GSLE Resident Camp Brochure 2015

Girl Scouts Louisiana East

2015 Resident Camp

Get Your

GIRL P WER. Camp Covington – Camp Marydale Camp Whispering Pines

Get Your

GIRL P WER.

Resident Camp 2015!

JOIN US AT 2015 CAMP

OPEN HOUSE Open to Girls in Grades K-12 and their families Saturday, March 7, 2015 Camp Covington Covington, LA Sunday, March 1, 2015 Sunday, March 8, 2015 Camp Marydale St. Francisville, LA Sunday, March 15, 2015 Sunday, March 29, 2015 Camp Whispering Pines Independence, LA ALL Open Houses are from 12-2 p.m.

The camp open house provides an opportunity for the girl(s) and her parents/guardians to explore camp, visit the camp sites, and receive information before camp begins. Please remember that exploring camp means walking.

Wear comfortable closed toed shoes and casual clothing. This is your chance to explore camp.

No need to register; come and visit us.

Turn in a completed

registration form and camp deposit at any of our Open Houses, and receive $10 off your camp balance!

2

We believe in the power of girls! At Resident Camp this summer, your Girl Scout will soar to new heights as she discovers exciting activities with brand new friends, challenges her limits with supportive adults by her side, and makes memories for a lifetime. You’ll be amazed at the skills and confidence she brings home. Fun is right around the corner!

Whether it’s hiking, horses, or water sports she loves, Girl Scouts Louisiana East has just the camp for your girl! No matter what program she chooses, your girl will enjoy swimming, boating, outdoor cooking, the beauty of nature, and so much more! She’ll learn new skills, as she revels in the joy of being outside, active, with friends she’s made along the way!

SUNDAY Check-in, settle in, and meet new friends, discuss week’s activities.

6 p.m. Dinner followed by “Welcome to Camp!” and s’mores!

MONDAY-THURSDAY 7:45 a.m.

Flag Ceremony/Breakfast 9 a.m. - 12 noon Activities 12:30 - 1:45 p.m.

Lunch/Turtle Time (rest time) 2 - 5 p.m.

Activities 5:45 p.m.

Flag/Dinner 7 - 9 p.m.

Evening Activities 10 p.m.

Showers/Bed - Lights Out

TUESDAY, BREAKFAST COOK OUT! WEDNESDAY, DINNER COOK OUT! FRIDAY

• Pack up, kapers (camp chores).

• Lunch • Scheduled activity • Check out — See you next summer!

* Girls have the option to swim every day (weather permitting)

Evening activities during the week include: SUNDAY Welcome to camp and s’mores!

MONDAY All camp game (Capture the Flag, Camper-Counselor Scavenger Hunt, Gold Rush, etc.)

TUESDAY

Girls Rock! Event (Music, Dancing, Snacks, etc.)

WEDNESDAY Following the cook out, units may choose a night swim, star gazing, night hike, dance, camp out, crafts, special activity, or just hanging out.

THURSDAY Closing camp fire

FRIDAY Traveling home and sharing your new experiences.

3

Girl Scout Camp Sessions AT-A-GLANCE

WEEK 7 7/12-7/17

WEEK 6 7/5-7/10

WEEK 5 6/28-7/1

WEEK 4 6/21-6/26

WEEK 3 6/14-6/19

WEEK 2 6/7- 6/12

WEEK 1 5/31-6/5

WP = CAMP WHISPERING PINES

CODE

DATES

MD = CAMP MARYDALE

COST

PROGRAM

GRADE

CC = CAMP COVINGTON

1-3

LOVE, HUG & PAINT

$180

MDLHP1

May 31-June 2 (Sun-Tue)

MD

1-3

LOVE, HUG & PAINT

$180

MDLHP2

June 3-5 (Wed-Fri)

MD

1-3

LOVE, HUG & PAINT

$180

MDLHP3

July 5-7 (Sun-Tue)

1-3

LOVE, HUG & PAINT

$180

MDLHP4

July 8-10 (Wed-Fri)

1-3

S’MORES

$175

MDSM01

May 31-June 2 (Sun-Tue)

MD

1-3

S’MORES

$175

MDSM02

June 3-5 (Wed-Fri)

MD

1-3

S’MORES

$175

MDSM03

July 5-7 (Sun-Tue)

1-3

S’MORES

$175

MDSM04

July 8-10 (Wed-Fri)

1-3

GIRLS ROCK

$275

MDGR01

June 7-12

1-3

GIRLS ROCK

$275

MDGR02

June 21-26

1-3

TADPOLES

$175

MDTP01

June 28-30 (Sun-Tue)

1-3

TADPOLES

$175

MDTP02

July 12-14 (Sun-Tue)

MD

1-3

TADPOLES

$175

MDTP03

July 15-17 (Wed-Fri)

MD

1-6

SAFARI GIRLS **NEW**

$150

CCSG01

June 7-9 (Sun-Tue)

1-6

SAFARI GIRLS **NEW**

$150

CCSG02

June 14-16 (Sun-Tue)

1-6

DYNAMIC DUO **NEW**

$150

CCDD01

June 10-12 (Wed-Fri)

1-6

DYNAMIC DUO **NEW**

$150

CCDD02

June 17-19 (Wed-Fri)

1-3

SHE & ME **NEW**

$150

MDSM11

June 28-July 1 (Sun-Wed)

MD

4-12

SHE & ME **NEW**

$150

MDSM41

June 28-July 1 (Sun-Wed)

MD

1-3

SHE & ME

$150

WPSM11

June 28-July 1 (Sun-Wed)

WP

4-12

SHE & ME

$150

WPSM41

June 28-July 1 (Sun-Wed)

WP

2-3

MARYDALE MERMAIDS

$275

MDMM01

June 7-12

2-3

MARYDALE MERMAIDS

$275

MDMM02

June 14-19

2-3

MARYDALE MERMAIDS

$275

MDMM03

June 21-26

3-4

PONY UP

$280

MDPU01

May 31-June 5

3-4

PONY UP

$280

MDPU02

June 14-19

3-4

PONY UP

$280

MDPU03

July 12-17

4-6

ART-RAGEOUS

$275

WPAR01

July 5-10

WP

4-6

CAMPING DIVAS

$275

MDCD01

July 5-10

MD

4-6

CAMPING DIVAS

$275

MDCD02

July 12-17

4-6

CWP SAMPLER

$175

WPSA01

June 7-9 (Sun-Tue)

