SUMMER DAY CAMP Registration Packet

“Adventure Today Success Tomorrow”

Return your completed forms in one of the following ways:

Mail to Camp Navigate, P.O. Box 3687, Terre Haute, IN. 47803 Drop off at The Life Center, 3000 College Ave, Terre Haute, Tues., Thurs., Fri 11:30 am—4:30pm Wed. 11:30 am—2 pm

Welcome!

And thank you for choosing Camp Navigate! We have included a brief overview of our mission and purpose to introduce

ourselves. Once your registration is received you will be able to go on-line and access a detailed parent packet. We are

excited for the arrival of summer and are looking forward to meeting you and your child! Our summer will be full of

adventure and fun as we add to their current STEM skills as well as learn some new skills along the way.

There will be swimming (at the new Aquatics Center), games (that your child invents), healthy meals and snacks (maybe

even some from your child’s garden), dining out and plenty of field trips, too!

Who are we? We are a management staff with over 50 years of combined youth experience that have joined forces

with a volunteer committee of some of the community’s most successful and committed educators and

businessmen/women to develop a Summer Day Camp with a Purpose

CAMP NAVIGATE MISSION STATEMENT Connecting students with Employability Skills and Traditional Values to ensure their successful futures.

Camp Navigate will offer a high quality and engaging summer camp for children pre-K to 8th grade. We are focused on

developing Employability/Soft skills, promoting healthy habits and creating servant leaders. Our curriculum has been

shaped around research conducted nationally and at the state level, which shows that soft skill training needs to be done

not just within the adult workforce, but also during the earlier years. The vision of Camp Navigate is that all young people

in the Wabash Valley have access to this opportunity to apply their academic skills and acquire new competencies that their

future employers will desire, supporting their year-round learning and well-being.

CAMP NAVIGATE DATES AND HOURS June 5th through August 4th, Monday through Friday. 6:30 am to 6 pm.

CAMP NAVIGATE LOCATIONS DeVaney Elem. School, 1011 S. Brown Ave. and The Life Center, 3000 College Ave., Terre Haute

CAMP NAVIGATE REGISTRATION Visit us a www.campnavigate.org to get registration information. Registration forms also available at Baesler’ Market,

Open Door Bookstore, Vigo County Library (Main Branch), Tribune Star, The Life Center 3000 College Ave., Terre Haute.

CAMP NAVIGATE CONTACT INFO For any additional questions please contact us at any time.

You may reach us by phone at 812-201-4862 or 812-232-3781 or email us at info@campnavigate.org.

Go to our Facebook page at Camp Navigate for up to date information.

Camp Navigate’s Three Focus Areas

Employability Skills

Workforce leaders have long been describing a gap in competencies among recent graduates revolving around soft skills –

or – employability skills. These desirable qualities that are said to be lacking apply across a variety of jobs and life situations

and are crucial in preparation for college and career success. More often than not, they are developed at an earlier age in

life. Camp Navigate offers an opportunity for young people to develop, not only employability skills, but also desirable

life skills through socialization, by learning the values, attitudes, and actions of others while building relationships with

them. We are committed to helping young people develop the ability to effectively communicate and to think critically and

creatively while collaborating with others. Our campers will also enjoy fun activities that will encourage such employability

skills as entrepreneurship, project management, and how to handle emotional setbacks, which will in turn help them to

later transition successfully from the early years of learning to high school to college or a career.

Healthy Habits Sure, eating well can be challenging — family schedules are hectic and convenient, pre-packaged food is often more

appealing. But at Camp Navigate, we reinforce healthy habits in the hopes that your child will develop the ability to make

healthy choices for the rest of their life and throughout their careers. Maintaining healthy habits enables one to lead a life

with less stress and a positive attitude – which is beneficial personally and professionally. Employees who know how to set

fitness goals and stay motivated to exercise are typically goal-oriented and focused individuals. Additionally, healthy and fit

employees also tend to have higher levels of self-confidence and are more likely to inspire confidence in others around

them.

Servant Leadership

Servant-leaders display a genuine desire to serve others for the common good and collective human development. Camp

Navigate believes in offering leadership training with Christian principles, because we believe this approach to leadership

is powerful and impactful. A servant leader chooses to serve others, regardless of seniority, race, ethnicity, socioeconomic

status or faith. As a result, servant leaders have the capacity to transform and effectively bring about change within not just

individual followers, but also within entire organizations.

