Fort Steuben Scout Reservation
GUIDE TO ADVENTURE
2016 Summer Camp Parent’s Guide
Boy Scouts of America Ohio River Valley Council
ON MY HONOR I WILL DO MY BEST TO DO MY DUTY TO GOD AND MY COUNTRY AND TO OBEY THE SCOUT LAW; TO HELP OTHER PEOPLE AT ALL TIMES; TO KEEP MYSELF PHYSICALLY STRONG, MENTALLY AWAKE, AND MORALLY STRAIGHT.
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CONTENTS 4) 5) 5) 6) 8) 10) 11) 12) 14) 16) 18) 19) 20) 21) 22)
Welcome Letter Pre-Camp Calendar Summer Camp Kick-Off Communicating With FSSR Camp Fees Getting to Fort Steuben Health and Safety Merit Badges Waterfront The Nature Center Handicraft Scoutcraft Sports Eagle University Shooting Sports
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Trailblazer Campsite Trading Post Dining Hall Experience Adult Leader Experience Religious Services Family Night Adventure Creek Day Trip Fishing on the Lake Mountain-Boarding Action Paintball Course Bike Program Pontoon Boating Logan Honors Program Order of the Arrow Appendices
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4 A Scout Is TRUSTWORTHY LOYAL HELPFUL FRIENDLY COURTEOUS KIND OBEDIENT CHEERFUL THRIFTY BRAVE CLEAN REVERENT
Welcome Scouts, Parents, and Leaders, The foundation for the 2016 Fort Steuben Scout Reservation program began the moment Scouts arrived for summer camp last year. We listened to suggestions made by the Scouts, Adult Leaders, Staff, and Parents throughout the summer in an effort to make our program more relevant to today’s scouts while offering even more opportunity and excitement in 2016 than ever before. The 2016 summer camp season will see the addition of 13 new merit badges as well as exciting new evening program options. In 2016 Fort Steuben will offer a total of 55 Merit Badges, 2 new BSA Programs, Unique opportunities for older scouts, and an evening program unlike any other. Some of the highlights for 2016 season include: • • • •
13 Eagle-required Merit Badges Mountain Boarding 40th Anniversary of the Logan’s Honor Program New Merit Badges such as Game Design, Communications, and Sustainability
Our 2016 program is centered on 5 key subject areas: Citizenship, Leadership, Conservation, STEM, and Physical Fitness. Many of our new merit badge offerings and supplemental programs reflect this philosophy, which we believe will help create a more inclusive atmosphere in which every scout can find something they are interested in. The Nature Center program, for example, reflects William T. Hornaday’s ideas of what it means to be conservation minded, while the Sports Center embodies the philosophy that a scout should be physically strong, mentally awake, and morally straight. Finally, it is our intent that this guide and our website be a source of reference for you, your family, and your unit throughout the year as you prepare for the summer. We are committed to making your pre-camp planning experience as easy as possible and will be providing additional resources as the summer approaches. Please take the time to read this guide carefully, as some of our procedures may have changed from previous years. We look forward to working with each of you in the months ahead as we draw closer to the summer. Tony Antonini Camp Director
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Cole Coates Program Director
Bob Drury Scout Executive
Pre-Camp Calendar
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• April 23rd (9am – 12pm): Summer Camp Kickoff & Pancake Breakfast • May 2nd – Pay on or before for Early Bird discount ($235/ camper) • June 1st – Pay on or before ($250/camper) • After June 1st – Late Fee ($275/camper) • July 10th-16th – BSA Week 1 • July 17th-23nd – BSA Week 2 • July 24th-30th – BSA Week 3
Summer Camp Kickoff & All You Can Eat Pancake Breakfast The Summer Camp Kickoff & Pancake Breakfast will replace the traditional 10 day out meetings. This meeting will take place at Fort Steuben Scout Reservation and will walk guests through check-in procedures, program overview, and give you an opportunity to present questions. Schedule: 9:00am – Pancake Breakfast 10:00am – Pre-camp meeting 11:00am – Area Director Meet & Greet 12:00pm - Lunch 12:00pm - Program Preview RSVP by April 13th with the Ohio River Valley Council Service Center with the number of attendees. We recommend bringing at least 2 adult and one youth leader, and we encourage any youth or adult who has questions to attend. As always, be sure to follow youth protection guidelines when making arrangements to travel to and from camp.
“A scout is never taken by surprise: he knows exactly what to do when anything unexpected happens”. -Lord Baden-Powell
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COMMUNICATING WITH FORT STEUBEN Fort Steuben Scout Reservation employs a variety of communication methods in order to make answering your questions as easy as possible. You can reach us throughout the year through Email, Phone, US Mail, the Fort Steuben website, or by following our social media presence. Specific questions can be addressed to any of the camp administrative staff: Tony Antonini, Camp Director tony.antonini1@gmail.com
Cole Coates, Program Director ccoates@westliberty.edu
Rob Sparks, Properties Director rob.sparks@scouting.org
Our general email is used for most questions, comments, or concerns you may have about the summer camp program at Fort Steuben. We check this email on a regular basis and make it our priority to respond as soon as we are able. support@fortsteuben.com
Phone: Ohio River Valley Council Service Center: (304) 277 – 2660 Fort Steuben Camp Office: (740) 942 – 3438 From August to May, the ORVC service center is the best place to call with questions or concerns. During the camping season (from the end of May to the first week of August), the camp office will be open and is the best place to call for camp-related matters.
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Social Media
Website
Fort Steuben now has an active social media presence as well. Follow us on Twitter, Facebook, or Instagram for the latest in camp news, pictures of the camp and the exciting activities leading up to your stay with us. You can follow us at: Facebook: www.facebook.com/fortsteuben. scoutreservation
We also maintain a website at www.fortsteuben. com. We keep the site updated all year long with the latest program information, announcements, and resources to make preparing for camp easier on your unit.
U.S. Mail While we prefer most communication to go through one of the methods listed above, we recognize that sometimes the postal service is the best way to send information. If you do need to send us mail, such as to send a package to a scout, you can send it to this address: Fort Steuben Scout Reservation 79601 Adams Road Freeport, OH 43973
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8 Camperships The Ohio River Valley Council, aided by local donors, provides a campership fund to help Scouts in financial need pay for camp. Camperships cover 1/3 to 1/2 of the camper fee, so if a scout in your troop is unable to pay for camp due to financial hardship we encourage you to submit a campership application to the ORVC Service Center by April 1st, 2016.
