Epic 2018! - Xenos Christian Fellowship
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Epic 2018! In the past eight years, the dream and prayer of seeing a camp full of high school students learning about Jesus Christ and spending time together has blossomed from a 300 person camp to over 800 in attendance. God has far exceeded our prayers! At Epic 2017, high school students from across Columbus were able to enjoy deep fellowship with one another, intriguing readings, discussions and teachings over the Signs in the Gospel of John, and enjoyed lots of fun activities! Many students during this week made a decision to trust and follow Christ. Now, we begin preparations for Epic 2018! We would love for your students to attend our camp this year. Epic 2018 will be held from July 1-July 7, 2018. Once again, these dates will not conflict with athletics or other fall school activities. We will provide commercial bus transportation, there will be a variety of activities to choose from (which are included in the cost and include zip line, rock climbing, paintball, and more), and students will hear from our very best Bible teachers. We will return again to Spring Hill Camp Indiana. Spring Hill provides an ideal setting and their staff understands and supports our mission. Please don’t wait to register for camp, as slots fill quickly! Epic is an excellent opportunity for students to learn the claims of the Bible and consider whether these claims are true. We hope and pray that many students who aren’t involved in the Xenos high school ministry will attend this trip with us! If you want to check out Spring Hill Indiana, please visit http://www.springhillcamps.com/in/. Brian Adams Nick Hetrick Josh Benadum
Epic 2018 What You Need to Know
Location – Spring Hill Camp Indiana
Dates – Sunday, July 1 – Saturday, July 7, 2018
Depart – 7am Sunday, July 1 Xenos Main Campus Auditorium Parking Lot
Return – 2-3 pm Saturday, July 7 Xenos Main Campus Auditorium Parking Lot
Transportation – Students will be provided with round trip transportation via chartered
commercial buses.
Meals – 3 meals will be provided each day
Eligibility – All students who will be enrolled in high school in the fall of 2018 and those
students who are graduating in the spring of 2018 are eligible to attend Epic.
Students do not have to attend Xenos in order to attend Epic (in fact, we hope that large
numbers of students who don’t attend any church will come to Epic with their Xenos
friends).
Costs - $395 per student. Epic fees will be discounted for families who have more than
one student attending Epic and/or Blow Out Camp. Family discounts are:
o 1 student - $0
o 2 students - $45
o 3 students - $135
o 4 students - $270
o > 4 students $270 plus $135 for each additional student
Financial Aid – A limited amount of financial aid is available to those families who are
unable to pay the full fee. To request financial aid please complete the “Application for
Financial Aid” form.
Registration Deadline – The deadline for registration is 5pm May 2, 2018. Registrations
will be accepted on a “first come, first served” basis. Once registration reaches capacity
students will be wait-listed until May 23 when they may be added if spots are available.
Any registration accepted after May 2 will be subject to a $75 per student surcharge.
Payments/Cancellations –
a. A nonrefundable deposit of $75 is required to secure a spot at camp
b. Balance due must be paid by May 23, 2018
c. Students added to Epic from the wait-list must pay by June 6, 2018.
d. Cancellations
Before May 2, 2018 will result in forfeiture of your deposit ($75).
Before May 23, 2018 will result in forfeiture of one half the full Epic fee.
After May 23, 2018 will result in forfeiture of the full Epic fee.
No-shows will forfeit the full Epic fee.
e. Cancellations must be requested in writing (e-mailed to epic@xenos.org)
Photo Waiver
a. By signing this paper, I agree for Xenos Christian Fellowship & SpringHill Camps to use any
photos or video of my child at camp for promotional material, including on the Internet.Epic 2018 What to Bring Bedding Miscellaneous Items Sleeping Bag Bible Sheets / Blanket Pen/Notebook Pillow Flashlights Clothing Not Recommended Underwear (daily change) Electronic Games Socks (daily change) MP3 Players Shorts Food / Candy Sweatshirt/ Sweater Cell Phones T-shirts (daily change) Tablets Jeans / Sweat Pants (2 pair) Digital Cameras Long Sleeve Shirt Don’t Bring Light Jacket / Coat Knives / Weapons Raincoat Alcohol / Drugs Pajamas Tobacco Swimsuit Vape Mod Shoes / Hiking Boots Sandals / Shoes that can get wet Hat / Baseball Cap Toiletries Shampoo Soap Toothpaste & Toothbrush 2 Towels Washcloths Insect Repellent (lotion only) Sunscreen Sunglasses Water Bottle
Epic 2018 Registration Form
Student name:
Parent names:
Registration Deadline Is May 2. After May 2 there is a $75 per student surcharge.
Home address:
City: Zip Code:
Home phone:
Parent cell: Student cell:
Parent email: Student email:
Emergency phone numbers:
Register early, spots are limited.
