release-2018

I, the undersigned parent (s) or guardian (s) of ___________________________________________________

Age _____________ hereby consent to the participation of my child in the activities connected with the Camp

R.O.C.K. program. I certify that my child is able to participate in all of these activities. If my child has medical

conditions which may be relevant to a physician in the event of an emergency they have been listed below. In

the event that an emergency occurs, I may be reached at the telephone listed below. If I cannot be reached

within a reasonable period of time, as determined by the staff, I hereby authorize the staff to make emergency

medical decisions for my child. If there are any activities that I do not want my child to be involved in, I have

listed them below.

I understand and hereby agree to assume all of the risks which may be encountered in said activities, including

activities preliminary and subsequent thereto. I do, for myself and for my child, heirs and assigns, hereby irrevo-

cably and unconditionally release, acquit and forever discharge Camp R.O.C.K., and its agents, employees, and

volunteers from any and all liability, actions, causes of actions, claims, expenses, obligations and damages of any

nature whatsoever, which I now have or which may arise in the future, in connection with my child’s participa-

tion in the described activity or any other associated activities including, but not limited to, any injury to my

child or property, even an injury resulting in death.

I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as per-

mitted by the law of the State of Illinois and that if any portion hereof is held invalid, it is agreed that the bal-

ance shall, not withstanding, continue in full legal force and effect. This release contains the entire agreement

between the parties hereto. It is understood that as a part of Camp R.O.C.K. I agree to abide by our deeply held

spiritual belief that all Christians are prohibited from bringing civil lawsuits against other Christians or the

Church to resolve personal disputes. We do believe, however, that a Christian may seek compensation for inju-

ries from another Christian’s insurance company as long as the claim is pursued without malice or slander. (I

Corinthians 6:1-8, Ephesians 4:30-32) Camp R.O.C.K. accepts the Biblical formula for conflict resolution as

found in Matthew 18:15-17.

I further state that I HAVE CAREFULLY READ AND UNDERSTAND THE FOREGOING RELEASE AND

KNOW THE CONTENTS HEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. I understand

that this is a legally binding agreement.

Consent and Release Form for Athletic Activities

Telephone number where I can be reached in an emergency: ________________________________________

Medical conditions to be aware of and physical restrictions: ________________________________________

_________________________________________________________________________________________

Instructions and medications: Date of last tetanus or booster: _______________________________________

_________________________________________________________________________________________

I do not wish my child to participate in the following: _____________________________________________

________________________________________________ ________________________________________

Parent/Guardian Signature Date

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South Suburban Christian Center

Camp R.O.C.K. Release, Waiver, and Indemnity Agreement-2018

I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as per-

mitted by the law of the State of Illinois and that if any portion hereof is held invalid, it is agreed that the bal-

ance shall, not withstanding, continue in full legal force and effect. This release contains the entire agreement

between the parties hereto. It is understood that as a part of Camp R.O.C.K. I agree to abide by our deeply held

spiritual belief that all Christians are prohibited from bringing civil lawsuits against other Christians or the

Church to resolve personal disputes. We do believe, however, that a Christian may seek compensation for inju-

ries from another Christian’s insurance company as long as the claim is pursued without malice or slander. (I

Corinthians 6:1-8, Ephesians 4:30-32) South Suburban Christian Center accepts the Biblical formula for conflict

resolution as found in Matthew 18:15-17.

I further state that I HAVE CAREFULLY READ AND UNDERSTAND THE FOREGOING RELEASE AND

KNOW THE CONTENTS HEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. I understand

that this is a legally binding agreement.

________________________________________________ ________________________________________

Parent/Guardian Signature Date

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South Suburban Christian Center

Camp R.O.C.K. Authorization For Off-Campus Activities-2018

Name of Camper: _____________________________________ Date: _________________

Address: ____________________________________________ Phone: ________________

I consent to have my child participate in field trips away from camp. I also authorize Camp

R.O.C.K. to call an emergency ambulance in case of accident or acute illness and to arrange

for all necessary emergency medical care in case I am not immediately available. Any quali-

fied physician, called by Camp R.O.C.K. staff, may treat and do whatever is necessary for the

good health and well being of my child.