Provisional Camping The Provisional Camper program allows Scouts to participate in Fort Steuben’s program when their troop isn’t at camp. This program is perfect for Scouts who can’t attend with their unit or for Scouts that wish to come back for another week. Provisional camping applications can be found in the appendix of this guide or at the ORVC Service Center.
Adult Leader Fees The base adult fee will be $150. There is no early bird discount for adult leaders. Scoutmasters will be able to attend with their unit, free of charge. Units that bring 2-10 youth are eligible for a free adult, while units that bring over 10 youth will be eligible for 2 free adults.
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CAMP FEES Fort Steuben Scout Reservation believes that every scout should have the opportunity to attend summer camp. To help achieve this goal, we have kept our camper fees as low as possible and are proud to say we offer one of the most competitively priced programs in the area. There are three price deadlines for camp fees this year: Early Bird (paid by May 2nd): $235 Regular (paid by June 1st): $250 Late Fee (paid after June 1st): $275 We encourage parents and units to take advantage of the Early Bird program, not only because it reduces costs for your scouts, but because it helps ensure access to some of the more popular programs and helps us be better prepared to offer you the best program possible. “A week of camp life is worth six months of theoretical teaching in the meeting room.” -Lord Baden-Powell
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Refunds & Transfers
Second Week
While individual camp fees are generally not refundable, they are transferable from person to person within a troop. If something comes up and a camper cannot come to camp, we encourage you to see if there is another scout in the troop who would like to go to whom the camper fee can be transferred. Individual refunds, whether full or partial, will only be granted by the Camp Director only for exceptional circumstances. The Camp Director may authorize a full, partial, or no refund for requests due to serious illness or family emergency. A written refund request detailing the circumstances must be submitted to the Camp Director in order for a refund to be considered.
Want to come back for a second week? Any Scout wishing to attend for a second week is more than welcome to return. We will place him with a troop that is attending that week or in the provisional camp. Fees for 2nd Week campers are $175.
Siblings Due to the limited space available in camp sites and the need to establish the particular setting of a scout camp, non-registered siblings are not permitted to stay with the unit. However, we also understand that family circumstances may not allow an adult leader or scout to attend without a tag-along. If arrangements must be made to accommodate non-scouting youth during your stay, we request that you make the arrangements with the camp administrative staff prior to your unit’s arrival at camp.
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GETTING TO FORT STEUBEN SCOUT RESERVATION
From US 250: US 250 will follow the shore of Tappan Lake. On the southern end of the lake turn onto a causeway road (Harrison Co. Road 55) crossing the lake. The intersection is clearly marked by a large sign for Tappan Lake Park. Follow CR 55 for 5 miles into Deersville, Ohio. From Deersville there are two ways to get to camp: 1. On the west side of Deersville look for camp signs at the intersection of CR55 and a very wide dirt road (Adams Road). Adams Road runs for 6 miles all the way into camp. 2. In Deersville, turn left on CR 21 at the intersections with a stop sign. A small sign on the telephone pole at the corner is marked ‘Scout Camp’. As you follow this road you will come to the beginning of another causeway, just before which there should be a dirt road marked with a camp sign on the right hand side. You can follow this road into camp. From I-70: On I-70 in Belmont County take SR 800 N. at the Barnesville (202) Exit. Follow 800N through Freeport, Ohio. Approximately 1 mile north of Freeport you will take the right fork at a Y-intersection onto US 799. Stay on US 799 for 6 miles, then turn left onto a dirt road marked with a Scout Camp sign. Following this dirt road will take you directly into camp.
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HEALTH AND SAFETY AT FORT STEUBEN The safety and well-being of our campers is our top priority at Fort Steuben. To ensure your campers are receiving the best medical attention we maintain a health office at the center of camp, where we have a quality, trained Health Officer on call 24 hours a day to handle any emergency that may occur during your stay.
Medications Only refrigerated medications, injectable medications, and controlled substances are required to be stored at the Health Lodge with the Medical Officer. Other medications will be kept by the unit leaders with a medical log and lockable container to use for storing the unit’s medications. It is the responsibility of the unit leader to ensure the timely distribution and logging of all medications given to members of the unit.
Annual BSA Health Form The BSA requires a physical evaluation be completed annually for both Scouts and Adult Leaders attending summer camp. A health form signed by a licensed Health Care Provider and dated within 12 months from when the camper will be attending camp must be on file at the camp’s medical facility. The form is good for 1 year through the month in which the form was completed. For example if a scout has a form filled out in July of this year that form is good for all scouting activities through July of next year.
Units may request a lock-box for secure storage of medication if a trailer is not kept in the campsite. Medications can also be dispensed by the Health Lodge, by request of a parent or guardian of the scout. However, the unit leader will remain responsible for ensuring all campers receiving medication from the Health Lodge arrive and take the medication. Any medications distributed by the Health Office for your unit must be turned in during Sunday Check-in. Medication should be placed in separate containers for each scout, including instructions for dispensing (how many, when, through what method, etc…). We ask that campers bring only medication being taken under a physician’s direction. The medications must be in the original container and clearly marked with the contents, dosage instructions, camper name, and camper’s unit number.
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MERIT BADGES AT FORT STEUBEN
The merit badge system is the core of BSA advancement, and as such it is the foundation for our daily program. Merit badges are designed to introduce scouts to new skills, experiences, and knowledge in a variety of different subjects, and at Fort Steuben we believe we have a duty to offer a diverse selection of quality merit badges to reflect this purpose. Our merit badge selection has grown to 55 classes, and is offered in fields such as Ecology, Aquatics, Sports, STEM, Outdoor Skills, Shooting Sports, and Citizenship. This year we are employing an online registration system that will launch in early 2016. We understand the registration process can be overwhelming at times, so we encourage you to contact us with any questions you may have while registering. For your convenience, we have also included some tips and tricks to help you avoid the most common registration mistakes and to help make sure your unit has the best possible experience at Fort Steuben: •
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Although merit badges are an essential part of the camp experience, we also provide a host of other experiences throughout the week. Don’t overburden yourself with merit badges, and be sure to leave time for other fun activities during the week – or even just time to sit back and enjoy your campsite. Merit badges are supposed to reflect your interests and abilities. Try to register for merit badges that are best suited to you and your interests. Many younger scouts find the merit badges offered at Handicraft to be fun and engaging, but many find it difficult to grasp the concepts explored at Eagle University. Many merit badges have prerequisites, which will be detailed later in this guide. We highly encourage campers to complete these requirements so they can complete the merit badge by the end of their stay with us. Even if your merit badge doesn’t have any prerequisites it always pays to be prepared. We recommend that a scout purchase and read their merit badges books prior to coming to camp, or at least be familiar with the requirements of the badge by the first merit badge session.