ABOUT US

Eleanor Ramseier – Camp Navigate Director

Eleanor has been serving youth in the Wabash Valley for 25+ years. She

began volunteering as a youth worker alongside her husband in 1990. In

the most recent past, as Executive Director of the local Y, she helped

develop and oversee the youth activities as well as the summer camps.

She is the mother of three awesome adult children. She has always had a

desire to encourage youth to find their passion, set goals and be strong in

their faith! With Camp Navigate she can now combine these passions

with another aspiration she has– developing youth to succeed in our

community’s workforce! She loves spending time with family and friends;

running, hiking, and anything adventurous.

What excites you most about Camp Navigate? “That this community has overwhelmingly embraced the philosophy of Camp Navigate! Also that we will help draw attention for others to see the importance of instilling Employability Skills and Traditional Values into the lives of our most important asset – our children!”

Tim Ramseier – Director of Middle School Campers

Tim has been involved in youth work since the early 80’s. He studied in Germany,

England, University of Wisconsin/Madison, Trinity Evangelical Divinity School in

Chicago and Gordon-Conwell Seminary in Boston. Tim is currently the Executive

Director of Youth for Christ and is passionate about working with youth. He works

with hundreds of Middle School and High School student each month during the

school year. He is married to Eleanor and is always looking for opportunities to hang

out with her, their three children and grandchildren!

What excites you most about Camp Navigate? “The ability to shape lives, not just

during the school year, but all summer long as we prepare them for the future."

Austin Benson – Lead Mentor (Counselor)

Austin as our new Lead Mentor (counselor) at Camp Navigate! He is a senior at Vincennes University majoring in Sports Marketing. He has worked as a camp counselor for 3 years and is ready to apply his experience and education once again at camp! He will be supervising our Camp Mentors (counselors) and developing recreational activities for our campers.

What excites you the most about Camp Navigate? “I am pumped to be a part of this exciting new camp that is available to the kids in my community and to be part of a summer program where kids can learn needed life skills while having a fun filled summer in a safe environment!”

Camp Navigate Weekly Themes Want your child to attend a camp with a purpose? Not only will we have the typical STEM activities, but we will

be engaging our campers weekly with the new 4-C’s from the 21st Century Skills list; Communication, Critical

Thinking, Creativity and Collaboration! In addition, we will have 9 different weekly themes that will focus on

some of the most-in-demand Employability (Soft) Skills needed for your child’s future success!

Week One

What’s up, World (Multi-Cultural Sensitivity)

This week is designed for the campers to experience other cultures within our world. This will provide the kids with

the opportunity to see what makes us alike and unique.

Week Two

Build it (Teamwork, Organizational Skills)

This week will be about working together side by side with a common goal. The kids will be given fun activities that

will require them to participate in collaboration with each other.

Week Three

Get It, Got It, Give It (Servant Leadership, Integrity, Volunteerism)

This week is all about discovering leadership capabilities within the campers. How they discover them, build

them up and use them to serve and help others.

Week Four

She Said, He Said (Girl/Guy Leadership, Adaptability, Active Listening)

This is a week where the girls and guys take turns in leading each other in a variety of activities and exercises.

The girls take the first part of the week and the guys take the second.

Week Five

Red, White, Blue Everything We Do (Patriotism, Public Speaking)

We will be honoring the heroes of our country and of our community. We will also learn what it means to be a

real hero and how each of us can become heroes in our own ways.

Week Six

Wrong can be Wright (Entrepreneurship, “Failures” Lead to Success)

During this week the campers will learn that failures can lead to success. Just like the great inventors, failures

are actually lessons that take us to success.

Week Seven

Time Flies (Time Management, Decision making skills)

This week the campers will learn that when they manage their time it doesn’t manage them. This will be done

through a series of fun games that lead them into decision making processes. This week will be enjoyable and

entertaining as well as instructive.

Week Eight

Art Smart (Creativity, Innovation)

Here is a chance for your creative side to go nuts! Be prepared to take home some fun creations and participate

in skit or two.

Week Nine

Pitch It (Building Confidence, Self-Motivation)

We all have to learn to present ourselves to others. During this week campers will not only present themselves

but their accomplishments from throughout the summer. This week will be a great way to show off what the

campers have learned through-out the summer.

Camp Navigate

Rate Sheet

Classification Rate

Full Time Camper (FT) 3-5 days $95 per week

Part Time Camper (PT) 1-2 days $50 per week

Discount Opportunities (Discounts can not be combined)

Multiple Siblings 15% each additional camper after the 1st at full price.

example: PT $50 for 1st child, 15% off next children, $42.50 ea.

