Camp St. Isaac Jogues. Fraternitas Sacerdotalis Sancti Petri

Transcription

1 Camp St. Isaac Jogues Fraternitas Sacerdotalis Sancti Petri Centered on the Holy Mass, Camp St. Isaac Jogues helps boys to grow in faith and in the practice of the virtues through daily catechism, sports, liturgy and team activities. It is run by seminarians of Our Lady of Guadalupe Seminary and by a priest of the Priestly Fraternity of Saint Peter. Boys 13 to 15 years old may apply. The cost per boy is $375.00, payable to Camp Saint Isaac Jogues. Please send to: Camp Saint Isaac Jogues Our Lady of Guadalupe Seminary 7880 W Denton Rd Denton NE The Camp is held on the campus of Gregory the Great Academy, located at 119 Griffin Road, Elmhurst Township, PA. The camp begins on Wednesday, July 12 th at 2:00 pm and concludes on Saturday, July 22 nd at 2:00 pm. Due to staff and space restrictions, only a limited number of boys can be accepted. Please send your applications only to the above address postmarked no later than Wednesday, May 17th. We will send a notification of acceptance by . Any checks received from boys who are not accepted will be disposed of properly. Attendees of Camp Saint Isaac Jogues are not permitted to contact home/parents by phone or at any time during the course of the camp. Letters are permitted and encouraged, and care packages may be received by the boys at any time. We do not permit private snacks and treats, however, so any food received will become a community snack. Please send appropriate proportions. Cell-phones, i-pods, laptops, mp3s, cd players, radios, etc. are not permitted at any time. The camp director may be contacted at csij@olgseminary.org Visit our blog at C.S.I.J. Page 1 of 8

2 Gear List for Camp Saint Isaac Jogues The following gear list is intended to provide campers with a specific idea of what to pack for camp. Even though the camp is long, please try to pack as tight and light as possible, for the boys will be sharing tents and excessive equipment crowds their sleeping quarters. The Camp is not responsible for loss or damage of any clothing, equipment or other personal items that belong to those attending the camp. Essential Clothing Items: 1 set of suitable church clothes (i.e. collared shirt, NO jeans or cargo pants) Essential Hygiene items: Toothbrush & paste 4 pairs of good socks Bar Soap or hand sanitizer 4 pairs of underclothes Washcloth & towel 1 pair of long pants Deodorant 2 pairs of shorts 1 Box of Baby Wipes (for field-showering ) 3 T-shirts / short sleeve shirts 1 pairs of pajamas/sleeping clothes Essential devotional items: Warm sleeping bag Hiking boots or shoes (broken in prior to camp) Camel Back or canteen (or a good water bottle) Rain jacket / poncho Sports mouth-guard Swim trunks Recommended Items: An extra pair of shoes (trail shoes /sports shoes) Wrist watch Rosary Scapular (Booklets with daily prayers & Mass propers will be provided by the camp for all) What NOT to bring: Weapons of any kind Matches or fire starting material Hat (for keeping off sun / rain) Knives w/ blade greater than 3" Sunglasses Mesh laundry bag Small pillow Recommended cold weather gear: Cold weather hat Sweater or warm shirt Jacket or vest Electronic devices Personal food Optional items: Belt / utility knife / flashlight Fishing pole / lures Cameras (waterproof or disposable nothing expensive) C.S.I.J. Page 2 of 8

3 Camp Saint Isaac Jogues Registration Form Registration Form Page 1 of 1 PLEASE PRINT CLEARLY *Note: If there are several applicants from the same household, duplicate information need not be included (i.e., contact/family/historical info) Camper s Last Name First Name M.I. Address City State Zip Age Date of Birth (parent/guardian) Home Phone #( ) School Mother s Name Work Phone # Cell Phone # ( ) ( ) Father s Name Work Phone # Cell Phone # How did you hear about Camp St. Isaac Jogues? ( ) ( ) Parish Priest Contact Information: FSSP Priest? Y / N Name: Contact Number: 1. Applicant lives with (please circle one): Both Parents Father Mother Guardian 2. Number of brothers 3. Number of sister 4. Has applicant ever attended any FSSP camp before? Y / N 5. If so, which one(s)? 6. Other pertinent (non-medical) information: I confirm that all of the above information on this page is answered completely and accurately. Signature: Date: C.S.I.J. Page 3 of 8

4 Health Questionnaire/History Page 1 of 2 Camp Saint Isaac Jogues Health Questionnaire We are aware of and respect the private nature of the following questions. Accurate and full answers are important to ensure your son s well-being. The back of this sheet may be used if necessary Name (Last, First, Initial): Parent/Guardian: Phone: Address: City: State: Zip: Date of Birth: Age: Emergency Contacts (other than mother or father) 1. In Emergency Notify: Relation to Child: Phone: ( ) 2. In Emergency Notify: Relation to Child: Phone: ( ) Insurance Information, please complete the following: 1. Is applicant covered by health insurance? Y / N 2. If yes, please fill out the following: Carrier: ID: Group #: Member Services Phone #: ( ) Address: Health History: (Check those that apply) Diseases Allergies Chronic or Recurring Illness Chicken Pox Animals Ear Infections Measles Food Heart Defect/Disease German Measles Hay Fever Seizures Mumps Insect Stings Bleeding Disorders Rheumatic Fever Medicine/Drugs Asthma Tuberculosis Plants Hypertension Kidney Pollen Diabetes Other Musculoskeletal Disorder Arthritis Sinusitis Other Health Questionnaire/History C.S.I.J. Page 4 of 8

