Middle School Reaching Out to the Community 2024

Student Name

Student Grade (August 2024)

Student Cell # (if applicable)

Parent/Guardian Name(s)

Parent/Guardian Best Email Contact (*where all camp info will be sent)

This address will receive a confirmation email

Parent/Guardian Phone (*emergency contact for the camp)

Student Mailing Address

HEALTH: Is there anything we should know to ensure your child's physical health/safety during our time together? (I.e. conditions, medications, food/material allergies, etc.) If none, write N/A.

Is there anything else you'd like us to know to help your child have a positive and enjoyable experience in our daycamp? Ex. Personal fears, anxieties, emotional needs, etc.(Please note - while we try to accomodate requests for students to be with at least one friend, we cannot promise to keep large groups of friends together.)

PHOTO/VIDEO RELEASE: Do you consent to your child's image being used in any of the following media formats? (Please check all that apply.)

Church Print Media (including weekly newsletters, annual stewardship campaign bulletin, future summer camp promos, etc.) Church Online Media (including e-news, website, Facebook - St. Thomas OP, and closed ministry leader groups) Episcopal Diocese of KS Print Media ("The Harvest" Quarterly Magazine Episcopal Diocese of KS Online Media (e-newsletter; Facebook; website) Local News Media

*OPTIONAL* Summer @ St. Thomas 2024 T-Shirt...
Our annual "summer camp t-shirt" can be purchased ONE TIME (at your child's earliest camp) and used for ALL of our summer camps. The shirt will be a soft, lightweight blend t-shirt in a light color for our later summer outdoor camps, and offer our staff an easy way to quickly identify our group when out and about. **All t-shirt requests and payments must be received by APRIL 30!**

OPTIONAL T-Shirt Order ($12 - must be paid in advance)

None Adult X-Small Adult Small Adult Medium Adult Large Adult X-Large Adult 2XL

COMMUNITY COVENANTS (Expecations) -
To ensure a safe and positive experience for all participants and staff, our Middle and High School Camps will abide by the Youth Community Covenants of the Episcopal Diocese of Kansas. Please read carefully with your student, and click the box below.

The Episcopal Church’s unofficial mottos of “All are Welcome!” and “God loves you, no exceptions.” point us to the following standards towards which we strive:

· I will do my part to make this a welcoming and inclusive community.

· I will seek to build up myself, others, and our community in my actions and words, doing my best to ‘love my neighbor as myself.’ (Matthew 22:39)

· I will respect the person, property, feelings and beliefs of each member of our community and I will care for the property of this church with the understanding that it is God’s Place, made the way it is through the gifts of numerous people.

· I will actively participate in all parts of the event and do my best to have fun!

The following rule is non-negotiable, meaning if violated, you will be sent home from the event:

· I will not engage in any form of emotional or physical aggression toward any member of camp or camp staff. If I find my emotions running high, I will seek the help of an adult staff member who will support me in finding safe space where I can regain control until I decide, with their support, that I am ready to return to activities.

· I will not bring or use alcohol, tobacco, nicotine, e-cigarettes (includes: e-cigs, vapes, hookah-pens, etc.), illegal drugs, drug paraphernalia, fireworks, firearms or any kind of weapon.

My student and I have read and understand the expectations contained in the Community Covenant.

Yes

PAYMENT: A $40 non-refundable deposit (along with $12 for a t-shirt, IF APPLICABLE) are required at registration. These funds secure our t-shirts, transportations and our Friday afternoon lunch/party at the end of camp. **If paying a deposit, a link will be sent to you for final payment around May 1st.**

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Middle School Reaching Out to the Community 2024

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