WP

4-6

CWP SAMPLER

$175

WPSA02

June 10-12 (Wed-Fri)

WP

4-6

CWP SAMPLER

$175

WPSA03

June 21-23 (Sun-Tue)

4-6

CWP SAMPLER

$175

WPSA04

June 24-26 (Wed-Fri)

4-6

CRAFTY CRITTERS

$275

MDCC01

May 31-June 5

4-6

CRAFTY CRITTERS

$275

MDCC02

June 7-12

4-6

COWGIRLS

$325

MDCG01

May 31-June 5

4-6

COWGIRLS

$325

MDCG02

June 7-12

4-6

COWGIRLS

$325

MDCG03

June 14-19

4-6

COWGIRLS

$325

MDCG04

June 21-26

4-6

COWGIRLS

$325

MDCG05

July 5-10

4-6

FIRE FLIES

$275

MDFF01

July 12-17

4-6

GSI-GIRL SCOUT INVESTIGATORS

$275

MDGSI1

June 14-19

4

MD MD

MD MD MD MD MD

CC CC CC CC

MD MD MD MD MD MD

MD

WP WP MD MD MD MD MD MD MD MD MD

Girl Scout Camp Sessions AT-A-GLANCE

MANE-LY HORSES

$250

MDMH01

June 7-9 (Sun-Tue)

MD

4-6

MANE-LY HORSES

$250

MDMH02

June 10-12 (Wed-Fri)

MD

4-6

PICTURE THAT

$300

MDPT01

June 21-26

4-6

PICTURE THAT

$300

MDPT02

July 5-10

4-6

SUMMER SPLASH

$275

WPSS01

June 7-12

4-6

SUMMER SPLASH

$275

WPSS02

June 21-26

4-6

SUMMER SPLASH

$275

WPSS03

July 5-10

6-8

BOOTS AND BRIDLES

$325

MDBB01

May 31-June 5

6-8

BOOTS AND BRIDLES

$325

MDBB02

June 21-26

MD

6-8

GIRL SCOUT SURVIVORS

$375

MDGSS1

June 21-July 1 (2 weeks)

MD

MD

6-8

STAR GAZERS

$375

MDGS01

June 21-July 1 (2 weeks)

MD

MD

6-8

SADDLE UP

$325

MDSU46

July 12-17

AGES 11-13 AGES 11-13 AGES 11-13

SPUR IN TRAINING

$175

MDSIT1

June 7-12

SPUR IN TRAINING

$175

MDSIT2

June 14-19

SPUR IN TRAINING

$175

MDSIT3

July 12-17

6-10

THRILL SEEKERS

$300

WPTS01

June 7-12

6-10

THRILL SEEKERS

$300

WPTS02

June 21-26

7-10

NIGHT RIDERS

$300

MDNR01

July 5-10

7-12

ALL ABOARD

$300

WPAA01

July 5-10

8-12

TRAIL BLAZERS

$225

MDTB01

June 28-July 1

9-12

BARN AIDE

$100

MDBA01

May 31-June 5

9-12

BARN AIDE

$100

MDBA02

June 7-12

9-12

BARN AIDE

$100

MDBA03

June 14-19

9-12

BARN AIDE

$100

MDBA04

June 21-26

9-12

BARN AIDE

$75

MDBA05

June 28-July 1

9-12

BARN AIDE

$100

MDBA06

July 5-10

9-12

BARN AIDE

$100

MDBA07

July 12-17

9-12

WRANGLER IN TRAINING I

$150

MDWIT1

May 31-June 5

9-12

WRANGLER IN TRAINING II

$275

MDWIT2

June 7-19 (2 weeks)

MD

10-12

COUNSELOR IN TRAINING I

$125

WPC141

June 7-12

WP

10-12

COUNSELOR IN TRAINING I

$125

MDC142

June 21-26

MD

10-12

COUNSELOR IN TRAINING II

$125

WPC243

June 21-26

WP

10-12

COUNSELOR IN TRAINING II

$225

MDC244

July 5-17 (2 weeks)

10-12

PROGRAM AIDE

$100

MDPA01

May 31-June 5

10-12

PROGRAM AIDE

$100

MDPA02

June 7-12

10-12

PROGRAM AIDE

$100

MDPA03

June 14-19

10-12

PROGRAM AIDE

$100

MDPA04

June 21-26

10-12

PROGRAM AIDE

$75

MDPA05

June 28-July 1

10-12

PROGRAM AIDE

$100

MDPA06

July 5-10

10-12

PROGRAM AIDE

$100

MDPA07

July 12-17

10-12

PROGRAM AIDE

$100

WPPA01

June 7-12

10-12

PROGRAM AIDE

$100

WPPA02

June 21-26

10-12

PROGRAM AIDE

$75

WPPA03

June 28-July 1

10-12

PROGRAM AIDE

$100

MDPA04

July 5-10

WEEK 7 7/12-7/17

4-6

WEEK 6 7/5-7/10

WEEK 5 6/28-7/1

WEEK 4 6/21-6/26

WEEK 3 6/14-6/19

WEEK 2 6/7- 6/12

WEEK 1 5/31-6/5

WP = CAMP WHISPERING PINES

CODE

DATES

MD = CAMP MARYDALE

COST

PROGRAM

GRADE

CC = CAMP COVINGTON

MD MD WP WP WP MD

MD MD MD MD WP WP MD WP MD MD MD MD MD MD MD MD MD MD

MD

MD

MD MD MD MD MD MD MD WP WP WP WP

5

entering GRADES 1, 2, & 3

love, hug & paint

In this mini session learn what it takes to be a true cowgirl! You will visit the barn each day where you may take a pony ride, paint a horse, or even feed them a carrot or two. When you aren’t at the barn, you’ll get to do other typical camp activities, like swimming and arts and crafts! *This session does not include archery. **Check-in 2 p.m. Sunday, check-out 5 p.m. Tuesday; or Check-in 9 a.m. Wednesday, check-out 3 p.m. Friday.** at CAMP MARYDALE, $180 DATE CODE May 31-June 2 (Sun-Tues) MDLHP1 June 3-5 (Wed-Fri) MDLHP2 July 5-7 (Sun-Tues) MDLHP3 July 8-10 (Wed-Fri) MDLHP4

