PBJ 2016 COORDINATOR PACKET

RETREAT COORDINATOR Each church’s Retreat Coordinator is in charge of organizing, collecting, and sending in all paperwork and fees for both campers and staff.

November 18th-19th, 2016 A WEEKEND OF INTENSE WORSHIP, DISCIPLESHIP, & CHALLENGE FOR 4TH, 5TH, & 6TH GRADERS.

Please make sure all Registration Forms, Staff Applications and fees are received IN THE OCM OFFICE on or before Friday, November 4th!

This will reserve your spot and allow us enough time to process the Volunteer Staff Applications.

The following should be submitted with your group’s registration:

- Retreat Registration Coversheet

- T-shirt Form

- Volunteer Staff Applications

- Medical Forms for each Staff Member & Camper attending

- Camper Registration Fees

- Volunteer Staff Administrative Fees

- Pastor’s Reference Form for all Staff Members

PB&J Retreat

Until Nov 4th

After Nov 4th

Camper Registration Fees

$60 per camper Includes T-Shirt

$30 per staff Includes T-Shirt

$70 per camper

Staff Administrative Fees

$40 per staff

Retreat Registration Forms should be mailed to:

P.O. Box 13179 Oklahoma City, OK 73113 Phone: (405) 475. 1172 Fax: (405) 475. 1176 Email: ocm@okag.org Website: www.okag.org

Fees are Non-Refundable. No Exceptions

TIMELINE SEPTEMBER 30

• Retreat Registration Opens

NOVEMBER 4

• All Retreat Registration Forms, Staff Applications, Medical Forms, & Registration Fees - are due IN THE OCM OFFICE. Postmark dates will not be honored. (We suggest allowing a minimum of 5 - 7 days for mailing.)

Retreat Registration Fees and Staff Administrative Fees increase by $10 per camper/staff member after November 4th.

NOVEMBER 6

• All groups attending the PB&J Retreat are required to undergo a lice check two weeks before the retreat.

This includes campers and staff.

NOVEMBER 18

• Be sure to review your Day-of-Retreat Checklist.

• All groups attending are required to undergo a lice check before leaving the church.

This includes campers and staff.

• Registration 4:00 p.m. - 5:30 p.m.

• Welcome to PB&J Retreat!

NOVEMBER 19

• Camper Pickup is at 4:30 p.m.

• See you next year!!!

REGISTRATION FORMS RETREAT REGISTRATION COVERSHEET Please complete in its entirety. If we have any questions, we need to be able to contact the correct person.

VOLUNTEER STAFF APPLICATIONS Provide each Volunteer Staff Applicant with a complete Volunteer Staff Application Packet. They must read the information packet and fill out the application in its entirety. Applications are to be included WITH your registration packet. Please review each one. Incomplete applications will be returned and will delay your registration.

Volunteers who are applying individually and not attending with a group should mail their forms directly to the OCM office.

MEDICAL INFORMATION FORMS Medical Information Forms are REQUIRED for retreat attendance for all campers and staff! Any camper or staff member unable to provide a signed Medical Information Form will be sent home. This form must be completed by the legal guardian for all campers and staff members under the age of 18.

MEDICAL FORMS ARE DUE WITH YOUR CHURCH’S REGISTRATION FOR EACH STAFF MEMBER OR CAMPER ATTENDING. All areas of the form must be completed.

If any area is unknown or not applicable, please write “N/A”.

The Medical Form is 2-sided .

T-SHIRT FORMS Be sure to include a completed T-shirt From. All T-shirt sizes will be taken from this form. We will not be able to accommodate changes or additions after Nov. 4th.

CAMP POLICIES & PROCEDURES The following are guidelines for the entire camp for the protective benefits of each person: Dorm Rooms/Facilities • • • • • • •

No swapping or changing of rooms.

Pranks, pillow fights, or wrestling in dorms is prohibited.

Girls and boys are NOT allowed in the dorm area of the opposite sex.

All rooms are to be left clean before activities each day and when leaving on your final day of camp.

Inspection of rooms will be daily.

Food or drinks will not be allowed in the Worship Center or in the cabins. (Water is allowed.)

No outside food, drinks, or ice chests are to be brought to camp. (This does not apply to special dietary needs.)

Behavior • • • • • •

You are expected to observe habits of personal courtesy and Christian conduct in order to protect and insure a wholesome atmosphere of an Assemblies of God Camp.

Campers are to stay with coaches at all times.

Alcohol, tobacco, and illegal drugs are strictly prohibited.

The daily schedule must be followed and attendance at all activities is required for both campers and staff.

Stay in lighted areas of the camp at ALL TIMES. Fire Arms, knives, or any other weapons, are not allowed in the camp.

Dress Code • • • • • •

Fingertip-length shorts may be worn during camp.

ALL clothing must cover chest, shoulders, backs, sides, and midriff at ALL times.

No tight clothing will be allowed (such as spandex, bike shorts, any type of shirt or dress).

Apparel may NOT display or promote tobacco, alcohol, controlled substances, or inappropriate language.