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9am
10am
Paddle Boarding
Canoeing
Lifesaving
Aquatics Swimming Kayaking
Shooting Sports
Swimming
Open Shoot
Trailblazer
Rowing
2pm
3pm
Lifesaving
Trailblazer Swimming
Swimming
Open Swim
Motorboating
Open Shoot
Rifle
Shotgun
Archery
Open Shoot
Cooking
Wilderness OrienteerPioneering Survival ing
Camping
Wilderness GeocachSurvival ing
Rank Advancement
Nature
Fish & Wildlife
Sustainability
Trailblazer Trailblazer Trailblazer Swimming Handicraft Focus
Forestry
Soil & Water Con.
Oceanography
Weather
Env. Science
Mining in Society
Nature
Archaeology
PhotograJournalism phy
Movie Making
Game Design
Space Ex.
Art/ Fingerprint
Basketry
Leatherworking
Wood Carving
Trailblazer Handicraft
Sports
Fishing
Personal Fitness
Sports/ Athletics
Personal Fitness
Chess
Eagle U.
Cit. Com
E. Prep
First Aid
Misc.
Indian Lore
Pottery
Welding
Cit. Nation Cit. World Scouting Heritage
American Cultures
Extra
Canoeing
Signs, Signals, Code
Energy
Handicraft
4pm
Camping
Cooking
Scoutcraft
Motorboating
Small Boat Sailing
Rifle Shotgun
11am
Astronomy
Open Program
Public Health Communi- Disabilities cations Awareness
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THE FORT STEUBEN WATERFRONT The waterfront at Fort Steuben has always been one of the most popular areas on camp and is sure to continue bringing fun and excitement to campers this year. At the waterfront scouts can earn several merit badges, enjoy open swimming and boating in the afternoons, or climb to the top of our popular ‘Jungle Joe’ inflatable mountain, which is returning for its second year. As always, safety is our top priority here at camp. Our waterfront staff employs a number of techniques to keep the area safe, and all guests of the camp are required to abide by these safety procedures. Any guests wishing to use the waterfront during their week at camp will be required to take the BSA Swim Test, after which they will receive a Buddy Tag that will be used whenever you are at the waterfront. Further details on how the Buddy Tag system works will be provided upon your arrival at camp, when your Unit first visits the waterfront. Finally, if you plan on taking merit badges at the waterfront, we recommend that you bring swimming trunks, shoes that can get wet, and an extra towel or two. Goggles, nose plugs, and other swimming aids are encouraged for any who wish to use them. Please keep in mind that every waterfront badge involves extensive time in and on the water, and passing the BSA Swimmer’s test as a swimmer is required for all badges.
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Pre-Reqs
Special Notes
Swimming
1b, 2
Eagle Required
Lifesaving
1a
Eagle Required
Motorboating
1b, 2
$10 Cost
Kayaking
1b, 2, 4a, 4b, 4c
Small Boat Sailing
1a, 1b, 2
Merit Badge
Canoeing
Rowing
Paddle Boarding
BSA Award
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THE NATURE CENTER Ecology and Conservation are at the heart of our Nature Center program at Fort Steuben. With nearly 500 acres of forests filled with Flora and Fauna, the program here is all about getting outside and learning about the natural world and all of the things it does for us – and what we can do for it. Merit badges here focus on the observation and study of the natural world and on the impact that humans can have on it.
Merit Badge Energy
Pre-Reqs
Special Notes
4a, 4b, 5a, 5b
Water: 2a, Sustainabil- Food: 2a ity P. Health: 7a, 7b, 7c
Eagle Required
Fish and Wildlife Forestry
1a, 1b, 1c
Archeology Env. Science
2, 3e, & 4
Eagle Required
Soil & Water Con. Mining in Society Oceanography Nature Weather Astronomy
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Taught Late Night
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William T. Hornaday Award The fundamental purpose of the Hornaday Awards program is to encourage learning by the participants and to increase public awareness about natural resource conservation. Understanding and practicing sound stewardship of natural resources and environmental protection strengthens Scouting’s emphasis on respecting the outdoors. The goal of this awards program is to encourage and recognize truly outstanding efforts undertaken by Scouting Units, Scouts and Venturers, Adult Scouters, and other individuals, corporations, and institutions that have contributed significantly to Natural Resource Conservation and Environmental Protection. Fort Steuben Scout Reservation is proud to support the spirit of conservation represented by the William T. Hornaday program. This year we are offering all of the merit badges required to earn the Silver Award, and scouts who wish may work with camp administration to complete up to two (if returning for a second week) of the four required conservation projects while at camp. Scouts wishing to complete a service project should contact their local advancement chair for more information on what a Hornaday Award-caliber project would entail.
World Conservation Award The World Conservation Award provides an opportunity for individual Cub Scouts, Boy Scouts, Varsity Scouts, and Venturers to “think globally” and “act locally” to preserve and improve our environment. This program is designed to make youth members aware that all Nations are closely related through natural resources and that we are interdependent with our World Environment. By completing the merit badges listed below, scouts can qualify to wear this patch on their uniform: Environmental Science Soil & Water Conservation OR Fish & Wildlife Management Citizenship in the World
Keep close to Nature’s heart... and break clear away, once in a while, and climb a mountain or spend a week in the woods. Wash your spirit clean. -John Muir
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HANDICRAFT Creativity and skillfulness are hallmarks of the Handicraft program. If you like to make things with your hands, come up with games to play, or love being behind a camera then Handicraft is the program area for you. The merit badges here are perfect for scouts of any age or experience level, and many of them will have you create works of art you can take home to show your family at the end of the week. Even without prior experience, many Handicraft badges can be started and completed during your stay at camp, but as always it is important to be prepared for the class by reviewing merit badge requirements and reading the merit badge book prior to your arrival at camp. All Scouts taking Handicraft merit badges should remember to bring extra money to purchase craft supplies at the Trading Post. Costs for each badge are detailed below.