5 Page 2 of 2 Suggestions from Parent: My child has permission to take or use the following (check all that apply): Tylenol/Acetaminophen Advil/Ibuprofen Sudafed/Decongestant Benadryl/Antihistamine Pepto Bismol Tums/Antacid Robitussin/Expectorant Swimmers Ear/Alcohol-vinegar solution Please describe conditions and give dates: Operations or serious injuries: Hospitalizations: Other diseases/disabilities: Comment where applicable: Fainting Sleep disturbance Bed Wetting Nosebleeds Constipation Other Emotional disturbances Restricted Specific activities to be encouraged Special medical or dietary regimen to be followed (specify) This health questionnaire/history is complete and accurate. My son has permission to engage in all prescribed activities, except as noted by me and the examining physician. I hereby authorize the camp director to secure all medical treatment necessary in the case of an accident or emergency. I understand that all efforts will be made to contact me prior to the initiation of treatment. I will be responsible for all expenses incurred. Signature of Parent/Guardian Date: C.S.I.J. Page 5 of 8

6 Camp Saint Isaac Jogues Medication Permission Form Medication Permission Form Page 1 of 1 I,, the parent/guardian of, give permission for the seminarians or priests at Camp Saint Isaac Jogues to administer any medications that are needed for my child during his stay at Camp Saint Isaac Jogues during the summer of Print parent/guardian name Signature of parent/guardian Date C.S.I.J. Page 6 of 8

7 Camp Saint Isaac Jogues Release & Consent Form Release & Consent Form Page 1 of 2 I/ we,, on behalf of my/our minor son,, with a current address of, do hereby acknowledge and understand that the Priestly Fraternity of St. Peter, Inc., d/b/a Our Lady of Guadalupe Seminary, sponsors Camp Saint Isaac Jogues which is scheduled to be held on the campus of Gregory the Great Academy at 119 Griffin Road, Elmhurst, PA 18444, from July 12, 2017, and ending on July 22, I/we acknowledge and understand that the Priestly Fraternity of St. Peter, Inc., d/b/a Our Lady of Guadalupe Seminary, shall provide a priest and seminarians to supervise and oversee Camp Saint Isaac Jogues. I/we hereby give our permission and consent for our son,, to attend Camp Saint Isaac Jogues and participate in all activities of the Camp. I/we hereby authorize the chaplain and seminarian staff of Camp Saint Isaac Jogues to consent to emergency medical examinations and ordered emergency medical treatment at my/our expense. I/we understand that I/we shall not require further permission or notification for the provision of emergency medical treatment to my/our son. I/we hereby give permission for my/our son to participate in off-camp trips sponsored and supervised by the staff of Camp Saint Isaac Jogues. I/we hereby give permission for my/our son to participate in all sports and outdoor activities offered by Camp Saint Isaac Jogues, and I/we understand and agree that the Priestly Fraternity of St. Peter, Inc., d/b/a Our Lady of Guadalupe Seminary, and Gregory the Great Academy shall not be responsible and/or liable in any way for any injury sustained by my/our son as the result of said activities. In consideration of being permitted to participate in Camp Saint Isaac Jogues and the mutual understandings and disclosures set forth herein, together with other good and valuable considerations, the receipt of which is hereby acknowledged, I/we, and on behalf of my/our minor son,, for ourselves, our heirs, executors, administrators, representatives, successors and assigns, do hereby indemnify, release and hold harmless the Priestly Fraternity of St. Peter, Inc., d/b/a/ Our Lady of Guadalupe Seminary, its board of directors, member priests, officers, administrators, employees, agents, representatives, successors and assigns, and Gregory the Great Academy, from any and all claims, demands obligations, actions, suits, causes of action, damages, costs, losses, expenses and compensation of any nature whatsoever, whether based on a tort, contract or other theory of recovery, and whether for compensation or punitive damages, that in any way grow out of, arise from, or that are in connection with my/our son s participation in Camp Saint Isaac Jogues, including but not limited to damages, injury or death arising from the negligence of the aforesaid parties. I/we, for myself/ourselves, my/our heirs, successors and assigns, hereby assume any and all risks attendant to my/our son s participation in Camp Saint Isaac Jogues. C.S.I.J. Page 7 of 8

8 Release & Consent Form Page 2 of 2 In Witness Whereof, I/we have executed this Consent and Release this day of -, 2017, intending to be legally bound hereby. Witnesses: Print Name: Parent(s) / Guardians(s): Print Name: Print Name: Print Name: C.S.I.J. Page 8 of 8