s’mores

Want to try out summer camp? Not quite ready to spend a whole week at camp? This session is for YOU! In this camp-tastic session you will discover all that camp has to offer. Take a dip in the pool, hike on a trail, make some nifty arts and crafts, and, of course, make S’MORES! *This session does not include archery. **Check-in 2 p.m. Sunday, check-out 5 p.m. Tuesday; or Check-in 9 a.m. Wednesday, check-out 3 p.m. Friday.** at CAMP MARYDALE, $175 DATE CODE May 31-June 2 (Sun-Tues) MDSM01 June 3-5 (Wed-Fri) MDSM02 July 5-7 (Sun-Tues) MDSM03 July 8-10 (Wed-Fri) MDSM04

girls rock

In this camp session, you’ll spend your time exploring camp programs. Plan to go on a hike, roast marshmallows, take a dip in the pool, and paddle around the lake, accompanied by older campers. *This session does not include archery. at CAMP MARYDALE, $275 DATE CODE June 7-12 MDGR01 June 21-26 MDSM02

tadpoles

Come to this three-day session to dip your toes in the water! Not a strong swimmer? Take your first stroke to becoming a more confident swimmer by participating in water games and activities. In your spare time, you will experience other typical camp activities. *This session does not include archery. **Check-in 2 p.m. Sunday, check-out 5 p.m. Tuesday; or Check-in 9 a.m. Wednesday, check-out 3 p.m. Friday.** at CAMP MARYDALE, $175 DATE CODE June 28-30 (Sun-Tues) MDTP01 July 12-14 (Sun-Tues) MDTP02 July 15-17 (Wed-Fri) MDTP03

6

entering GRADES 1 through 6

SAFARI GIRLS

**new**

Come spend three days at camp with the woman you admire most! Go on a trust hike together, make jewlery, and take a dip in the river! You will enjoy many other activities like team building and outdoor cooking. You and your duo will even take a trip to the near-by Global Wildlife and go on a safari! This is a staff-led event in which “campers” (adults and girls) will follow the lead of their counselors (council camp staff) throughout the entire day. Limit: each girl may bring one female adult. Activities depend on the camper’s grade level. Duos are responsible for their own transportation to Global Wildlife Center. **Check-in 2 p.m. Sunday. Check-out 5 p.m. Tuesday.** at CAMP COVINGTON, $150/person DATE CODE June 7-9 (Sun-Tues) CCSG01 June 14-16 (Sun-Tues) CCSG02

DYNAMIC DUO

**new**

Enjoy three days at camp with the fella you admire most! Your duo will go on a trust hike together, build a craft, and take a dip in the river! One of the days, you will even go on a field trip! You will enjoy many other activities like team building and outdoor cooking. This is a staff-led event in which “campers” (adults and girls) will follow the lead of their counselors (council camp staff) throughout the entire day. Limit: each girl may bring one appropriate male adult. Activities depend on the camper’s grade level. **Check-in 9 a.m.

Wednesday. Check-out 3 p.m. Friday.** at CAMP COVINGTON, $150/person DATE CODE June 10-12 (Wed-Fri) CCDD01 June 17-19 (Wed-Fri) CCDD02

entering GRADES 1 through 12

she & me

**new**

Four, fun days are in store for you and the woman you admire most! Go on a trust hike together, make jewlery, and canoe around the lake! You will enjoy many other activities like archery, swimming, and the high ropes course. This is a staff-led event in which “campers” (adults and girls) will follow the lead of their counselors (council camp staff) throughout the entire day. Limit: each girl may bring one female adult. Activities depend on the camper’s grade level. **Check-in 2 p.m. Sunday. Check-out 3 p.m.

Wednesday.** at CAMP Marydale, $150/person DATE GRADES CODE June 28-July 1 (Sun-Wed) 1-3 MDSM11 June 28-July 1 (Sun-Wed) 4-12 MDSM41

she & me

Come spend four days at camp with the woman you admire most!

Go on a trust hike together, make jewlery, and canoe around the lake! You will enjoy many other activities like archery, swimming, and the high ropes course. This is a staff-led event in which “campers” (adults and girls) will follow the lead of their counselors (council camp staff) throughout the entire day. Limit: each girl may bring one female adult. Activities depend on the camper’s grade level. **Check-in 2 p.m. Sunday. Check-out 3 p.m. Wednesday.** at CAMP WHISPERING PINES, $150/person DATE GRADES CODE June 28-July 1 (Sun-Wed) 1-3 WPSM11 June 28-July 1 (Sun-Wed) 4-12 WPSM41

7

entering GRADES 2 & 3

marydale mermaids

Take your swimming skills to the next level! Learn basic water safety, improve on your swimming techniques, play water games, and just enjoy splishin’ and splashin’ all week long! *This session does not include archery. at CAMP MARYDALE, $275 DATE CODE June 7-12 MDMM01 June 14-19 MDMM02 June 21-26 MDMM03

entering GRADES 3 & 4

pony up

Still trying to figure out where you fit in the horse world? No problem! This progressive equine session is just what you need. Begin the week with a pony ride to get the feel of horses. Throughout the week you will grow by learning about ground safety, grooming, leading, and feeding! If you feel up to it at the end of the week, you’ll ride your horse all by yourself! **Campers in this session do not ride horses each day, but will work hands-on with them daily in order to become comfortable.** at CAMP MARYDALE, $280 DATE CODE May 31-June 5 MDPU01 June 14-19 MDPU02 July 12-17 MDPU03

entering GRADES 4, 5, & 6

art-rageous

A Camp Whispering Pines favorite is Art-Rageous! Enjoy making jewlery, playing with clay, tie-dying, and painting! When you’re not crafting, you’ll enjoy typical camp activities such as swimming, hiking, and canoeing. at CAMP WHISPERING PINES, $275 DATE CODE July 5-10 WPAR01

camping divas

Does your heart love the outdoors but your body love pampering? This week, you’ll host a dance party (Bring your party planning ideas!), make your own lip gloss, make a no-sew pillow case, attend a water aerobics class, and learn yoga! In your spare time, you’ll get to enjoy other typical camp activities! at CAMP MARYDALE, $275 DATE July 5-10 July 12-17

8

CODE MDCD01 MDCD02

www.gsle.org

Girl Scouts Louisiana East

•

• A separate registration form and deposit is required for each camper.