Merit Badge
Pre-Req
Special Notes
Movie Making Game Design
8
Space Ex. Photography Journalism Art
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Taught w/ Fingerp.
Fingerprinting
Taught w/ Art
Basketry
$25 Cost
Leatherworking
1b
$10 Cost
Wood Carving
1b, 2a
$6 Cost
Indian Lore
$25 Cost
Scouting Heritage American Cultures Pottery Welding
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$5 Cost
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SCOUTCRAFT Pre-Req
Special Notes
Cooking
1b
Eagle Required
Camping
1, 4a, 4b, 9a, 9b, 9c
Eagle Required
Wild. Survival
1b
Pioneering
1b, 2a
Orienteering
1
Merit Badge
Signs, Signals, Code Geocaching
One trademark of the Boy Scout program is our knowledge of how to live outdoors. Scoutcraft is where Scouts can learn skills that are essential to life in the outdoors, while developing essential leadership and teamwork skills. From cooking meals over a fire, to building your own survival shelter (and sleeping in it overnight), Scoutcraft is sure to ignite the inner survivalist in anyone. Most of the merit badges offered at Scoutcraft are perfect for Scouts with a little more experience and who enjoy working outdoors. Many of them require hard work and completion of prerequisite requirements in order to earn them at camp so it is highly recommended that scouts taking these merit badges have the prerequisites done by the time they arrive at camp.
1b
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SPORTS Returning for the second year at Fort Steuben, the Sports Center is all about Physical and Mental fitness. Learn the ins and outs of athletics in America – from both a player’s and official’s perspective with the only double merit badge class offered at camp: Sports & Athletics. If you prefer something less physical, try our Fishing class, or sharpen your mind against opponents in our Chess merit badge. The merit badges offered at sports are perfect for scouts of all ages, providing a mix of challenge and fun, and most can be completed during your stay at camp.
Merit Badge Fishing
1b, Catch a Fish
Personal Fitness
1a, 1b, 6, 7, 8
Sports
Athletics Chess Public Health
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Pre-Req
1, 5 (part 1), Play a Sport 1, 5 (part 1), Play a Sport
Special Notes
Taught w/ Athletics Taught w/ Sports
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EAGLE UNIVERSITY Pre-Req
Special Notes
Cit. Community
3a, 3b, 7a, 7b, 7c
Eagle Required
Cit. Nation
2
Eagle Required
Merit Badge
Eagle Required
Cit. World E. Prep
1
Eagle Required
First Aid
1, 3b
Eagle Required
Communications
4, 5
Eagle Required
Dis. Awareness
Eagle Univeristy is ideal program area for older scouts looking to work towards their Eagle Scout award. Eagle University offers the largest selection of Eagle Required merit badges of any program on camp. Most of these badges focus on Citizenship and Leadership, while a few focus on scouting skills such as First Aid. Because of the nature of the badges being taught in this area, we encourage Scouts to wait until their 3rd year before beginning these badges, but will welcome all who come. Be prepared to work hard before camp arrives, as the majority of these merit badges require prerequisites to be completed before the badge can be finished at camp.
Taught after lunch
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SHOOTING SPORTS One of the many highlights of a Scout’s experience at summer camp is the opportunity to shoot a Rifle, Shotgun, or Bow. While shooting comprises the majority of the time spent on the Range, every Scout who participates will go through a safety course taught by our National Camping School certified Safety Instructors and is supervised at all times while on the shooting range. Because of the nature of these types of programs and the risks they involve, we strongly recommend that only scouts over the age of 14 be allowed to take these. However, as always, we will welcome any Scout whom the unit leaders and parents believe can safely participate It should be noted that all of these Merit Badges have additional fees associated with them, which help offset the program’s ammunition costs.
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Merit Badge
Pre-Req
Special Notes
Rifle
$10 Cost
Shotgun
$15 Cost
Archery
$5 Cost
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TRAILBLAZER Trailblazer Requirements Covered
Tenderfoot 1, 2, 3, 4a, 4b, 5, 6, 7, 8, 9, 10, 11 Second Class 1, 1b, 2, 3c, 3d, 3e, 3f, 4, 6, 7 First Class 1, 2, 6, 7a, 7b
The Trailblazer Program was designed by our own Bill Kulstad, a registered Speech Pathologist and 30 year veteran of the Ohio public school system, as a way to introduce first-year Scouts to the excitement and adventure at Boy Scout Summer Camp. Scouts who participate in the program will spend the week working on requirements for Tenderfoot through First Class ranks in the morning, while the afternoon will see them earning merit badges at Handicraft and Aquatics. By the end of the week, scouts in the program should be nearly done with all of the requirements for Tenderfoot through First Class and have earned a few merit badges in the process. The highlight of the Trailblazer Program is the overnight camp out on Thursday. Trailblazers will meet before dinner on Thursday and hike out to the overnight campsite. There, they will make dinner over the fire before settling in for a night of fun and games. In the morning, the Scouts will pack up and hike back into camp before breakfast on Friday. Due to the large number of requirements in the Tenderfoot, Second Class, and First Class ranks we cannot cover all of them the way they were meant to be. Attached you will find a list of requirements covered by the program, divided by rank.
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THE CAMPSITE Fort Steuben maintains and operates 10 campsites on property, all within a short walking distance of the Dining Hall and most program areas. Each campsite comes with its own unique feel and history and whether it’s your 1st or 25th year coming to Fort Steuben, finding the right campsite for your unit is essential to the camping experience. However, each campsite is provided with the same amenities and service, listed below: • • •
Walled ‘A-Frame’ tents & platforms A fully stocked latrine & running water nearby Picnic tables and a dining fly
Each campsite is also equipped with an established fire pit. We encourage troops to have campfires in their site (with supervision) and will gladly provide the tools to make sure your campfires are kept safe.
