LUKECAMP Parent Agreement Form

Parent or Guardian to complete a different form for each Camper. *

Parent or Legal Guardian’s Name:

Single Line Text *

Child’s Name:

Paragraph Text

Signature *

I understand that each camper is required to wear a LukeCamp tee shirt every Monday, Tuesday, Wednesday, Thursday and everyday while they are at God’s Farm (week 8 or 9) and for the entire overnight reward trip (week 10). We will provide each student with 2 shirts during their first week of camp. Additional or replacement shirts cost $10.00 each. If a camper does not wear a LukeCamp shirt to camp the camper will be charged $10.00 before camp begins and a shirt will be provided. I understand my child is required to wear closed- toed shoes daily. Also, students are expected to wear appropriate shorts and or jeans that meet the Luke Camp dress code. Shorts or skorts must be knee length for girls. No loose or dangling jewelry allowed. Boys must wear a belt; Sagging will not be tolerated.

Section

Single Line Text

Girl Camper Size:

Single Line Text

Girl Camper Size:

Single Line Text

Girl Camper Size:

Single Line Text

Girl Camper Size:

Section

Single Line Text

Boy Camper Size:

Single Line Text

Boy Camper Size:

Single Line Text

Boy Camper Size:

Single Line Text

Boy Camper Size:

Single Line Text

Yes, I would like to purchase ______ (number) of shirts in addition to the 2 shirts provided by LukeCamp.

Water

Signature *

My child will bring water to camp every day. (Please do not freeze the entire water bottle. Campers should freeze half or a quarter of a bottle and fill the remainder of the bottle with water.)

Swimming

Swimming may be an activity during Luke Camp.

My child can swim in a Lake?

YES

NO

My child can swim the 8’ deep end of a pool?

YES

NO

My child can swim in a river?

YES

NO

My child can swim at water park?

YES

NO

Paragraph Text

Please note that whether your child can swim or not, he / she may be allowed on the field trip and will be permitted to participate in non- swimming activities if possible. Girls must wear a one-piece bathing suit with a dark tee shirt. Boy’s swim trunks must have a drawstring. Every camper will be required to take a swim test before entering the water. I understand my child will be required to wear a life-vest as required.

Medical Devices and Medicine

INITIAL

I will send my child’s medical devices, every day, inside of a Ziploc bag, that are inside of a fanny pack.

What medical devices will you send with your child?

What medicine will you send with your child?

What medical devices will you send with your child?

Does your child administer their own medication?

Checkboxes

Yes, I will check the date and quantity of medication being sent?

Yes, I will check the date and dosage(s) on the medical device being sent?

Yes, I understand siblings do not and cannot share medicine?

Lunch

Signature

I will send my child’s medical devices, every day, inside of a Ziploc bag, that are inside of a fanny pack.

Checkboxes

Yes, I understand my child may have to wait to eat if I send 3-4 items that require the use of a microwave. LukeCamp does not have a full kitchen

Big Canoe – Overnight Trip (Week 9 or 10)

* Camper's must turn 10 years old prior to departure for Big Canoe

INITIAL

I realize that my child must earn 9 of the 12 field trips in order to be eligible for Big Canoe.

Allergies

Single Line Text

My child is allergic to:

Single Line Text

My child is allergic to:

Single Line Text

My child is allergic to:

Checkboxes

YES

NO

Has your child ever been stung by a bee?

Checkboxes

YES

NO

Does your child have (2) EpiPens?

Getting a Camp Physical from your Doctor

INITIAL

Although a doctor’s visit before camp in not mandatory, it is strongly recommended your child visit his/ her physician prior to camp to receive a full physical. LukeCamp is physically demanding and pro-longed activity in extreme heat is normal for all campers.

Single Line Text

My child has the following physical restrictions:

Single Line Text

My child has the following physical restrictions:

Drop off and Pick-up

INITIAL

I understand that my child must be dropped off between 8 a.m. and 9 a.m. and must be picked up between 3:15 and 3:45 daily.

Paragraph Text

LukeCamp Point and Reward System

INITIAL

I understand that daily attendance is mandatory as well as good behavior positioning my child so that he / she will earn the weekly field trip as well as points that count towards the overnight trip (week 9 or 10).

INITIAL

I understand that I must notify the camp staff at least 24 hours in advance if the camper plans on missing camp to see if the absence will be excused. (Call 678- 754-7700) The “only” excused absence is when a camper wakes up the morning of camp with the stomach flu – Note: We require a 24 hour period between the last time your camper was sick to their return to camp.

INITIAL

I realize that my child must earn 9 of the 12 field trips in order to be eligible for Big Canoe.

Electronic Games, Cell phones or any “Device” – IPod, etc.

INITIAL

I understand my child will not bring electronic games or cell phones to camp. In the event my child brings an electronic game, cell phone or device to camp I understand my child will receive a two-week suspension from camp.

LukeCamp Curriculum

INITIAL

I understand my child will use the NIV version of the Bible as well as curriculums developed or group discussion facilitated by the staff modeled after The Little Black Book, The Seven Check Points or 252 Basics or similar. Basic Life Skill Classes will be developed as required by the staff or volunteers. Example: How to make a healthy smoothie, etc.

Paragraph Text

Little Black Book Series - By: Blaine Bartel 
Seven Check Points – Andy Stanley
252 Basics – http://www.thinkorange.com