Mail to address listed above or fax with credit card information to (225) 927-8402.

Include $50 non-refundable deposit per session.

MAIL REGISTRATION FORMS TO:

• One camper and one session per form.

Registration form must be filled out completely to be processed.

545 Colonial Drive Baton Rouge, LA 70806

•

Resident Camp Registration Form

• CAMPER INFORMATION

PLEASE PRINT CLEARLY Front & Back Form

CHECK how you want the confirmation packet sent to you. q Email q Postmaster

Camper’s Full Name _____________________________________________________________________________________

Address ___________________________________________________ Parish _____________________________________

q Yes

q No

Grade entering in Fall _______ Troop # ________

City _____________________________________ State_____ Zip____________ Age______ Date of Birth ________________ Registered Girl Scout (check one)

______________________________ (______)__________________ (______)_________________ ________________________________ Parent/Guardian Day Cell Email

______________________________ (______)__________________ (______)_________________ ________________________________ Parent/Guardian Day Cell Email

This camper is in the custodial care of ______________________________________________________________________ BUDDY INFORMATION Name of girl(s) your camper would like to have in the same cabin. Campers must request each other and submit forms by walk-in or by mail in the same envelope. Placement cannot be guaranteed.

_________________________________ Code

Buddy Name(s) _________________________________________________________________________________ RESIDENT CAMP PROGRAM/CODE 1st Choice _____________________________________________________________ Program Name

____________________________________________ Date

CELL PHONE AGREEMENT • I understand that cell phones are not appropriate at camp and I agree to leave my cell phone at home.

EXPECTED CAMPER BEHAVIOR Girls are expected to follow the Girl Scout Promise and Law, listen and follow the directions of counselors, use the buddy system, and stay within camp boundaries. No drugs, alcohol, pets, or weapons are permitted on camp property. The camp director reserves the right to send home any camper who neglects to follow camp rules, becomes a danger to herself and/or others, or damages property. No refund will be given if a child is sent home due to misconduct.

______________________________________________________ Parent/Guardian Signature

My child has permission to participate in all phases of camp except as noted on the Camp Health Form, to appear in pictures for publicity purposes, including council website and related organizations websites, and to be registered as a Girl Scout if she is presently a non-Girl Scout. I have read the camp information and agree to cooperate with all policies. Campers will have the opportunity to participate in high-risk activities such as swimming, horseback riding, canoeing and/or the challenge course/climbing wall. Although care is given to greatly reduce the risk involved through safety procedures, education and equipment, I understand high adventure programs are not without an element of danger. I understand the risk involved with this type of program, and I feel the benefits outweigh the potential hazards of the program. My child has permission to take part in and travel to an activity off site of camp or between any of the Girl Scouts Louisiana East camps as part of the planned activities for my child’s camp session.

I understand if my child has requested a Camp Buddy, ALL registrations and deposits must be received at the council office in the same envelope. I understand every attempt will be made to honor their request. I understand that my camper will be sharing a cabin/tent with girls similar in age. I understand that an adult camp counselor is in a cabin nearby.

PARENT/GUARDIAN PERMISSION: I am enclosing the non-refundable $50 deposit (per session). I also understand the balance of remainder of the camp fee is due three weeks prior to camp session.

Resident Camp Registration continued

One Form and One Deposit Per Session Per Girl — May be Photocopied

Make your doctor’s appointment today for your physical examination.

gIRl HEaltH EXaMInatIOn RECORd

State

Zip Code

Parent or Guardian

Address

Chronic or Recurring Illnesses ❑ ADD/ADHD ❑ Asthma

❑ Bleeding Disorders

❑ Diabetes

❑ Ear Infections ❑ Heart Defect/Disease ❑ Hypertension ❑ Musculoskeletal Disorders ❑ Seizures ❑ Other (Specify)__________

Date of Birth

(Area Code) Phone

Age

datE attEndIng

pROgRaM attEndIng

suggestions from parent:

(Area Code) Phone

Sex

THIS PORTION TO BE fIllEd In by paREnt AND REvIEWED WITH PHYSICIAN AT THE TIME Of ExAMINATION

City or Town

Name (Last, first, Initial) Address In Emergency Notify

Health History: (Check those that apply) ❑ Chicken Pox ❑ Measles ❑ German Measles ❑ Mumps

allergies ❑ Animals ❑ food ❑ Hay fever ❑ Insect Stings ❑ Medicine/Drugs

❑ Plants ❑ Pollen ❑ Other

COMMEnts WHERE applICablE:

Operations or serious injuries _________________________________________________ Hospitalizations _____________________________________________________________ Other diseases/disabilities ____________________________________________________

COMMEnts WHERE applICablE:

fainting ___________________________________________________ Sleep Disturbances _________________________________________ Bed wetting________________________________________________ Menstrual cramps __________________________________________ Constipation _______________________________________________ Nosebleeds ________________________________________________ Emotional disturbances _____________________________________ Other _____________________________________________________ Specific activities to be encouraged _________________________________________________________________________________________ restricted _______________________________________________________________________________________________________ Special medical or dietary regimen to be followed (specify) ____________________________________________________________ This health history is correct and my daughter has permission to engage in all prescribed activities, except as noted by me and the examining physician.