“A Scout smiles and whistles under all circumstances.” - Lord Baden-Powell
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THE FORT STEUBEN TRADING POST
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The Trading Post at Fort Steuben is the place to go for all of your camp purchases. The Trading Post is stocked with all of your summer camp essentials – including raincoats, water bottles, merit badge supplies, and even bags to carry everything in! If you fancy a mid-day snack, the Trading Post is also stocked with all manner of food supplies, including the ever-popular Slushes and Pepsi products. We also carry a selection of Fort Steuben memorabilia, including: T-shirts, Nalgene Bottles, Blankets, and even Stoneware dishes. The Trading Post is also an excellent opportunity to learn budgeting and responsibility. We recommend that every scout bring $100, which should cover all of the scouts needs, with enough to bring home a souvenir commemorating their week with us. Some of the items available in our Trading Post include: Stamps
Camp T-shirts
Batteries
Canteens
Camp Patches
Flashlights
Shotgun tickets
Pizza
Rifle Tickets
Cook Books
Meal Tickets
Camp Hats
Hat Pins
Ponchos
Candy
Ice Cream
Soft Drinks
Compasses
Pocket Knives
Bagged Ice
Handicraft Kits
Tooth Brushes
Soap
Chips
Belt Buckles
Postcards
Merit Badge Books
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THE DINING HALL EXPERIENCE For 2016, Fort Steuben will be continuing to serve meals family style. Units will select 2 scouts per table as waiters to set up prior to, and clean up after the meal. Waiters should arrive in the dining hall 15 minutes prior to each meal, which will be signaled by the sounding of the first meal bell. After each meal, waiters will be required to wipe down, sweep and mop around each table and must be dismissed by the Dining Hall Steward. During each meal, the Fort Steuben staff presents a program consisting of a mealtime knot, a song, and other activities to get scouts engaged and energized for the day of program. Campers with special dietary needs should notify the camp at least three weeks prior to arrival. Notification can be sent via the camp email, addressed to the Health Officer or Camp Director. Notifications sent less than one week prior may not be able to be met upon arrival.
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THE ADULT LEADER EXPERIENCE
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The Adult Leader Experience begins every morning at 6:30am with a complimentary carafe of fresh-brewed coffee personally delivered to your campsite by the Camp Director. Throughout the day we endeavor to provide our adult leaders with plenty of activities to ensure our adults have just as exciting of a week as their scouts. Adult Leaders’ Meetings Camp leadership will host daily adult leader meetings at the Trading Post at 9:15am. Open Shoot Adult leaders will be given the opportunity to participate in open shoot throughout the week during select times at shooting sports. Adult leaders, like campers, must purchase rifle and shotgun shooting tickets at the trading post to participate. Archery is free of charge. Trainings Adult leaders will have the opportunity to take BSA training classes throughout the week, Monday through Thursday. All trainings are scheduled for 3:00pm at the waterfront, or at the chapel depending on weather. The announcement on location will be made at lunch. Adult leaders must register for the training. A sign up sheet will be available at Breakfast the day of the training. The courses offered will be: • American Heart Association First Aid/CPR • Youth Protection • Trek Safely/Climb On Safely • Safe Swim Defense/Safety Afloat Scoutmaster and Troop Service Projects Fort Steuben offers opportunities for adult leaders to volunteer their time to help maintain and beautify the camp. Leaders interested should meet Rob Sparks (Properties Director/Camp Ranger) at the maintenance building following breakfast. Volunteer Commissioner Corps Any Scoutmasters or adult leaders with free time in the morning are encouraged to join the Commissioner in his daily campsite rotation. Each morning, the Commissioner will visit each campsite and “inspect them” on several criteria, and at the end of the week recognize the best campsites. Other adult leaders willing to help with this process can meet the Commissioner after the morning adult leaders’ meeting at the Trading Post. Most inspections are completed by 12pm each day. Scouters’ Award Adult leaders who participate in each of these activities (one open shoot, one training, one service project, and one day serving in the Commissioner Corps) will earn the Scouter’s Award and will be recognized at the closing awards show. Steak and Egg Breakfast If a unit is successful in bringing 85% or more of their registered scouts to camp, the adult leaders will be treated to a complementary Steak and Egg breakfast, cooked by the Scout Executive.
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RELIGIOUS SERVICES Fort Steuben encourages scouts to practice the 12th point of the scout law by attending one of our two religious services. When troops check in they will list a scout as their unit’s Chaplain’s Aide for the week; the Chaplain’s Aide will help the camp Chaplain plan the interfaith service for the week, say the prayer before meals, and work towards their Duty to God. Services will be held Tuesday at 5:15pm. Catholic mass will be held in the Chapel, while the Interfaith Service will be held at the Ken Moore Pavilion.
FAMILY NIGHT Family Night will be held on Wednesdays beginning at 5pm. Dinner may be cooked in the campsite, or your Unit can join us in the Dining Hall for a cookout dinner. Tickets for the dinner will be $8, and are available for sale at the trading post. The Family Night Campfire begins promptly at 8pm, followed directly by the OA Callout Ceremony.
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ADVENTURE CREEK DAY TRIP Back by popular demand for 2016 is our Zip Line experience with our friends at Adventure Creek. As one of our most popular activities last year, we have brought back the program again for campers of all ages. Transportation and a bag lunch will be provided. Be advised that there is an additional $30 participation fee, and Scouts will miss at least their morning classes the day of the adventure. Scouts and parents will also have to fill out a waiver form, located in the appendices.
FISHING ON THE LAKE While fishing is an activity we encourage here at Fort Steuben, we ask that you follow scouting safety procedures as well as our own camp rules when undertaking the activity. As always, you must use the buddy system when exploring the camp and the same rule applies to fishing. It is also important to note that our waterfront space is limited, and the lake is owned by the Muskingum Watershed. Therefore, a fishing license is required for anyone fishing over the age of 16 and is limited to the Fishing Trail so to keep hooks away from our designated swimming areas. Anyone fishing in the evening is advised to bring a flashlight in case of sunset; remember: “The sun always goes down just when you need it the most.�
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MOUNTAIN-BOARDING
ACTION PAINTBALL COURSE
Brand new to the evening program lineup this summer at Fort Steuben is the Mountain-boarding course. For those who may be new to the concept, Mountain-boarding is comparable to a combination of snow-boarding and skate-boarding that takes place on an all-terrain, sloped course. Scouts will be able to challenge themselves physically by participating in the Mountain-board program while having a fun and safe time.
Whether you have never shot a paintball gun before or are an experienced paintball player, the Action Paintball Course will surely bring some excitement to your summer camp experience at Fort Steuben. The course consists of five shooting galleries where scouts will travel among and fire at three-dimensional targets of various sorts. Scouts may sign up for an evening time slot on the paintball course upon arrival at camp in the trading post.