I also agree to accept all financial responsibility for medical care.

Physician’s Name: _________________________________ Phone: ___________________

Address: ___________________________________________________________________

Father’s Name: ________________________________ Day Phone: ___________________

Employed By: ______________________________________________________________

Mother’s Name: _______________________________ Day Phone: ___________________

Employed By: _______________________________________________________________

Relative or Neighbor: ___________________________ Day Phone: ___________________

This form must have the parent’s or guardian’s signature. Please indicate if your child is in the

custody of one parent ____________ both parents ____________ guardian ___________

Father: ___________________________________________ Date: ___________________

Mother: __________________________________________ Date: ___________________

Legal Guardian: ____________________________________ Date: ___________________

Insurance Carrier: ___________________________ Policy Number: __________________

Page 12: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

Dear Parent,

Permission for Publication of Camper’s Photograph/Work-2018

South Suburban Christian Center and Camp R.O.C.K. maintain websites on the world wide web,

www.sschristiancenter.com and www.camprockonline.com. These sites are a means for communicating information and ad-

vertising our church and camp. I understand that from time to time South Suburban Christian Center may wish to publish

examples of camper projects, photographs of campers, and other work on its websites or in local newspapers. The newspaper

and websites are a chance for the campers to have their work published and shared worldwide. This is a great way for out of

town relatives and friends to keep in touch with the events at South Suburban Christian Center & Camp R.O.C.K. and have

means to view and enjoy camper work.

All camper pictures on the website will be anonymous unless expressed written consent is provided by the parent.

Camper work may be identified by name. At times, pictures and names of campers may appear in the newspaper or on televi-

sion for a promotional event.

Please check ONE IN EACH SET OF TWO that apply.

__________Permission is granted for my child’s photograph and work to be published on the Internet at SSCC’s web site,

www.sschristiancenter.com and Camp R.O.C.K.’s website, www.camprockonline.com. No names will be identified with

camper pictures unless expressed written consent is provided by a parent or guardian.

__________I would prefer that my child’s photograph and work not to be published on the Internet.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

__________Permission is granted for my child’s photograph and/or work, along with his or her name to be published in the

newspaper or presented in a television promotion.

__________I would prefer that my child’s photograph and/or work not be published in the newspaper or presented in a tele-

vision promotion.

Camper Name: _________________________________________ Grade: _____________ (Please Print)

Parent Name: _____________________________________________________________ (Please Print)

Parent Signature: __________________________________________________________

Page 13: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

South Suburban Christian Center

Camp R.O.C.K. Standard of Conduct-2018

General Policy:

Campers are expected to abide by these standards of conduct throughout their enrollment

whether at home, church, or elsewhere. Campers found to be out of harmony with the camp’s

ideals of work and life may be invited to withdraw whenever the administration determines it is

necessary.

As a camper I pledge to uphold this camp’s standards against cheating, swearing, smoking,

gambling, drinking alcoholic beverages, using or talking favorably about narcotics, or using

indecent language, and will act in a very orderly and respectful manner. I will maintain Chris-

tian standards in courtesy, kindness, morality, and honesty. I will strive to be of unquestionable

character in dress, and other areas of life.

I agree to abide by the above standards of conduct and other regulations expected of each

camper enrolled in the Christian education program while I am a camper attending this camp

and will not give the impression to campers, parents, or faculty that I am not in harmony with

the goals, aims and standards of the camp.

I understand that if my child is removed from Camp R.O.C.K. for behavioral issues, I will not

receive a refund.

_________________________________________________ _________________________

Camper’s Signature Date

_________________________________________________ _________________________

Parent’s/Guardian’s Signature Date

Page 14: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

The following people have permission to pick up/drop off my child(ren) to/from Camp R.O.C.K.