Signature of Parent/Guardian _________________________________________________________________ Date _______________________

* Not required for every health examination. A Girl Scout Daisy, Brownie, or Junior should have the test if she has not already had it, either when entering school or at any time since. A Girl Scout Cadette, Senior or Ambassador should have this test if she has not had it since entering puberty. **Adult tetanus-diphtheria toxoid *** Haemophilus influenza b

Health Examination: Date of examination ________________________________________ Height _______________ Weight ______________ B.P. ____________ Appearance – Nutrition _____________________________________ Without Glasses With Glasses Eyes R 20/ ________ L 20/________ R 20/ _______ L 20/ _________ Ears ______________________________ Hearing R ____________ L____________ Code: Satisfactory ✔ Not Satisfactory ✗ Not Examined W Nose______________________________________________________ Throat ____________________________________________________ Teeth _____________________________________________________ Heart _____________________________________________________ Lungs _____________________________________________________ Abdomen _________________________________________________ Genitalia __________________________________________________ Hernia ____________________________________________________ Skin ______________________________________________________ Musculoskeletal ____________________________________________ General physical and emotional status ________________________ Urinalysis* _______________________ HGB* ____________________ Other notes________________________________________________ __________________________________________________________ __________________________________________________________ Year Primary Series Completed ________________

Year Of Last Booster ________________ ________________ ________________ ________________ ________________ ________________ ________________ ________________

Phone (_________)___________________________

Date _____________ UD: 02/2011

City_______________________________ State _______ Zip _____________

Address ________________________________________________________

Licensed physician’ s signature______________________________________

This person is in satisfactory condition and may engage in all usual activities except as noted.

Licensed physician’ s name _________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Physician’ s comments and recommendations Give details or indicate management of significant illnesses.

D.T.P. Diphtheria Pertussis (Whooping Cough) Tetanus Td** ________________ Oral polio ________________ Measles ________________ Mumps ________________ Hib*** Hbpv*** ________________ ________________ Tuberculin test Type ___________ ________________ Year last given ____________________________ Result ___________________________________ Other ________________ ________________

Record of Immunizations: Immunization

THIS PORTION TO BE fIllEd In by pHysICIan AfTER REvIEW Of HEALTH HISTORY WITH paREnt/guaRdIan.

This health history is correct and my daughter has permission to engage in all prescribed activities, except as noted by me and the examining physician.

Signature of Parent/Guardian _________________________________________________________________ Date _______________________

entering GRADES 4, 5, & 6

camp whispering pines sampler

In this three-day session, you will sample all that our water camp has to offer. Take a paddle around the cove, splash in the pool, and slide down the water slide! In your spare time, you’ll enjoy tie dye and hiking! **Check-in 2 p.m. Sunday; 9 a.m. Wednesday. Check-out 5 p.m. Tuesday; 3 p.m. Friday.** at CAMP WHISPERING PINES, $175 DATE CODE June 7-9 (Sun-Tues) WPSA01 June 10-12 (Wed-Fri) WPSA02 June 21-23 (Sun-Tues) WPSA03 June 24-26 (Wed-Fri) WPSA04

crafty critters

If you enjoy making arts & crafts, this session is for you! You will learn how to make jewlery and lanyards, mold clay, and play with modge podge and plaster! When you’re not being a crafty critter, you’ll be participating in camp activities such as hiking and swimming! at CAMP MARYDALE, $275 DATE CODE May 31-June 5 MDCC01 June 7-12 MDCC02

cowgirls

Brush off your boots! It’s time to grab the reins and hang on tight! In this camp session you will learn the basics of horsemanship. Groom, saddle, and study the essentials of walking, trotting, and trail riding on your horse! When you aren’t playing cowgirl, you will be swimming, cooking over an open fire, and discovering all that camp has to offer! at CAMP MARYDALE, $325 DATE CODE May 31-June 5 MDCG01 June 7-12 MDCG02 June 14-19 MDCG03 June 21-26 MDCG04 July 5-10 MDCG05

fire flies

Enjoy sleeping in and staying up late while experiencing all that camp has to offer.

During the night, you’ll enjoy activities such as tent camping, canoeing, arts & crafts, and scavenger hunts. at CAMP MARYDALE, $275 DATE July 12-17

CODE MDFF01

9

entering GRADES 4, 5, & 6

mane-ly horses

Here is your chance to see if hanging out with Camp Marydale’s horses is for you! In this short three-day session, you will learn the basics of riding and grooming horses. Get ready for the last day because you’ll be kicking up your heels on a trail ride to test out what you’ve learned. Little or NO riding skill needed! **Check-in 2 p.m.

Sunday; 9 a.m. Wednesday. Check-out 5 p.m. Tuesday; 3 p.m. Friday.** at CAMP MARYDALE, $250 DATE CODE June 7-9 (Sun-Tues) MDMH01 June 10-12 (Wed-Fri) MDMH02

gsi – girl scout investigators

There have been shenanigans at Camp Marydale and we need YOU to solve them!

Spend your week solving different mysteries, taking scavenger hunts, and putting your brains together to create a scavenger hunt for the rest of camp! In your free time you’ll participate in other activities such as swimming and arts & crafts! at CAMP MARYDALE, $275 DATE CODE June 14-19 MDGSI1

picture that!

Budding photographers, come to Marydale and learn to use your new camera (included in the session price). Meet a professional photographer and get tips on how to take fantastic pictures. You will document your summer vacation with great photos of your camp experience and your new friends.

Turn those pictures into a camp keepsake scrapbook. Enjoy all the other fun camp has to offer. at CAMP MARYDALE, $300 DATE CODE June 21-26, 2015 MDPT01 July 5-10, 2015 MDPT02

summer splash!

Do you love the water? Spend the week playing pool games, boating, and tubing! You’ll, of course, get to play on the Timber Lake Slide!

When you’re not playing in the water, you’ll get to enjoy archery and climbing the rock wall! at CAMP WHISPERING PINES, $275 DATE CODE June 7-12 WPSS01 June 21-26 WPSS02 July 5-10 WPSS03

10

_______________________________________________________

______________________________________________________

________________________________________ Relation to Camper

BACK

GSLE 11/14

______________________________________________________________________________________________________

______________________________________________________________________________________________________ ______________________________________________________________________________________________________

______________________________________________________________________________________________________ ______________________________________________________________________________________________________

(________)_____________________________ (________)_____________________________ (________)___________________________ RACIAL BACKGROUND Home Cell ETHNIC BACKGROUND q American Indian, Alaskan Native q Asian Work q Hispanic or Latina q Not Hispanic or Latina qRACIAL Black, African American q Hawaiian, Pacific Islander BACKGROUND qq White q Other ETHNIC BACKGROUND American Indian, Alaskan Native q Asian q Hispanic or Latina q Not Hispanic or Latina q Black, African American q Hawaiian, Pacific Islander qq Please if your child needs special assistance, i.e. dietary, mobility, interpreter, etc. We will make every effort White check q Other to accommodate all girls where possible. Please explain. q Please check if your child needs special assistance, i.e. dietary, mobility, interpreter, etc. We will make every effort ______________________________________________________________________________________________________ to accommodate all girls where possible. Please explain.