31 BIKE PROGRAM
PONTOON BOATING
Last summer bikes were reintroduced to Fort Steuben, and we are pleased to announce that Campers of all ages are once again welcome to participate by either bringing their own bike, or renting one at the trading post. Rental fees are $10.00 for Sunday through Wednesday, and $15.00 for the entire week. Riding a bike is a quick and enjoyable way to travel between program areas throughout the day and also provides a leisurely way to enjoy the beauty of Fort Steuben. While having a good time at camp is important, the safety of all campers is just as essential. For this reason, each participant choosing to ride a bike must wear a helmet at all times, and also follow the FSSR bike rules which will be attached to every bike upon arrival.
Lake Clendenning will once again be the host of many exciting program pieces made possible by the Pontoon boat, rented from the Lake Clendining Marina. Scouts and Scoutmasters alike will have the opportunity to cool off on hot summer days on the pontoon boat by participating in adult leader trainings, fishing trips, and the always enjoyable pontoon boat luncheon.
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LOGAN HONORS PROGRAM For 40 years the Logan Honor program has served as a unique camper experience at Fort Steuben. Founded in 1976, the Logan Honor program supplements other camp programs by aiding in a Scout’s personal growth, leadership, and advancement through the scouting program.
S
The Logan program also exposes scouts to local history and Native American culture. The Logan Honor’s program culminates on Friday evening with a Native-American themed recognition ceremony, which honors the campers for their achievements and service throughout the week. The Logan program also provides countless service hours to the camp throughout the year and is considered a cornerstone of the Fort Steuben Scout Reservation program. Out of council troops are encouraged to participate as well. For more information please contact our chairman of the Logan program, Kyle Crago, at kyle.d.crago@gmail.com.
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THE ORDER OF THE ARROW The Order of the Arrow (OA) is the National Honor Society for the Boy Scouts of America. The OA recognizes honored campers for their exceptional leadership abilities, and for their service to scouting. The Ohio River Valley Council’s Onondaga Lodge 36 performs their callout ceremony on Wednesday evenings at the family night campfire, where candidates for the OA are recognized in front of the entire camp. Onondaga Lodge also holds an Ice Cream Social for all members and candidates of the OA on Thursday evenings. The Lodge provides outstanding service and countless volunteer hours to the camp through various events sponsored by the camp, council, and the lodge, and Fort Steuben Scout Reservation is proud to have Onondaga Lodge 36 as a strong part of our camp program. For any questions about the Order of the Arrow, contact Lodge Associate Advisor, Robert McCabe at macabe2005@frontier. com.
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A
Part A: Informed Consent, Release Agreement, and Authorization High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
Informed Consent, Release Agreement, and Authorization I understand that participation in Scouting activities involves the risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Information about those activities may be obtained from the venue, activity coordinators, or your local council. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and the standards of conduct. In case of an emergency involving me or my child, I understand that efforts will be made to contact the individual listed as the emergency contact person by the medical provider and/or adult leader. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical providers are authorized to disclose protected health information to the adult in charge, camp medical staff, camp management, and/or any physician or health-care provider involved in providing medical care to the participant. Protected Health Information/ Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities. (If applicable) I have carefully considered the risk involved and hereby give my informed consent for my child to participate in all activities offered in the program. I further authorize the sharing of the information on this form with any BSA volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Scouting activities.
or staff position: ___________________________________
With appreciation of the dangers and risks associated with programs and activities, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program or activity. I also hereby assign and grant to the local council and the Boy Scouts of America, as well as their authorized representatives, the right and permission to use and publish the photographs/film/videotapes/electronic representations and/or sound recordings made of me or my child at all Scouting activities, and I hereby release the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I further authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the BSA, and I specifically waive any right to any compensation I may have for any of the foregoing.
!
NOTE: Due to the nature of programs and activities, the Boy Scouts of America and local councils cannot continually monitor compliance of program participants or any limitations imposed upon them by parents or medical providers. However, so that leaders can be as familiar as possible with any limitations, list any restrictions imposed on a child participant in connection with programs or activities below.
List participant restrictions, if any:
!
None
________________________________________________________ I understand that, if any information I/we have provided is found to be inaccurate, it may limit and/or eliminate the opportunity for participation in any event or activity. If I am participating at Philmont, Philmont Training Center, Northern Tier, Florida Sea Base, or the Summit Bechtel Reserve, I have also read and understand the supplemental risk advisories, including height and weight requirements and restrictions, and understand that the participant will not be allowed to participate in applicable high-adventure programs if those requirements are not met. The participant has permission to engage in all high-adventure activities described, except as specifically noted by me or the health-care provider. If the participant is under the age of 18, a parent or guardian’s signature is required.
Participant’s signature: ________________________________________________________________________________________ Date: ______________________________
Parent/guardian signature for youth: _____________________________________________________________________________ Date: ______________________________ (If participant is under the age of 18)
Second parent/guardian signature for youth: ______________________________________________________________________ Date: ______________________________ (If required; for example, California)
Complete this section for youth participants only: Adults Authorized to Take to and From Events: You must designate at least one adult. Please include a telephone number. Name: ______________________________________________________
Name: ______________________________________________________
Telephone: __________________________________________________
Telephone: __________________________________________________
Adults NOT Authorized to Take Youth To and From Events: Name: ______________________________________________________
Name: ______________________________________________________
Telephone: __________________________________________________
Telephone: __________________________________________________
680-001 2014 Printing
B
Part B: General Information/Health History High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
or staff position: ___________________________________
Age:___________________________ Gender: ________________________ Height (inches): __________________________ Weight (lbs.): ____________________________ Address: ________________________________________________________________________________________________________________________________________ City: __________________________________________ State: __________________________ ZIP code: ______________
Telephone: ______________________________
Unit leader: ________________________________________________________________________________ Mobile phone: _________________________________________ Council Name/No.: __________________________________________________________________________________________________ Unit No.: ____________________ Health/Accident Insurance Company: _________________________________________________ Policy No.: ___________________________________________________
!
Please attach a photocopy of both sides of the insurance card. If you do not have medical insurance, enter “none” above.
!