Name______________________________________ Relationship__Father__________________________ Name______________________________________ Relationship___Mother________________________ Name______________________________________ Relationship_________________________________ Name______________________________________ Relationship_________________________________ Name______________________________________ Relationship_________________________________ Name______________________________________ Relationship_________________________________ Name______________________________________ Relationship_________________________________ _______________________________ ___________ Parent/Guardian Signature Date Note: If at any time you need to make changes to this list, please call the church office at 708.748.0327

Please Note: When each person comes to pick up our child(ren), they must present a picture ID

for security purposes.

Pick Up - Drop Off Form

2018

Page 15: Camp ROCK Registration Packet 2018 · Camp R.O.C.K. South Suburban Christian Center Financial Agreement-2018 Ages 3-12 Years I/we understand that the cost for the program is: First

Mediation and Binding Arbitration Agreement Between South Suburban Christian

Center (which includes the ministry of Camp ROCK) and parents, legal guardians,

and family members of campers enrolled at South Suburban Christian Center/Camp

ROCK

The parties to this agreement agree to attempt to resolve differences or conflicts by following the

Matthew 18 principle, the biblical pattern of addressing the conflict in private with a coworker, or the

administration, consistent with Matthew 18:15. Should the issue remain unresolved, the parties

agree to be bound by the following mediation and binding arbitration agreement in an attempt to

resolve these issues and bring reconciliation.

The parties to this agreement are Christians and believe that the Bible commands them to make

every effort to live at peace and to resolve disputes with each other in private or within the Christian

community in conformity with the biblical injunctions of 1 Corinthians 6:1–8, Matthew 5:23–24, and

Matthew 18:15–20. Therefore, the parties agree that any claim or dispute arising out of, or related

to, this agreement or to any aspect of the employment relationship, including claims under federal,

state, and local statutory or common law, the law of contract, and law of tort, shall be settled by

biblically based mediation. If resolution of the dispute and reconciliation do not result from media-

tion, the matter shall then be submitted to an independent and objective arbitrator for binding arbi-

tration.

The parties agree for the arbitration process to be conducted in accordance with “Rules of Proce-

dure for Christian Conciliation” (“Rules”) contained in the Peacemaker Ministries booklet, Guide-

lines for Christian Conciliation. Consistent with these “Rules,” each party to the agreement shall

agree to the selection of the arbitrator. The parties agree that if there is an impasse in the selection

of the arbitrator, the Institute for Conciliation, a division of Peacemaker Ministries of Billings, Mon-

tana (406-256-1583), shall be asked to provide the name of a qualified person who will serve in that

capacity. Consistent with the “Rules,” the arbitrator shall issue a written opinion within a reasonable

time.

The parties acknowledge that the resolving of conflicts requires time and financial resources. In an

effort to fully encourage and implement a biblically faithful process, SSCC agrees to pay all fees

and expenses, which may be required by the mediator, case administrator, and/or arbitrator related

to such proceeding. The issue of final responsibility for such costs will be an agreed issue for con-

sideration or determination in the mediation or arbitration. The parties agree that they will endeavor

to exchange information with each other and present the same at any mediation or arbitration pur-

suant to the ICC Rules of Procedure with the

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Mediation and Binding Arbitration Agreement Between South Suburban Christian

Center (which includes the ministry of Camp ROCK) and parents, legal guardians,

and family members of campers enrolled at South Suburban Christian Center/Camp

ROCK (continued)

intent to minimize costs and delays to the parties. They will seek to cooperate with one another and

may request the mediator, case administrator, and/or arbitrator to direct and guide the preparation

process so as to reasonably limit the amount of fact-finding, investigation, and discovery by the

parties to that which is reasonably necessary for the parties to understand each other’s issues and

positions, and to prepare the matter for submission to the mediator and/or arbitrator to inform the

mediator and/or arbitrator. In addition, the parties agree that in the event of arbitration, they will use

a single arbitrator who is experienced in the relevant area of law and familiar with biblical principles

of resolving conflict.