Birth date: Gender: M F (circle)
Grade Fall 2018:
Xenos High school home church name (if any):
Friends going to Epic if not involved in a Xenos home church:
Epic 2018 Fee Calculation – Fees due in full by 5/23/17
Epic Fee (# of students attending Epic x $395/student) $
Less: Family Discount* $
Net Epic Fee Due $
* Epic discount for families with multiple students attending Epic and Blow Out Camp
# of Students Discount
1 $0
2 $45
3 $135
4 or more $270 plus $135 for each student more than 4
Make checks payable “Xenos Christian Fellowship”
Return completed registration forms and $75 deposit no later than May 2 to:
Xenos Christian Fellowship
Attn: Epic 2018
1340 Community Park Dr.
Columbus, OH 43229Epic 2018 Application for Financial Aid Student Name: Xenos Home Church (if any): Parents Marital Status Single Married Divorced Names and ages of siblings living at home (under 18): Please explain your family situation and why you believe you should receive financial aid:
Epic 2018 Medical Information/Release Form
PARTICIPANT INFORMATION
Participant’s Name ______________________________ Date of Birth ________________________________
Permanent Address _____________________________ Gender ____________________________________
City, State, Zip _________________________________ Home Phone _______________________________
MEDICAL EMERGENCY CONTACT INFORMATION
Person to Contact First Backup Contact (Relative or Friend)
Name ________________________________________ Name ____________________________________
Relation to Participant ___________________________ Relation to Participant _______________________
Daytime Phone ________________________________ Daytime Phone _____________________________
Evening Phone ________________________________ Evening Phone _____________________________
Email ________________________________________ Email _____________________________________
Name of Doctor ________________________ Office Number _______________________________
Name of Dentist _______________________ Office Number _______________________________
Pharmacy Number ____________________________
INSURANCE POLICY INFORMATION
The above-named participant is covered by health insurance. Yes** No*
* If no, initial this line stating that you do not have health insurance and are aware that neither Spring Hill Camp nor Xenos
Christian Fellowship carries any health insurance for you.
** If yes, attach a photo copy of the insurance card which is required by Xenos Christian Fellowship to expedite treatment and to
facilitate the billing process.
Attach Medical Insurance Card Copy Here
HEALTH INFORMATION (Please Print)
Does the student have any of the following conditions or a history of any of the following conditions? ( Check
all that apply.)
Asthma Bronchitis Fainting Spells
Diabetes
Attach Medical Insurance Card Copy Here
Ear Infections Heart or cardio-vascular problems/disease
Convulsions/seizure Hay Fever Chronic bone, muscle or joint injuries
Migraine headaches Other condition(s): (Please list) __________________________
Allergies or reactions: (Check all that apply.)
Aspirin Penicillin Dairy Gluten Peanuts
Insect bites or stings Ivy/oak/sumac toxins Other (list) _________________________
Is your student currently on any prescribed or over-the counter medication? (If so, please record the
condition/ailment, name of medication, dosage, time(s) of day, prescribing physician.)
______________________________________________________________________________________
Date of last tetanus shot (approximate if necessary):_________________________________Epic 2018 Medicine Info/Release Form
I give permission for my son/daughter, _____________________________, to be
transported to and from and to participate in Epic 2017. Most adult chaperones
are volunteers (not on Church staff) from Xenos Christian Fellowship.
I understand that in spite of the best and focused efforts of these volunteer adult
chaperones to provide a safe and healthy environment for my child,
circumstances may arise leading to unintentional injury or losses on the part of
my child. I release Xenos Christian Fellowship and their agents from all claims and
expenses arising out of, or resulting from, my child’s participation during this
event.
I give permission for any medical personnel to render necessary emergency
medical care for my child if I can’t be reached or if my child needs immediate
medical attention.
I authorize the medical personnel to administer the following medications to my
child as needed and directed:
Tylenol/acetaminophen Y/N
Advil/ibuprofen Y/N
OTC cold/allergy medications Y/N
Antibiotics if recommended by camp physician Y/N
Other:
________________________________________________________________
I authorize my child to possess and self-administer the following medications:
_____________________________________________________________________
Signature of parent or guardian:
____________________________________________
Printed name of parent or guardian:
____________________________________________ Date: ________________
Cell phone number: ____________________SPRINGHILL CAMPS
(INDIANA)
Release of Liability, Waiver, Indemnification, and Consent to Medical Attention
I understand that all day camp, overnight camp and other recreational programs carry with them significant risks. Although SpringHill Camps
(“SpringHill”) has taken reasonable and prudent steps to reduce foreseeable risks, they still exist. Accordingly, in exchange for my being allowed to
participate in a day and/or overnight camp or recreational program or activity (the “Program”), sponsored by SpringHill, I, and if I am not yet 18 years old,
my parent(s) or legal guardian(s) (individually and collectively referred to below in the first person singular), agree to be bound by each of the following:
1. Voluntary Participation. I understand and confirm that my participation in the Program is voluntary.
2. Identification of Risks. I understand that there are certain dangers, hazards, and risks inherent in day camp, overnight camp, and other
recreational activities. More specifically, there are certain dangers, hazards, and risks inherent in certain activities conducted at the Program, including, but
not limited to, climbing walls, inflatables, water games and events, and outdoor games (in the day camps), and swimming, horseback riding, river rafting,
canoeing, paintball, extreme sports, high adventure activities, blobbing, winter tubing, snowboarding, skiing, cross country skiing, rock climbing,
gymnasium activities, sports, zip line, rappelling, camp transportation, sleeping in tents or cabins, bathing and eating and other residential activities (in the
overnight camps), all of which are regularly scheduled Program activities. I may voluntarily participate in some or all of these activities. I also understand that
medical facilities or treatment may be inadequate or unavailable during portions of the Program. I understand that my participation in the Program may
involve risk of injury and loss, both to person and to property. I also understand that the risk of injury may include the possibility of permanent disability and
death. There may be other risks not known to SpringHill and not reasonably foreseeable at this time. I further understand that some of the premises,
facilities, and equipment used in connection with the Program may not be owned, maintained, or controlled by SpringHill, but rather by the premises
owners (the “Premises Owners”). I understand that this Release of Liability, Waiver, Indemnification, and Consent is intended to address all of the risks of
any kind associated with my participation in any aspect of the Program, including, particularly, such risks created by actions, inactions, or negligence on the
part of SpringHill or its directors, officers, employees, agents, volunteers, successors, or assigns (collectively, the “Representatives”), including, but not
limited to, risks created by the following: (a) my physical, emotional, and psychological limitations and/or discomfort; (b) the physical, emotional, and
psychological limitations and/or discomfort of others; (c) the use and/or condition of premises on which various Program events occur; (d) the lack or
inadequacy of policies, rules, or regulations with respect to the Program; (e) the failure of SpringHill or its Representatives to foresee or to protect me from
actions, inactions, negligence, recklessness, or intentional or criminal misconduct of other persons; (f) the inadequacy or unavailability of medical facilities,
treatment, and/or professionals; or (g) the lack or inadequacy of supervision by SpringHill or its Representatives.
3. Assumption of Risk. I assume all risks, known and unknown, foreseeable and unforeseeable, in any way connected with my participation in
the Program. I accept personal responsibility for any liability, injury, loss, or damage in any way connected with my participation in the Program.
4. Release and Waiver. I release SpringHill and its Representatives from any and all liability for and waive any and all claims for injury, loss, or
damage, including attorneys’ fees, in any way connected with my participation in the Program, even if caused in whole or in part by the negligent acts or
omissions or other misconduct of SpringHill or any of its Representatives (a “Claim”). This release does not apply to reckless or intentional misconduct of
SpringHill or any of its Representatives.
5. Indemnification. I agree to indemnify and to hold harmless (in other words, to reimburse and to be responsible for) SpringHill and its
Representatives, and the Premises Owners, from any Claim or expense, including reasonable attorneys’ fees for the legal counsel of SpringHill's choice
(including the cost of defending any Claim I might make, or that might be made on my behalf, that is released or waived by this instrument), in any way
connected with a Claim.
6. Binding Effect. This instrument shall be binding upon my relatives, personal representatives, members, heirs, beneficiaries, next of kin,
or assigns and shall inure to the benefit of SpringHill, the Program, and their respective directors, officers, employees, agents, volunteers, successors, and
assigns.
7. Consent to Medical Treatment. I authorize SpringHill and its Representatives, and the Premises Owners, if present, to provide to me,
through medical personnel of their choice, customary medical assistance, transportation, and emergency medical services should I require such assistance,
transportation, or services as a result of injury or damage related to my participation in the Program. This consent does not impose a duty upon SpringHill
or its Representatives, or upon the Premises Owners, to provide such assistance, transportation, or services.
8. Severability. If any provision (or portion of any provision) of this instrument is held to be invalid or unenforceable, that provision shall be
enforceable in part to the fullest extent permitted by law, and such invalidity or unenforceability shall not otherwise affect any other provision of this
instrument.
9. Applicable Law. Because the SpringHill Program is located in the State of Indiana, and in order to provide certainty in the law to be applied
to the construction of this instrument, this instrument shall be governed, construed, and enforced in accordance with the law of Indiana.
THIS IS A RELEASE OF LIABILITY AND WAIVER. I HAVE READ THIS RELEASE OF LIABILITY, WAIVER, INDEMNIFICATION, AND
CONSENT. I UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING IT. I AM SIGNING THIS RELEASE OF LIABILITY,
WAIVER, INDEMNIFICATION, AND CONSENT VOLUNTARILY.
Printed Name Signature Date
If the person participating in the Program is not yet 18 years old, both parents or the legal guardian(s) must sign:
In exchange for my/our child or ward being allowed to participate in the Program, and as the parent(s) or legal guardian(s) of the above-named
individual, I/we verify that I/we fully understand, agree to, and accept all provisions of this Release of Liability, Waiver, Indemnification, and Consent.
Printed Name (Parent or Legal Guardian) Signature Date
Printed Name (Parent or Legal Guardian) Signature Date
dms.us.53664118.01Photo Waiver I give consent for Xenos Christian Fellowship & Spring Hill Camps to use any photographs and/or video taken of me and/or my child during Epic camp to be published and use to illustrate report and advertise camp including on the Internet. Signature ____________________________________________ Date _______________________
You can also read