In case of emergency, notify the person below: Name: ___________________________________________________________________________ Relationship: ___________________________________________________ Address: ____________________________________________________________ Home phone: _______________________ Other phone: _________________________ Alternate contact name: ____________________________________________________________ Alternate’s phone: ______________________________________________
Health History Do you currently have or have you ever been treated for any of the following? Yes
No
Condition Diabetes
Explain Last HbA1c percentage and date:
Hypertension (high blood pressure) Adult or congenital heart disease/heart attack/chest pain (angina)/heart murmur/coronary artery disease. Any heart surgery or procedure. Explain all “yes” answers. Family history of heart disease or any sudden heartrelated death of a family member before age 50. Stroke/TIA Asthma
Last attack date:
Lung/respiratory disease COPD Ear/eyes/nose/sinus problems Muscular/skeletal condition/muscle or bone issues Head injury/concussion Altitude sickness Psychiatric/psychological or emotional difficulties Behavioral/neurological disorders Blood disorders/sickle cell disease Fainting spells and dizziness Kidney disease Seizures
Last seizure date:
Abdominal/stomach/digestive problems Thyroid disease Excessive fatigue Obstructive sleep apnea/sleep disorders
CPAP: Yes
List all surgeries and hospitalizations
Last surgery date:
No
List any other medical conditions not covered above 680-001 2014 Printing
B
Part B: General Information/Health History High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
or staff position: ___________________________________
Allergies/Medications Are you allergic to or do you have any adverse reaction to any of the following? Yes
No
Allergies or Reactions
Explain
Yes
No
Allergies or Reactions
Medication
Plants
Food
Insect bites/stings
Explain
List all medications currently used, including any over-the-counter medications. CHECK HERE IF NO MEDICATIONS ARE ROUTINELY TAKEN. Medication
YES
NO
Dose
IF ADDITIONAL SPACE IS NEEDED, PLEASE INDICATE ON A SEPARATE SHEET AND ATTACH.
Frequency
Reason
Non-prescription medication administration is authorized with these exceptions:_______________________________________________
Administration of the above medications is approved for youth by: _______________________________________________________________________ / _______________________________________________________________________ Parent/guardian signature
MD/DO, NP, or PA signature (if your state requires signature)
Bring enough medications in sufficient quantities and in the original containers. Make sure that they are NOT expired, including inhalers and EpiPens. You SHOULD NOT STOP taking any maintenance medication unless instructed to do so by your doctor.
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!
Immunization The following immunizations are recommended by the BSA. Tetanus immunization is required and must have been received within the last 10 years. If you had the disease, check the disease column and list the date. If immunized, check yes and provide the year received. Yes
No
Had Disease
Immunization Tetanus Pertussis Diphtheria Measles/mumps/rubella Polio Chicken Pox Hepatitis A
Date(s)
Please list any additional information about your medical history: _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ DO NOT WRITE IN THIS BOX Review for camp or special activity.
Reviewed by:____________________________________________
Hepatitis B
Date: ___________________________________________________
Meningitis
Further approval required:
Influenza
Reason: ________________________________________________
Other (i.e., HIB)
Approved by: ____________________________________________
Exemption to immunizations (form required)
Date: ___________________________________________________
Yes
No
680-001 2014 Printing
C
Part C: Pre-Participation Physical
This part must be completed by certified and licensed physicians (MD, DO), nurse practitioners, or physician assistants.
High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
or staff position: ___________________________________
You are being asked to certify that this individual has no contraindication for participation inside a Scouting experience. For individuals who will be attending a high-adventure program, including one of the national high-adventure bases, please refer to the supplemental information on the following pages or the form provided by your patient.
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!
Examiner: Please fill in the following information: Yes
No
Explain
Medical restrictions to participate Yes
No
Allergies or Reactions
Explain
Yes
No
Allergies or Reactions
Medication
Plants
Food
Insect bites/stings
Explain
Height (inches):__________________ Weight (lbs.):__________________ BMI:__________________ Blood Pressure:__________________/__________________ Pulse:__________________ Normal
Abnormal
Explain Abnormalities
Examiner’s Certification I certify that I have reviewed the health history and examined this person and find no contraindications for participation in a Scouting experience. This participant (with noted restrictions):
Eyes
True
Ears/nose/ throat
False
Explain Meets height/weight requirements. Does not have uncontrolled heart disease, asthma, or hypertension.
Lungs
Has not had an orthopedic injury, musculoskeletal problems, or orthopedic surgery in the last six months or possesses a letter of clearance from his or her orthopedic surgeon or treating physician.
Heart
Has no uncontrolled psychiatric disorders. Has had no seizures in the last year.
Abdomen
Does not have poorly controlled diabetes. If less than 18 years of age and planning to scuba dive, does not have diabetes, asthma, or seizures.
Genitalia/hernia
For high-adventure participants, I have reviewed with them the important supplemental risk advisory provided.
Musculoskeletal
Examiner’s Signature: ___________________________________ Date: _______________ Provider printed name: ________________________________________________________
Neurological
Address: ______________________________________________________________________ City: _____________________________________ State: ____________ ZIP code: _________
Other
Office phone: _________________________________________________ Height/Weight Restrictions If you exceed the maximum weight for height as explained in the following chart and your planned high-adventure activity will take you more than 30 minutes away from an emergency vehicle/accessible roadway, you may not be allowed to participate. Maximum weight for height: Height (inches)
Max. Weight
Height (inches)
Max. Weight
Height (inches)
Max. Weight
Height (inches)
60
166
65
195
70
226
75
Max. Weight 260
61
172
66
201
71
233
76
267
62
178
67
207
72
239
77
274
63
183
68
214
73
246
78
281
64
189
69
220
74
252
79 and over
295
680-001 2014 Printing
Ohio River Valley Council & Fort Steuben Scout Reservation All-Terrain Vehicle (ATV) Program Participation and Hold-Harmless Agreement Fort Steuben Scout Reservation and the Ohio River Valley Council will be conducting an ATV program at camp. Scouts will be instructed in the safe operation and handling of an ATV on a closed training course, then on approved trails. Scouts will be on the unit individually and in control of the power and brakes. Scouts will be required to wear a helmet, goggles, gloves, over-the-ankle boots, long-sleeve shirts, and long pants. Scouts are expected to abide by all safety rules and the instructions of the camp instructor(s). I, the undersigned, give my child (Name) , permission to participate in this program. I understand that participation in the activity involves a certain degree of risk. I have carefully considered the risk involved and have given consent for my child to participate in the activity. I understand that participation in the activity is entirely voluntary and requires participants to abide by the rules and standards of conduct. I release the Boy Scouts of America, the ATV Safety Institute, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation. For safety, my child and I agree that he/she will do the following or he/she will be removed from the program. Because space is limited, any additional cost associated with participation in this program will not be refunded. 1. Complete the ATV safety class taught at Camp __________________________. 2. Wear all required safety gear at all times on or around the equipment. 3. Follow all safety rules provided in the training class. 4. Follow the instructions of the camp staff instructor(s). 5. Maintain control of the ATV at all times and remain within the speed determined to be safe by the camp instructor(s). 6. Be in full compliance with all local, state, and federal guidelines, including age restrictions and original equipment manufacturer standards. 7. Respond to the camp satisfaction survey from the Boy Scouts of America as it evaluates the ATV program. Participant’s  signature:
Date:
/
/
Parent/guardian signature:
Date:
/
/
Parent/guardian printed name:
Date: ___/____/____
22
Campership Application 2016
Name of Scout ______________________________ Unit Number ______________ Age______ Rank______ Parents Names ___________________________________ Address _________________________________ City, State, Zip ____________________________________________________ Telephone ______________
Scouting and Family Background
Circle the Activity your son will Attend.
