Warm Beach Christian Camp & Conference Center
(bring to camp or email to Bishop Ashman)
Waiver Of Liability And Release
PLEASE READ THE FOLLOWING CAREFULLY
Challenge Course activities often involve warm-ups, games, group initiative problems, low and high challenge elements, a forty foot high climbing tower and other rigorous physical adventure activities. The level of participation in all programs and activities is at all times determined by the participant. While participants’ safety is paramount to Warm Beach Camp, all risk cannot be eliminated from any activity. By choosing to participate, each participant assumes the risk that he/she may incur an emotional or physical injury and/or disability. Injuries can include, but are not limited to; cable burns, rope burns, sprains, skin abrasions, and pulled/strained muscles. In the unlikely event of a failure of a helmet, belay, or other safety precautions, more serious injuries or even death could result.
If you have any questions, have them answered before signing this document.
Release of Liability
I, the undersigned, understand that parts of the Challenge Course experience at Warm Beach Camp may be physically or emotionally demanding. In consideration of being permitted to participate in the Challenge Course at Warm Beach Camp, I, the undersigned, in full recognition and appreciation of the dangers and risks inherent in such activities, do hereby waive, release, and forever discharge Warm Beach Christian Camp and Conference Center, its officers, agents, volunteers, and employees from and against any and all claims, demands, action or causes of action for costs, expenses or damages to personal property or personal injury, or death, which may result from my participation in these activities.
I understand and admit that my participation is voluntary. I hereby agree to comply with all rules and regulations. I assume full responsibility for any injuries or damages resulting from my participation in these activities, including responsibility for using reasonable judgment in all phases of participation of the program. I recognize and understand that the activities may be hazardous, that my participation is solely at my own risk, and that I assume full responsibility for any resulting injuries and damages.
I affirm that I am in good health. I further declare that I am physically fit and capable to participate in such activities. I understand that it is my responsibility to notify the appropriate person should an injury occur.
I acknowledge that I have read and understand this entire Waiver of Liability and Release, and I agree to be legally bound by it.
Participant’s Signature Signature of Parent or Guardian if
Participant is Under 18 Years of Age
_______________________________ Print Participant’s Name
This Waiver must be presented to the Recreation Staff prior to participation in the activity.
THE ARCHBISHOP ROBERT SHERWOOD MORSE YOUTH CAMP
INFORMATION & REGISTRATION FORMS
SUNDAY, June 30th – FRIDAY, JULY 5th, 2019
Every year, the Bishop Morse Youth Camp gathers members and friends from parishes throughout the Anglican Province of Christ the King for a five-day program at Warm Beach Camp & Conference Center. We start our days with Holy Communion in a beautiful chapel overlooking Port Susan Bay. After breakfast, we have free time to prepare for the day (cleaning up, etc.) followed by instruction to learn more about living the Christian Faith in the Anglican tradition. Afternoons are given to outdoor recreation and fellowship. We may also take day trips to the surrounding areas and a special fireworks outing on July Fourth. After dinner, we gather for Evening Prayer and Wrap UP, followed by evening activities such as movie night, skits, games, and campfires and of course S’mores.
Check-in: Sunday, June 30, 2019, 3:00 – 4:00 PM
Check-out: Friday, July 5, 2019, 10:00 AM
Campers will be challenged to grow spiritually, physically, emotionally, and socially. Opportunities will abound for making new friends and meeting people from all over the United States, learning leadership skills, taking responsibility for oneself and others, and having lots of fun!
Staff and Counselors
In addition to the priests and deacons who volunteer their time, counselors (of college age or older) who desire and demonstrate the ability to serve as Christian role models are chosen to supervise and guide the campers. They are selected for their maturity and experience in working with teenagers and youth. Moreover, qualified and trained staff members supervise campers and program activities such as canoeing.
The Summer Youth Camp is open to youth entering the 7th grade through 12th grade. Counselors (those of college age) are also welcome to apply. Please contact the Camp Manager Erin Ashman Salazar at firstname.lastname@example.org if you need assistance or have questions.
How to Register
Carefully print all information on the Registration Form for each camper and be sure to have a parent or legal guardian sign the statement on the last page of the Registration Form. (Incomplete applications will be returned and cannot be processed until properly completed.) Included is a special Waiver of Liability Form necessary for the high ropes and other vigorous activities.
We are trying to shift over to email registration, so it would be appreciated if the Registration Form could be filled out as a Word Document and sent to Mrs. Salazar at email@example.com and a second email copy to Bishop Ashman at firstname.lastname@example.org But please also mail a hard copy (snail mail) of the completed Registration Form and the Waiver of Liability and Release Form (necessary for high challenge activities), together with your check payable to Diocese of the Western States (with “Bishop Morse Youth Camp” in the memo line) to:
Diocese of the Western States P. O. Box 15095 San Francisco, CA 94115
The fee is $300.00 per person (adjusted for families). After April 10th, the fee rises to $350.00 - Scholarships are available and as always, applications will be kept confidential. Please contact Bishop Ashman directly if you know of a camper that needs assistance: 818-749-8139 or email@example.com
For insurance purposes, the owners of the camp must have an accurate count of those attending before we arrive. Therefore, applications (with health information and signature of parent or guardian) and camp fees must be received by the APCK office not later than June 15, 2018. If there is a problem, call us.
Campers are responsible for their own transportation to and from the camp. Anyone coming to Washington by airplane should plan to arrive at SEA-TAC International Airport (SEA) in Seattle by 1pm Sunday afternoon. If you need help with transportation or assistance getting from the airport to Warm Beach camp, please contact Erin Ashman Salazar at her cell (818) 415-0177. We always find a way to get campers to camp!