Bring shoes/clothes that may be worn in the water or mud.

Everyone is to wear shoes at ALL TIMES.

Off Limits!

• • • • • •

The recreation property to the south is OFF LIMITS, except for announced activities.

NO camper is allowed on staff vehicles, except in the case of an emergency.

Please observe the OFF LIMITS signs.

Cabins are off limits without an adult present.

No one is to leave the camp without permission from the Camp Director or Assistant Director.

No guests are allowed at camp, except credentialed ministers with the Assemblies of God.

Personal Belongings • • • • • •

Respect the property rights of others. Do not borrow anything without permission.

The camp is not responsible for lost, damaged, or stolen items.

Shaving cream is for shaving only. Water balloons and water guns are NOT allowed in the cabins or worship center.

Campers are not allowed to bring electronic devices of any kind to camp. This includes cell phones, computers, tablets, CD players, iPods, etc.

Staff who bring electronic devices to camp, do so at their own risk.

If warranted, the camp leadership reserves the right to search for and hold or dispose of personal belongings.

Administration of Medication & Lice Check • • • •

All Staff Members and Campers must provide a completed Medical Form no less than 2 weeks before the first day of camp, to allow time for processing. If a Medical Information Form is not provided, the Staff Member/Camper will be sent home; transportation is the responsibility of the church.

All medications must be administered by the First Aid Staff. No exceptions.

Medication that is not listed on the Medical Form, expired, or sent in baggies or weekly dose containers will not be given.

All Staff Members and Campers are required to undergo a lice check two weeks prior to camp and, again, on the morning of camp. The check will be administered by your church’s Camp Coordinator or their representative. All persons must be nit-free in order to attend camp. Any person found to have lice at camp will be sent home; transportation is the responsibility of the church.

Lost and Found •

Please label all items with first and last name. We will do our best to return items to their owner. We will hold all luggage and lost & found items for one week. All items not claimed within one week will be donated to charity.

Media Disclosure •

All campers agree that any media captured (photos, video, audio) is the property of the Oklahoma District Council of the Assemblies of God and can be used for future promotion.

Rules of acceptance and participation in the program are the same for everyone with regard to race, gender, or national origin.

ADDITIONAL POLICIES RELEVANT TO THE COORDINATOR AGES FOR RETREAT ATTENDANCE Campers The PB&J Retreat is a discipleship camp focused on 4th, 5th and 6th graders. It is important that these guidelines be followed, for we want your campers to receive effective ministry on a level that is most appropriate for their age. If you have any question on whether or not a camper meets the age criteria for your camp, please contact the OCM Office.

Volunteer Staff Any Volunteer Staff who serves as a Coach, must 18 years old or older. Because Coaches are responsible for the campers in their room, legally they must be an adult. Support Staff must be at least 17 years old or older. No exceptions.

Visitors/Children Guests are not allowed at camp, except credentialed ministers with the Assemblies of God. Likewise, Volunteer Staff may not bring children who do not meet the Camper age requirements.

No exceptions.

LICE CHECKS All OCM Camps have a “Nit-Free Policy�. As the Retreat Coordinator, it is your responsibility to facilitate two lice checks - one two weeks prior to the retreat and one the morning of the retreat.

This procedure is required for retreat attendance. Each Retreat Coordinator will be asked to sign an agreement during registration that states every person in your group has been checked. Any person found to have lice at camp will be sent home immediately; transportation is the responsibility of the church.

CAMPER/STAFF SUBSTITUTIONS AND CANCELLATIONS

Camper and Staff substitutions may be made with no additional charge. Please notify the OCM Office of any substitutions you may have. We will try our best to accommodate T-shirt sizes for substitutions.

We cannot guarantee T-shirts for changes or additions made after Nov. 4th. Staff Administrative Fees and Camper Registration Fees are NON-REFUNDABLE.

DAY OF RETREAT CHECKLIST

Facilitate Final Lice Check for ALL campers and volunteer staff. OCM Camps and Retreats have a Nit Free Policy. Any camper or staff found to have lice should stay home.

Collect all camper/staff medication. Make sure all medication is in its original container and with a current label. Medication sent in plastic baggies will not be administered. Check expiration dates on all medication. Expired medications will not be given.

Make sure all campers, staff and parents have read and understood the Camp Policies and Procedures. Campers and staff must follow the Dress Code.

Welcome to PB&J Retreat!

Registration will be held from 4:00 pm - 5:30 pm.

HAVE FUN!!!

HELPFUL TIPS

FOR RETREAT COORDINATORS Devote a Sunday to kick-off and promote the Retreat sign-up. Have copies of the Medical Form available. Be sure to collect T-shirt sizes.

Two weeks before arrival at camp, have a Pre-Retreat Meeting with parents and campers. Go over the Dress Code and the Retreat Policies and Procedures.

During the Pre-Retreat Meeting, screen all campers for lice. Our retreat has a nit-free policy.

Remind parents that medication cannot be sent in baggies. It must be in its original container.

Parents should also check the expiration date on all medications. If expired, medications will not be administered at camp.