FT $95 for 1st child, 15% off next children, $80.75 ea.

Military 15% 15% discount on all children.

example: PT $42.50 for all children.

FT $80.75 for all children.

Foster Children Subsidy (Limited Funds available) 50% Families who are fostering children are eligible to receive 50% off for

the children they are fostering.

Corporate Subsidy 10% The following Corporations support Camp Navigate by offering to pay

10% of Camp Navigate weekly tuition for their employee’s child to attend.

If you are an employee of Thompson Thrift, Baesler’s Market, Dorsett Automotive

or Sackrider Accounting, please call us for more info.

Scholarship opportunity available Limited funds are available for those who qualify through our CAULDER JOHNSON SCHOLARSHIP FUND and

Foster Family Support Fund. If you are interested please go on line www.campnavigate.org , print and fill out

an application and attach it to your registration form.

Camp Navigate 2017 Registration

June 5TH to August 4th Monday – Friday 6:30 am to 6:00 pm

DeVaney Elementary School & The Life Center 3000 College Ave. RATE SHEET / DISCOUNTS / FINANCIAL ASSISTANCE INFORMATION ATTACHED

Total Registration Fees:

1st Camper Name:

WEEK THEMES YES NO Full Time Part Time

June 5-9 What’s Up World

June 12-16 Build It

June 19-23 Get It, Got It, Give It

June 26-30 She said, He said

July 3-7 Red, White, Blue in Everything We Do

July 10-14 Wrong Can Be Wright

July 17-21 Time Travel

July 24-28 Art Smart

July 31-Aug 4 Pitch It

2nd Camper Name:

WEEK THEMES YES NO Full Time Part Time

June 5-9 What’s Up World

June 12-16 Build It

June 19-23 Get It, Got It, Give It

June 26-30 She said, He said

July 3-7 Red, White, Blue in Everything We Do

July 10-14 Wrong Can Be Wright

July 17-21 Time Travel

July 24-28 Art Smart

July 31-Aug 4 Pitch It

DISCOUNTS: Sibling Discount Military Discount Foster Care Subsidy Corporate Subsidy Caulder Huff Johnson Scholarship Applicant

All charges including Registration Fees will be withdrawn on my behalf in the following manner.

I am authorizing a bank draft from my checking account and I have attached a voided check I am authorizing a credit card draft and I have provided all the information below

Credit Card type: Visa MasterCard CSC: __ __ __ (back of card)

Name on Card: Authorized Signature:

Card Number: Expiration Date:

Billing Address: Billing Zip Code:

I have the legal authority to register the child/children named on this form and to the best of my knowledge the information on this application form is complete and accurate. I understand that my application will not be processed unless it includes the full fee or automatic draft authorization. In the event I cannot be reached in an emergency, I hereby give permission to the director of the program or their designee to secure emergency medical services, including transportation and medical care. I also give permission for the attending physician to order injections, anesthesia or surgery for this child as named above. I understand that medical and accident insurance is the responsibility of the parent or guardian. I understand that I may revoke this release by written request presented with a 48 hour prior notice.

My child(ren) may be photographed and/or interviewed for Camp Navigate promotional purposes. YES NO

Signature of Parent/Guardian: Date: _______________________________________________________ _______________________________

Register by May 8th for the Early Bird Discount on registration fees. $25 per child/$50 per household.

After May 8th $35 per child /$70 per household.

Full time Camper (FT) 3 – 5 days a week Part Time Camper (PT) 1 – 2 days a week

Camp Navigate Summer Day Camp 2017 Registration Register online or submit the completed registration form and the registration fee to:

Camp Navigate, P.O. Box 3687 Terre Haute, IN. 47803. Also you MUST provide a

copy of child’s immunization record and a recent photo.

Be sure to fill ALL pages of the registration form

Or save time and get an application from www.campnavigate.org

For assistance, call 812-201-4862 or 812-249-3561

CAMPER (must be siblings or fostered child to register on the same registration)

First Name: Middle Initial: Last Name:

Date of Birth: / / Gender: Age: Grade in Fall 2017: Shirt Size: YS / YM / YL / S / M / L / XL

Race: African American Asian American Indian White Multi-Racial Native Hawaiian/Pacific Islander Other

Physical Conditions/Special Needs: Medications/allergies:

To better serve your child, please indicated if he/she has been diagnosed with any of the following: ADD/ADHD Convulsion Bleeding/Clotting Disorders Autism Asperger’s Fragile X Cerebral Palsy Bipolar Dis. Tourette Rett Syndrome Down Syndrome Chronic Health Problems Asthma/Severe Allergies Diabetes Heart defect/disease Other ____________________________