Location, Address and Contract Information
The Warm Beach Camp & Conference Center is located between Stanwood and Camano Island, Washington about an hour north of Seattle.
The weather is cool to mild (rarely hot) and sometimes light rain.
Warm Beach Camp & Conference Center, 20800 Marine Drive, Stanwood, WA 98292
(360) 652-7575 (Local) – (425) 743-5471 (Seattle) – (800) 228-6724 (Toll free)
Cancellation & Refunds
If a camper withdraws his or her registration and written notice is received seven days prior to the start of the camp program, a full refund will be made. If one must leave camp because of illness or injury, the refund will be pro-rated on a per diem basis. No other refunds will be given. If a camper leaves early due to homesickness or parent request, no refund will be made.
The Anglican Province of Christ the King reserves the right to cancel the program due to extenuating circumstances. Should the program be canceled in its entirety, a full refund will be made to all enrolled individuals.
The clergy, counselors, and staff will do everything possible to help campers adjust to camp life. However, the Youth Camp reserves the right to send home anyone who exhibits inappropriate behavior. In this event, the camper’s parent or guardian is responsible for picking up the camper from camp; and no refund will be made.
While the youth camp program is generally quiet, campers may participate voluntarily in sporting activities including field games such as Ultimate Frisbee, Soccer, and Capture the Flag. Even though these are “non-contact” sports, they have inherent risks from fall or collision ranging from pulled muscles to broken bones and even death. Campers may also go swimming in the swimming pool and canoeing in Port Susan Bay. Although these two activities are supervised by our counselors and Warm Beach staff (licensed lifeguards), they still involve the obvious risk of drowning. Campers may also elect to go hiking, which presents the possible risk of injury from falling or exposure.
While we are prudent and have never had a serious injury among our campers, we believe it important to inform you of these risks. If you and/or your child do not want to participate in any of the physical activities at camp (especially the high ropes), please notify us prior to the beginning of the program.
Holy Bible and 1928 Book of Common Prayer
(We have extras in case you need them but it really helps if you bring your own).
Be prepared to bring a sleeping bag, pillow, and possibly a sheet and light blanket
We will notify you, if these are necessary (last year the camp supplied them except the pillow)
Jacket and other warm clothing (it can get cool at night and rain is likely).
Bring a hat!!!
Tennis shoes, hiking shoes, old shoes for canoeing on the lake &/ or creek
Socks and underwear (One cannot have too many socks)
Shirts (both long and short sleeved)
Trousers &/ or jeans
Soap, shampoo, towel, deodorant, comb or brush, toothbrush, toothpaste, necessary personal items
Sunscreen, lotion, insect repellent
Musical instrument (if desired – we do have a skit night and/or talent show)
Flashlight – VERY IMPORTANT
Any medicine or prescriptions (if necessary)
Cell phones for calling home and taking pictures are permitted
Your imagination for skit night!
A Christmas hat, shirt or easy to pack decorations for our group picture
Please do not bring any food items, candy, or drinks.
VIDEO GAMES, GAMING CONSOLES, iPODs, COMPUTERS, TABLETS, iPADs, MP3 PLAYERS & PERSONAL STEREOS, or DVD PLAYER, MAY NOT BE BROUGHT TO CAMP (It’s camp)
BISHOP MORSE YOUTH CAMP REGISTRATION FORM
Last name: _______________________________________________
First name: _______________________________________________
Birth date: __________________ [ ] Male [ ] Female
Age: (arrival at camp)____________ Tee Shirt Size __________________
Street address: ________________________________________________________________
State: __________________ Zip Code: _________________
Telephone: ( ) _______________________ Cell phone: ( ) _______________________
Name of parent or guardian:
In case of emergency, notify:
Day phone: ( ) __________________ Night phone: ( ) _________________
Address (if different from camper):
Day phone: ( ) __________________ Night phone: ( ) _________________
Address (if different from camper):
Health Information Immunizations (dates):
Tetanus: ____________________________ Booster: __________________________________
Allergies? (If so, please explain)
Reactions to any drugs? (If so, please explain)
Dietary modifications: ____________________________________________________________________________
Current medications: ____________________________________________________________________________
Special information: ____________________________________________________________________________
Health Insurance Company: ____________________________________________________
Policy No.: __________________________________________________________________
Note: No medication (prescription or over-the-counter) will be administered unless the parent or guardian provides (1) The medication in the original container, and (2) A written authorization with dosage instructions.
I acknowledge that I have read this form entirely, including the Danger Disclosure, and understand its contents. I give my permission for the registered person to attend the Bishop Morse Youth Camp. To the best of my knowledge and belief, this person is healthy and fit for an active camp program, and all information contained on the registration form is correct.
I have read the Danger Disclosure outlined in the brochure and agree not to hold the Bishop Morse Youth Camp of the Anglican Province of Christ the King, its Director, and/or Staff liable for any accident, injury, and/or damage that occurs excepting those caused by their gross negligence.
In the event of a medical emergency, I understand that every effort will be made to contact a responsible parent or guardian of this person after immediate medical needs have been met.
I hereby give permission to the Anglican Province of Christ the King Camp Directors and attending Physician, who may select to secure proper medical treatment, to hospitalize and/or to order any injection(s), anesthesia, medications or operations that may be urgently needed and necessary for this person. I will not hold the Anglican Province of Christ the King Camp Directors and/ or staff liable for any emergency treatment given.
Signature: _____________________________________ Date: _______________________
Relationship to camper: ______________________________.