________________________________________________________________________ ________________________________________ (________)_____________________________ (________)_____________________________ (________)___________________________ Name Relation to Camper Home Work Cell

________________________________________________________________________ EMERGENCY CONTACT (if parent/guardian cannot be reached) Name

EMERGENCY CONTACT (if parent/guardian cannot be reached)Print Name of Camper Print Name of Parent/Guardian

_______________________________________________________ _______________________________________________________ Camper Signature Date Print Name of Camper

______________________________________________________ ______________________________________________________ Parent/Guardian Signature Date Print Name of Parent/Guardian

• I understand that cell phones are not appropriate at camp and I agree to leave my cell phone at home.

• I also understand that if I break this rule and I am found with a cell phone, the Camp Director will hold phone until CELL PHONE AGREEMENT checkout.

• I understand that cell phones are not appropriate at camp and I agree to leave my cell phone at home.

• The camp and camp director are not responsible for lost or damaged cell phones.

• I also understand that if I break this rule and I am found with a cell phone, the Camp Director will hold phone until • I agree to speak to my unit counselor in the event of an emergency, homesickness, etc. so that my needs can be checkout. addressed.

• The camp and camp director are not responsible for lost or damaged cell phones.

• I agree to speak to my unit counselor in the event of an emergency, homesickness, etc. so that my needs can be ______________________________________________________ _______________________________________________________ addressed.

Parent/Guardian Signature Date Camper Signature Date

_________________________________ Code

RESIDENT CAMP PROGRAM/CODE 1st Choice _____________________________________________________________ Program Name

_________________________________ Code

Check here if requesting Camp Scholarship Attach Camp Scholarship application to this registration. (Application are DUE by March 15, 2015)

2nd Choice ____________________________________________________________ Program Name o

$

$

$

T-shirt size: q YS q YM q YL q AS q AM q AL q AXL q AXXL

Parent/Guardian Signature ___________________________________________

q AMEX

Credit Card Number:

Cardholder’s Signature

Expiration Date: ______________________

____________ – ____________ – ____________ – ____________

$

$50 non-­‐refundable deposit *must be included with this form.

– $ 50.00* Payable with Cash, Credit Card, Check or Santa’s certificate(s).

Total Camp Fees

IF NOT currently a registered Girl Scout, please include $15 Girl Scout Membership fee. Please register my camper as a Girl Scout for the 2015 membership year.

(Total balance is due 3 weeks prior to camp session.)

Camp Fee Checklist Amount Session Fee *Membership Registration Fee SUB-TOTAL Deposit(s) Due with this form

q Visa

DUE three weeks prior to your camper’s session. — Total Balance Due

You have the option to pay an additional amount towards your balance, please indicate it in the box to the right.

q Mastercard

q Money Order

Check method of payment: q Cash

q Check

q Discover

q Debit

Print Cardholder’s Name

X ____________________________________________________

q Santa’s Certificate(s) must be enclosed with this form. Amt. $______

X ______________________________________________________

OVER à

entering GRADES 6, 7, & 8

boots and bridles

Love to ride? Don’t have much experience? Come to Marydale for a week of skill-building and trail riding. You will have a chance to improve your riding skills, and learn some new ones. When you aren’t horsin’ around, enjoy archery, swimming, and the challenge course. at CAMP MARYDALE, $325 DATE CODE May 31-June 5 MDBB01 June 21-26 MDBB02

star gazers

Expect to “geek out” during this 11-day session! Stay up late and learn about astronomy, see the stars, tent camp under the night sky, play night time games, and take a dip in the pool after dark. During the day time, enjoy all that camp has to offer with canoes, archery, and more! at CAMP MARYDALE, $375 DATE CODE June 21-July 1 MDSG0

girl scout survivors

During this 11-day session, you will have the opportunity to explore all that Girl Scout camps have to offer while learning key survival skills! Learn how to build a shelter and how to start a fire with no matches. Go horseback riding at Camp Marydale and challenge yourself on the high ropes and rock climbing course at Camp Whispering Pines. Take a kayak trip down the Tangipahoa River and camp-out at the end of the trip! In your spare time, take a trip down the lake slide, a dip in the pool, and make some pretty awesome arts & crafts. Be prepared to cook over a fire and tent camp several times during your adventure! **This session includes travel between camps.** at CAMP MARYDALE/ WHISPERING PINES, $375 DATE CODE June 21-July 1 MDGSS1

saddle up

Are you a seasoned rider? Want to take your knowledge to the next level? This advanced session is for you! Spend your time learning about equine first aid, nutrition, and different riding disciplines. When you aren’t learning, you’ll be practicing your trail riding skills! at CAMP MARYDALE, $325 DATE CODE July 12-17 MDSU01

11

girls AGES 11 through 13

spur in training

Ready to be a Wrangler, but just not old enough? Try out the Spur in Training program, designed especially for those girls who are eager to train to become a “Spur” in Marydale’s Wrangler/Spur Program.

You will spend the week learning the ropes by assisting the Wranglers and riding staff at the barn, caring for the horses and, in your spare time, riding! **The focus of this program is not riding—it is learning leadership skills for the Wrangler/Spur Program.** at CAMP MARYDALE, $175 DATE CODE June 7-12 MDSIT1 June 14-19 MDSIT2 July 12-17 MDSIT3

entering GRADES 6 through 10

thrill seekers

Are you a thrill seeker? Join us at Camp Whispering Pines and spend the week going through challenges. Learn the ins and outs of the High Ropes Course–practice rescue techniques and knots used on the course. You will learn new boating techniques and even take a short trip on the lake. So, practice your packing skills–because you’ll be eating in your boat! Practice pitching a tent and listening to the night life, because you’ll be doing just that all week! at CAMP WHISPERING PINES, $300 DATE CODE June 7-12 WPTS01 June 21-26 WPTS02

entering GRADES 7 through 10

night riders

Are you an intermediate to advanced rider looking to have a little fun on horseback? In this session, you will have a chance to ride at night (in a lit arena) while you work on your horsemanship skills, play rodeo games, and even take a trail ride at dusk. You will participate in an overnight trail ride where you’ll ride your horse to your camping site, pitch a tent, and listen to the many sounds of the night. at CAMP MARYDALE, $300 DATE CODE July 5-10 MDNR04