How many years of camp has this scout attended at Fort Steuben?
________________
What other long term camps has he attended?
________________
Is a parent attending camp with your son?
________________
Annual Household Income: (attach a copy of the front 2 pages of this year’s tax return; please black out personal date of birth and social security number)
________________
Boy Scout Summer Camp $________ Cub Resident Camp $________ Day Camp $________
How many children from your family will attend scout camping programs this summer? Did this scout participate in Unit Money Earnings projects? (ie. Popcorn sale)
Scout Master Scout sold popcorn Scout did another fundraiser
________________ ________________
Scout has __________ in Troop Funds earned through fundraising. _________________________________ Scout Master’s Signature
Campership applications should be received by the Service Center no later than April 1. Late applications may or may not be accepted depending on the state of the campership fund. Camperships typically cover up to half the cost of a camp fee. Scouts are expected to pay the remainder of the camp fee by participating in troop fundraising activities and through other sources. The number of camperships awarded will vary each year, the amount awarded is determined by the state of the campership fund.
Note here any special family circumstances that make it difficult for your son to afford his camp fee.
Use back if more space is needed
Signature of Parent/Guardian
Office Use Only Approved _______________ Not Approved ____________
Date:
Date Received: ____________ Amount __________________ Notified _________________
Mail completed form to: Ohio River Valley Council PO Box 6186 Wheeling WV 26003
*Resident Camps require a BSA Medical Form to attend camps. Contact Council Office if this causes a family hardship. 800.365.8028
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July%24th%–%July%30th%%
July%17th%–%July%23rd%
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Mail%all%forms%and%payments%to:% % Lori%Abraham% Ohio%River%Valley%Council,%BSA% P.O.%Box%6186% Wheeling,%WV%26003%
Registration%deposit%must%be%received%before% reservation%will%be%accepted.%
Unit%Deposit:%$50%%
Ohio%River%Valley%Council%%%%%%%%%%%%%%%%%%%%%Camp%Unit%Registration%Form%%%%%%%%%%%%%%%%%%%%%%Fort%Steuben%Scout%Reservation%
Unit%Number:%%% % %
Unit%Information%
Scoutmaster:%%% %
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Dietary% Release% Paid?% Restrictions% Form% %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % %
Health% Form% % % % % % % % % % % % % % % %
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Dietary% Release% Paid?% Restrictions% Form% %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % % %%(Y/N)%%%% % % %
Ohio%River%Valley%Council%%%%%%%%%%%%%%%%%%%%%Camp%Unit%Registration%Form%%%%%%%%%%%%%%%%%%%%%%Fort%Steuben%Scout%Reservation% % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % % % % % %%(Y/N)%%%% % % % Youth%Roster%&%Checklist%
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Ohio River Valley Council
Special Needs / Dietary Request Form Submit AT LEAST 2 WEEKS BEFORE START of Camp/Event If you have a need that requires special a n on due to medical or religious reasons, l out this request form and submit to the Ohio River Valley Council Service Center at PO Box 6186, Wheeling WV 26003 or to the Camp Director at tantonini@fortsteuben.com.. Please submit the completed form a minimum of two weeks before the person will be a ending camp/event. Name: ____________________________________________________ Pack/Troop #_________________ Date: ________________ Name of event: ______________________________________________Dates of event: ________________ to _________________ Loca
n of Event: _____________________________________________________________________________________________
We ask individuals requiring a very special diet (please use this op on only if medically necessary or required by religion) to bring their own food to camp. Camp sta can store and help prepare the food. I am submi ng this form because I or a Scout coming with me (please check all that apply)‌ Needs a CPAP Has a special diet (please answer the ques ons below) Has an allergy (please answer the ques ons below) Has a medical cond on Needs special arrangements (please answer the ques ons below) i.e. sleeping arrangements, medicine storage, transporta on around camp, etc. ALLERGIES: Please name the allergen (i.e. Peanuts):____________________________________________________________________________ What is the trigger for a reaction to the allergen, please check all that apply: Person has a nega ve reac on when the allergen is within ___ feet of the person: ____ Person has a nega ve reac on when they come into physical contact with the allergen: ____ Person has a nega ve reac on only when inges ng or ea ng the allergen: ____ Please tell what reac n happens when the person comes into contact with this allergen: __________________________________ ____________________________________________________________________________________________________________ MEDICAL CONDITION: Please describe below in as much detail as possible the medical cond on and special need. _________________________________ ____________________________________________________________________________________________________________ SPECIAL DIETARY NEEDS: Please describe dietary requests such as special food storage or vegan diets here. _________________________________________ ____________________________________________________________________________________________________________ OTHER SPECIAL NEEDS OR REQUESTS: Please share other special arrangements or needs here not men oned previously (please be speci ). _________________________ ____________________________________________________________________________________________________________
Camp Management
Fort Steuben Scout Reservation Ohio River Valley Council Boy Scouts of America 2016 Summer Camp Parent’s Guide