The parties to this contract agree that these methods shall be the sole remedy for any controversy

or claim arising out of their parent/school/camper relationship or this agreement and expressly

waive their right to file a lawsuit against one another in any civil court for such disputes, including

any class action proceeding, except to enforce a legally binding arbitration decision. The parties

acknowledge that by waiving their legal rights to file a lawsuit to resolve any dispute between them,

they are not waiving their right to employ legal counsel at their own expense to assist them in any

phase of the process.

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Mediation and Binding Arbitration Agreement Between South Suburban Christian

Center (which includes the ministry of Camp ROCK) and parents, legal guardians,

and family members of campers enrolled at South Suburban Christian Center/Camp

ROCK (continued)

I agree that if any provision of this agreement is declared invalid, illegal, or unenforceable, its invalidity

or unenforceability shall not affect any other provision of this agreement.

**********************************************************************************************************************

I acknowledge that I have read, understand, and will abide by the terms and conditions of this contract,

and I agree that it represents the total agreement between the parties.

_____________________________________________________________________________

Parent(‘s) signature(s) Date

_____________________________________________________________________________

Legal Guardian(‘s) signature(s) Date

_____________________________________________________________________________

Head of Camp ROCK signature Date

_____________________________________________________________________________

Senior Pastor signature Date

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South Suburban Christian Center

Camp R.O.C.K.

Camper-Parent Technology Agreement

2018

I, ________________________, (camper name) understand that the computers at South Suburban Christian Cen-

ter are for educational purposes. This agreement is for the protection of campers and for the security of South Sub-

urban Christian Center equipment.

I understand that abuse or unauthorized use of South Suburban Christian Center computers shall result in discipli-

nary measures including: loss of computer privilege, financial compensation, detention, parental correction, sus-

pension, or expulsion from camp. In addition, any activity that violates state or federal law shall be turned over to

the appropriate law enforcement agency. While using South Suburban Christian Center computers,

1. Campers shall not give out any personal, family, or school information such as: name, address, phone num-

ber, e-mail, or other such information.

2. Campers shall not load any software, from CD, media disks or floppy disks, external data storage devise

(thumb drive or PDA) or Internet downloads. Any program installation must be done by an authorized staff mem-

ber.

3. Campers shall not attempt to access server or other workstations.

4. Campers shall not attempt to access the Internet unless they have an “Internet Pass” from their teacher. Inter-

net Passes must be returned to the teacher when Campers have completed the approved activity or at the end of the

day, whichever comes first. The exception to this is Internet sites embedded in the SOS curriculum which has

been pre-approved; however campers may not “surf” the Internet outside of these pre-approved links.

5. Campers shall not be permitted to sign up for Internet accounts, messaging, e-mail, purchases/orders, or other

services on South Suburban Christian Center computers.

6. Campers are not permitted to use South Suburban Christian Center computers to, send, receive, or read e-

mail. Cell phones or PDA’s are not allowed in the classroom or computer lab.

Campers shall not be permitted to play games over the Internet unless site has been approved by teacher and they

have a pass to be on privilege status.

Camper and Parent(s) agree to hold South Suburban Christian Center blameless for camper Internet activity. Any

violation of this agreement shall be taken seriously.

_____________________________ ____________

Camper’s Signature Date

_____________________________ ____________

Parent/Guardian’s Signature Date

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South Suburban Christian Center

Camp R.O.C.K. Ages 3-12 Years

Registration Checklist

Camper’s Name: _________________________________

______ Registration Form

______ Financial Agreement

______ Medical History

______ Immunization Record

______ Allergy Sheet

______ Identification and Emergency Information

______ Consent to Treat a Minor

______ Athletic Consent and Release

______ Release, Waiver & Indemnity Agreement

______ Authorization For Off-Campus Activities

______ Permission for Publication of Camper’s Photograph/Work

______ Standard of Conduct

______ Pick Up, Drop Off Form

______ Mediation and Binding Arbitration Agreement

______ Camper-Parent Technology Agreement