12

entering GRADES 7 through 12

all aboard

Camp Whispering Pines is your destination for aquatic thrills. This water session is filled to the gills with kayaking and canoeing on the lake, tubing down the Tangipahoa River, swimming in the pool and lake, going down the Timber Lake Slide, and camping in tents on the barge. There will be a lot more to explore around camp, too. at CAMP WHISPERING PINES, $300 DATE CODE July 5-10 WPAA01

entering GRADES 8 through 12

trail blazers

Four-day horse campout – Advance Skills Saddle up Cowgirls! Trail Blazers is the perfect short session for those girls who LOVE to trail ride! As a special treat for this outfit, Trail Blazers will take their gear out for a sleepover trail ride, cook over a fire, and develop outdoor living, horsemanship, and horseback riding skills. This session is short, so campers MUST be intermediate to advanced riders to participate in all portions of Trail Blazers. at CAMP MARYDALE, $225 DATE CODE June 28-July 1 MDTB01

entering GRADES 9 through 12

wrangler in training I

Discover your leadership and horsemanship potential. Explore the basics of assisting the riding program at Marydale. You will spend one week learning the ropes of being a Wrangler by assisting the Riding Staff at the barn, caring for the horses and, in your spare time, riding! **The focus of this program is not riding–it is learning leadership skills for the Wrangler Program.** at CAMP MARYDALE, $150 DATE CODE May 31-June 5 MDWIT1

13

entering GRADES 9 through 12

wrangler in training II

Once you have completed Wrangler in Training I, you are eligible for Wrangler in Training II. Come spend your time at camp teaching younger girls how to care for and ride horses. Share your love of horses with other girls to foster their own special connection with the herd. **The focus of this program is not riding—it is learning leadership skills for the Wrangler Program.** at CAMP MARYDALE, $275 DATE CODE June 7-19 (2 weeks) MDWIT2

barn aide

Are you looking for a special way to spend your summer and have already completed WITs I & II? Spend several weeks at the Camp Marydale barn sprucing up the teaching methods you already know, establishing your leadership and decision making skills, and leading trail rides. Send your application to Angela Arneal at aarneal@gsle.org for consideration of the Barn Aide position. *The focus of this program is not riding. Campers go home each weekend.* at CAMP MARYDALE , $100 (**EXCEPT MDBA05, $75) DATE CODE May 31-June 5 MDBA01 June 7-12 MDBA02 June 14-19 MDBA03 June 21-26 MDBA04 June 28-July 1** MDBA05 July 5-10 MDBA06 July 12-17 MDBA07

entering GRADES 10 through 12

counselor in training I

Have you always dreamed of being a summer camp staff member? Welcome to the first step… the CIT program! This session gives girls a chance to start developing skills as future camp counselors. Learn counseling and leadership skills, behavior management techniques, role play situations, and new songs. You will learn to help with camp activities, work with younger campers, and of course, have fun! at CAMP WHISPERING PINES, $125 DATE CODE June 7-12 WPCIT1

at CAMP MARYDALE, $125 DATE CODE June 21-26 MDCIT1

14

entering GRADES 10 through 12

counselor in training II

If you have already completed Counselor in Training I, you will learn to work with staff and campers of all backgrounds and ages, hone your skills as a facilitator at program areas, and get certified in First Aid and CPR. At the end of your training, you will be placed with a unit as a junior staff member to put all your training and knowledge in practice. CITs go home on the weekend. at CAMP WHISPERING PINES, $125 DATE June 21-26 (1 week)

CODE WPCIT2

at CAMP MARYDALE, $225 DATE July 5-17 (2 weeks)

CODE MDCIT2

program aide

After you have completed CIT I & CIT II, consider applying for the Program Aide position. Program Aides will help facilitate program areas such as arts & crafts, swimming, canoeing, and challenge course. You might also help out in the units, the office, or the dining hall as well. Program Aides must be available for a pre-camp training. Turn in your application to Angela Arneal at aarneal@gsle.org. at CAMP MARYDALE , $100 (**EXCEPT MDPA05, $75) DATE CODE May 31-June 5 MDPA01 June 7-12 MDPA02 June 14-19 MDPA03 June 21-26 MDPA04 June 28-July 1, 2015** MDPA05 July 5-10, 2015 MDPA06 July 12-17, 2015 MDPA07

program aide

After you have completed CIT I & CIT II, consider applying for the Program Aide position. Program Aides will help facilitate program areas such as arts & crafts, swimming, canoeing, and challenge course. You might also help out in the units, the office, or the dining hall as well. Program Aides must be available for a pre-camp training. Turn in your application to Angela Arneal at aarneal@gsle.org. at CAMP WHISPERING PINES , $100 (**EXCEPT WPPA03, $75) DATE CODE June 7-12 WPPA01 June 21-26 WPPA02 June 28-July 1** WPPA03 July 5-10 WPPA04

15

CAMP SCHOLARSHIP Financial assistance is available for one camp session to those demonstrating financial need and will be a percentage of the session fee. Confidential camp scholarship request applications are due by March 15, 2015. After this date funds may be limited, but applications will be accepted for review. If you wish to request financial assistance, please complete the form and attach it to your daughter’s registration form.

Deposits are still required with a completed financial assistance form. Return the confidential application with your daughter’s camp registration form. Only girls registered with the Girl Scouts Louisiana East council are eligible for financial assistance.

GIRL SCOUT COOKIE DOUGH Girls who earn Cookie Dough or Nutte Bucks may use it toward the balance of the camp fees.

Please note on the registration form if you have not received your certificate but are eligible.

Cookie Dough cannot be used as a deposit.

MULTIPLE SESSION DISCOUNT Girl Scouts who attend more than one session will receive a $25 discount applied to each additional camp session.

CONFIRMATIONS After registration forms and deposits have been received and processed, confirmation packets will be sent via email or mail indicating placement in camp session(s), balance due, and detailed information on what to pack, trading post, etc. It will take some time to process registrations. If you are curious about the status of your confirmation packet, please call no earlier than May 1, 2015.