Does this child have an IEP (Individual Education Plan) Yes No

First Name: Middle Initial: Last Name:

Date of Birth: / / Gender: Age: Grade in Fall 2017: Shirt Size: YS/ YM / YL / S / M / L / XL

Race: African American Asian American Indian White Multi-Racial Native Hawaiian/Pacific Islander Other

Physical Conditions/Special Needs: Medications/allergies:

To better serve your child, please indicated if he/she has been diagnosed with any of the following: ADD/ADHD Convulsion Bleeding/Clotting Disorders Autism Asperger’s Fragile X Cerebral Palsy Bipolar Dis. Tourette Rett Syndrome Down Syndrome Chronic Health Problems Asthma/Severe Allergies Diabetes Heart defect/disease Other

Does this child have an IEP (Individual Education Plan) Yes No

PARENT/GUARDIAN

Name: Relationship to Child:

Address: City: State: Zip: Date of Birth: / /

Employer: Would you like to opt in for text message alerts:

Phone (work): Phone(cell):

Email:

Name: Relationship to Child:

Address: City: State: Zip: Date of Birth: / /

Employer: Phone (work) (cell):

Email:

Emergency Contact/Authorized Pick-Up (anyone picking up your child must be: at least 18+ and must show photo ID)

In addition to the parents/guardians listed above, I authorize the following to pick up the child(ren) and or be contacted in an emergency:

Name: Relationship to Child: Phone (work): Cell:

Name: Relationship to Child: Phone (work): Cell:

Physician/Insurance Information:

Insurance Carrier: Policy Number:

Physician Name: Phone:

Preferred Hospital in the event child needs to transported for medical attention:

1st

2nd

1st

2nd

Swimming Ability

Please check the swimming ability of your child:

____Non- Swimmer: not able to swim 50 continuous feet without dog-paddling or interrupting a stroke to stand in the water, or both.

____Beginner: able to jump feet first into water deeper than camper is tall, level off, and begin swimming. Capable of swimming 50

continuous feet, including a sharp turn to return to the starting place.

____Swimmer: able to jump feet first into water deeper than camper is tall, level off, and begin swimming. Capable of swimming 100

yards in a strong manner using more than one stroke. Must be able to float.

PARENT AUTHORIZATION AND RELEASE

My child has the medical approval to participate in the activities of CAMP NAVIGATE, and in my judgment my child is in good

health and physical condition and able to safely participate in the activities of CAMP NAVIGATE. My child has my permission to

engage in all activities offered by CAMP NAVIGATE except as noted by me in writing. I further understand that neither CAMP NAVIGATE nor any of its paid staff or volunteer workers can be held responsible in the event of an accident. I promise and agree on

behalf of myself, my spouse or partner or other family members not to sue and agree to waive, release, discharge, and hold harmless and

indemnify CAMP NAVIGATE, its agents, employees, members and volunteers from all claims, demands, rights and causes of action

of any kind, whether arising from my own acts, the acts of my child, or those of CAMP NAVIGATE. I hereby waive all claims of

injury or damage, suffered by my child, myself, my spouse, my partner, or other family member in connection with or arising out of the

participation of my child in CAMP NAVIGATE’S activities. I certify that my child is amenable to discipline and free from habits or

attitudes, which would make him/her an undesirable participant.

CAMP ACTIVITY AND TRANSPORTATION AUTHORIZATION

I hereby give permission for my child to participate in camp activities and to travel by bus with the CAMP NAVIGATE Staff. I

understand that only licenses and qualified personnel will operate any vehicle during Day Camp, and that there will be at least one

CAMP NAVIGATE staff member present at all times. I agree to release CAMP NAVIGATE, and its officers, directors, and

CAMP NAVIGATE’S staff from any and all claims of damages or liabilities which may arise as a result of my child’s participation in

camp activities and bus trips.

EMERGENCY AUTHORIZATION

I hereby give permission to the medical personnel selected by CAMP NAVIGATE’S camp director or designated CAMP NAVIGATE staff to order X-rays, routine tests and treatment for me or my child, and, in the event that I am not able to communicate or

cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director or designated CAMP NAVIGATE staff to hospitalize, secure proper treatment for, and order injection(s) and/or anesthesia and/or surgery for me or my child

as named prior. I will be fully responsible for any costs of such treatment, even if not covered by my insurance.