16

Resident Camp

Registration Information

placement begins February 2!

Mail in your registration to Girl Scouts Louisiana East, 545 Colonial Drive, Baton Rouge, LA 70806.

Non-Refundable Registration Deposit: $50

In anticipation of a camper’s attendance, various expenses are incurred on her behalf, such as supplies, equipment, registration and camp staffing costs. Accordingly, there is a non-refundable $50 deposit for each session requested due with the registration form. Forms received without the deposit(s) will be returned. Cash, credit card, check, or money order are accepted for deposit payment. As the registration process continues, this deposit is applied to the session fees.

However, if the participant cancels a session, the deposit is retained. If the council must cancel a session, the deposit will be returned. Please note that the deposit is not transferable to another camper. Cookie Dough is not accepted as payment for the deposit (but is acceptable for the remainder of camp fees). ** Make your doctor’s appointment today for your physical examination. Don’t forget to bring the enclosed Girl Health Examination Record.

BALANCE DUE

The balance of the camp fee must be received at either council office three weeks prior to session. NO FEES WILL BE ACCEPTED AT CAMP.

REFUNDS

Partial refunds (less non-refundable deposit) may be given in some instances and are considered on a case by case basis. Written requests for a refund must be received by the council at least three weeks prior to the opening day of the session. A partial refund (less non-refundable deposit) may be secured if the council receives a written certificate from a licensed M.D. stating she is unable to attend her camp session or if there is a family emergency.

No refund will be given if a camper is sent home due to unacceptable behavior or homesickness. Full refunds will only be issued for sessions canceled by the council.

Girl Scouts Louisiana East

MAIL REGISTRATION FORMS TO:

841 Clearview Pkwy.

545 S. Colonial Drive New BatonOrleans, Rouge,LA LA70121 70806

PLEASE PRINT CLEARLY

www.gsle.org

Girl Scout Camp Scholarship Request

Any active registered Girl Scout in Girl Scouts Louisiana East may apply for a camp scholarship to attend one camp session.

Complete the camp registration form and camp scholarship request and send both to the Girl Scout Office by March 15 to be eligible for first round of allocations. After this date, funds may be limited.

TO BE COMPLETED BY PARENT OR GUARDIAN: _______________________________________________ Camper’s Name

___________________________________________________ Parent/Guardian

_______________________________________________ Address

_________________________________ City, State

(______)___________________ Home

(______)__________________ Work

_______________ Zip

(______)__________________ Cell

________

Grade in Fall

Is she a: q Registered Girl Scout: Troop # _______________ Service Unit # _____________ q Individual Member Program Age Level in Fall: q DA/BR q JR q CAD q SR/AMB No. of Years as a Girl Scout ____ Did she participate in the most recent Girl Scout Fall Product and Cookie Sales? q Yes q No How often does she participate in Girl Scout activities, meetings, etc.? ______________________________________________

________________________________________ Leader’s Name

Family Income:

(______)__________________ Home

(______)_______________ Work / Cell

q Under $15,000

q $15,000 - $25,000

q $25,000 - $35,000

q $35,000 - $45,000

q $45,000 - $55,0000

q OVER $65,000

Number of people supported by this income ____________

Number of dependent children living at home ______________

List any unusual or extraordinary family expenses or circumstances (Attach a letter if necessary!) ___________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ___________________________________________________________________________ Program your camper would like to attend

______________________ Dates

Although not required, partial or full reimbursement (when and if possible) of any funds granted is appreciated and accepted Amount of FeeThis $ ____________________________________ at any time. enables your council to continue to provide assistance for girls and adults when the need arises.

Amount you can pay $ ____________________________________ Has she received financial assistance from the Girl Scouts before?

q No

q Yes —When, amount received and for what

purpose? ______________________________________________________________________________________________ Signature _____________________________________________________________ Date ___________________________ q Parent/Guardian

q Troop Leader

q Other

OFFICE USE ONLY: Amount Granted: $____________ Total Due from applicant $_____________ Appv’d by__________ Date_________ Program Cost: $____________ ________________________% authorized Receipted by ______________ No. ______________ date ______________ DATA ENTRY: by __________ date __________ GSLE 11/14

gsle.org 800-644-7571

Contact Information For more information about registration for summer camp, please contact Cherrill at (800) 644-7571. For camp program questions, please contact Angela Arneal at aarneal@gsle.org.

Girl Scout summer camp is for every girl, even those not yet in Girl Scouts! For girls new to Girl Scouting, simply include the $15 annual national membership dues along with the camp fees/form and pay the regular session fees.

Bring a Friend! Non-Girl Scouts welcome!

Girl Scout Camp Covington, Camp Marydale, and Camp Whispering Pines are accredited by the American Camp Association.

Accreditation means that each camp undergoes a thorough review process by outside camping professionals every three years. Our Girl Scout camps consistently achieve the highest standards in the areas of personnel, program, site administration, and health care.

ACA Accreditation

About Us‌

Girl Scouts Louisiana East serves the parishes of Ascension, Assumption, East Baton Rouge, East Feliciana, Iberville, Jefferson, Lafourche, Livingston, Orleans, Plaquemines, Pointe Coupee, St. Bernard, St. Charles, St. Helena, St. James, St. John, St. Mary, St. Tammany, Tangipahoa, Terrebonne, Washington, West Baton Rouge, and West Feliciana. It is funded by voluntary philanthropic contributions, the cookie and fall product sales, fees for services, and the United Way in selected parishes.

Our counselors are selected based on their program skills, maturity, education, caring attitude, and experience with children. Counselors are primarily college students, both female and male, with male counselors housed in separate quarters. Program areas, such as ropes course, horses, swimming and boating, are directed by certified and trained staff. All of our staff must successfully complete precamp staff training, pass background screening and become members of Girl Scouts of the USA.

Who are the camp counselors?

Girl Scouts Louisiana East P.O. Box 10800 New Orleans, LA 70181-0800 (504) 733-8220 • (800) 644-7571 www.gsle.org

NON-PROFIT ORGANIZATION U.S. POSTAGE PAID NEW ORLEANS, LA PERMIT NO. 428