PARENT OR GUARDIAN PERMISSION My signature below indicates that I have the legal authority to sign up the child named on this form and that to the best of my knowledge

the information on this application form is complete and accurate. I further understand that this application and the named child’s

participation is contingent upon space being available in the program in which I want the child to participate. I also understand that once

my registration is confirmed, I must complete payment(s) by the deadlines of said program as outlined prior and that, furthermore, all

necessary health, security, and waiver forms must be signed and on file with CAMP NAVIGATE prior to my child attending the

program.

_________________________________________________ __________________________

Signature of Parent or Legal Guardian Date

Camp Navigate’s

Caulder Huff Johnson Scholarship

Application Form

Caulder Huff Johnson was only two years old when he tragically and accidentally lost his life on January 2, 2017. His mother,

Heather Kumpf Johnson grew up in Terre Haute, and along with Caulder's father, Patrick, from the time Caulder was born

they prayed daily that he would someday glorify God. With great faith and trust his parents know that even now God is in

control and through Camp Navigates's Scholarship Fund Caulder's life is doing just that. They would also like others to know

that just like a compass can always find due north, that God will never change. No matter what direction your life takes, He

is constant. Life is lived best when we trust and allow God to navigate our path. (Proverbs 3:5-6) It can sometimes be a

bumpy path, but it is ALWAYS the best one. We hope that the Caulder Huff Johnson Scholarship fund will be a help to your

child as he/she begins to choose their path in life.

REQUIRED DOCUMENTATION CHECKLIST:

Completed application. (Please print clearly and fill out the front and back of the application completely.)

A copy of the first page of the most recent 1040 Tax Form for EACH ADULT (age 18+) in the household. If you do

not file taxes, you may obtain an IRS transcript by calling the Internal Revenue Service at 1-800-829-1040 or go to

www.irs.gov .

Proof of income for EACH ADULT (age 18+) in the household. This includes copies of the last TWO pay stubs, social

security or disability checks. You may also submit copies of bank statements showing automatic monthly deposits

of government checks. Please, no W-2’s.

If you are requesting that your status as a full time student be considered, you must provide evidence of

enrollment.

Documentation of ANY federal assistance you receive such as food stamps, rent subsidy, or Aid to Dependent

Children cash assistance.

Student loan documentation, if applicable.

Additional information may be requested to help determine need.

Applicant’s Information Other Adults in Household’s Information

NAME NAME

ADDRESS ADDRESS

CITY CITY

STATE, ZIP STATE, ZIP

HOME PHONE HOME PHONE

CELL PHONE CELL PHONE

EMAIL EMAIL

DATE OF BIRTH DATE OF BIRTH

EMPLOYER EMPLOYER

EMPLOYER CONTACT INFO

EMPLOYER CONTACT INFO

DEPENDENTS OR ADDITIONAL ADULTS LIVING IN THE HOUSEHOLD

Name:______________________________ Gender Male/Female Date of birth: __________________

Name:______________________________ Gender Male/Female Date of birth: __________________

Name:______________________________ Gender Male/Female Date of birth: __________________

Name:______________________________ Gender Male/Female Date of birth: __________________

Name:______________________________ Gender Male/Female Date of birth: __________________

GROSS ANNUAL INCOME AND EXPENSES:

Household Income Head of Household $ Additional Adults $ Household Expenses $

Employment $ $ Mortgage $

Child Support $ $ Electric/Gas/Water $

Government Asst. $ $ Phone $

Food Stamps $ $ Medical Expenses $

Student Loan Income $ $ Auto Loan $

Other $ $ Other $

TOTAL $ $ TOTAL $

Please tell us your story. Please take the time to describe your circumstances/reason for applying for financial assistance,

including any unusual expenses you must meet. (Attach additional pages if necessary.)

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

I certify that the above information and the supporting documents are correct and complete to the best of my knowledge. I

agree to inform Camp Navigate of any changes in my income, family size, or mailing address. I understand that I may lose

all Camp Navigate privileges for lack of payment or falsifying information in connection with this application. I understand

that my reduced financial assistance will not be automatically extended beyond the aware period and that I must bring

updated information annually, or as requested, to qualify. Financial assistance is provided based on household income

and available resources.

Camp Navigate encourages financial assistance recipients to write a brief note describing how the program has been of

help to them. These stories may b shared with Camp Navigate supporters to show them how their contributions are used

and to encourage prospective donors to become involved.

Would you be willing to share your story ___Yes ___No

Signature _________________________ Printed Name_____________________________ Date __________