Encourage campers who have a challenge with wetting the bed by telling them that many campers successfully deal with this by wearing “Goodnights”.

Convey to parents that a concession stand will be available.

Since PB&J Retreat is for older kids and it is for a short time period, the Bank will not be available for Campers to deposit their money. Please encourage campers to keep track of their own money safely. OCM is not responsible for the loss of money.

REGISTRATION PROCESS Registration will be held from 4:00 pm - 5:30 pm in the Dining Center.

Only one representative from your church (either the Retreat Coordinator or designated adult) will be needed to check in your church’s campers and staff. All other staff may wait with your campers.

Your church’s representative should have all camper/staff medication and any final payment for your group.

When you arrive in the Dining Center, you will be given a note card. Simply fill in your church’s name, along with your name. After turning in the card, you may then have a seat until someone at the registration table calls your name.

SPARKS CAMP FACILITY

FROM I-44 Exit 166 and go South on Hwy 18. Turn Left (East) on Hwy 18-B. When the road starts to curve to the left, turn right (South) on 3470 Rd. At the stop sign, turn left (East) on 990 Rd. The Camp will be on the right.

FROM I-40 Exit 186 and go North on Hwy 18. Turn right (East) on Hwy 18-B. When the road starts to curve to the left, turn right (South) on 3470 Rd. At the stop sign, turn left (East) on 990 Rd. The Camp will be on the right.

C A M P P H Y S I C A L A D D R E S S: Sparks AG Campground 347489 E 990 Rd Sparks, OK 74869

Please call (405) 475-1172, if you have any questions!

VOLUNTEER STAFF - SENIOR/LEAD PASTOR‘S REFERENCE PASTORS MAY CONSULT THEIR YOUTH OR CHILDREN’S PASTOR, BUT THE FORM IS TO BE COMPLETED ONLY BY THE SENIOR/LEAD PASTOR.

Church City:___________________________

Church Name:_____________________________________________

Dear Pastor, In an effort to reduce the amount of paperwork that we are asking you to complete, we have created a one sheet reference form. Your church’s Retreat Coordinator has listed the names of each applicant applying to be a staff member for PB&J Retreat. Please take a moment to consider each applicant.

All information concerning this reference form will be kept confidential. Please do not take this recommendation lightly.

We rely on your knowledge and recommendation of the applicant to make our decision of acceptance. If you have any questions or concerns, please fee free to call our office at (405) 475-1172.

Thank you so much for taking the time to help us! Your opinion is valuable, and we appreciate you!

Applicant’s Name: _________________________________________________________________________________ How long have you known this applicant?_______________________ Does the applicant work well with others?

Always Usually Rarely

Does the applicant currently work with children at your church?

Yes

No

Explain_________________________________ Do you think this applicant would be: ? Excellent Good Fair Poor Do you feel confident that this applicant will represent you and your church in a responsible and Godly way? Yes Do you recommend this applicant without reservation? Yes

No

No

Comments: ______________________________________________________________________________________ ______________________________________________________________________________________

Applicant’s Name: _________________________________________________________________________________ How long have you known this applicant?_______________________ Does the applicant work well with others?

Always Usually Rarely

Does the applicant currently work with children at your church?

Yes

No

Explain_________________________________ Do you think this applicant would be: ? Excellent Good Fair Poor Do you feel confident that this applicant will represent you and your church in a responsible and Godly way? Yes Do you recommend this applicant without reservation? Yes

No

No

Comments: ______________________________________________________________________________________ ______________________________________________________________________________________ Please see back for additional applicant names.

Pastor’s Name (Print):_________________________ Signature:_________________________________ Date:__________________________

FOR OFFICE USE ONLY

District Superintedent’s Signature:

Pastor—Please return this form to your church’s Camp Coordinator in a sealed envelope labeled “Pastor Reference”.

This envelope will be submitted with your church’s camp registration.

Applicant’s Name: _________________________________________________________________________________ How long have you known this applicant?_______________________ Does the applicant work well with others?

Always Usually Rarely

Does the applicant currently work with children at your church?

Yes

No

Explain_________________________________ Do you think this applicant would be: ? Excellent Good Fair Poor Do you feel confident that this applicant will represent you and your church in a responsible and Godly way? Yes Do you recommend this applicant without reservation? Yes

No

No

Comments: ______________________________________________________________________________________ ______________________________________________________________________________________ Applicant’s Name: _________________________________________________________________________________ How long have you known this applicant?_______________________ Does the applicant work well with others?

Always Usually Rarely

Does the applicant currently work with children at your church?

Yes

No

Explain_________________________________ Do you think this applicant would be: ? Excellent Good Fair Poor Do you feel confident that this applicant will represent you and your church in a responsible and Godly way? Yes Do you recommend this applicant without reservation? Yes

No

No

Comments: ______________________________________________________________________________________ ______________________________________________________________________________________ Applicant’s Name: _________________________________________________________________________________ How long have you known this applicant?_______________________ Does the applicant work well with others?

Always Usually Rarely

Does the applicant currently work with children at your church?

Yes

No

Explain_________________________________ Do you think this applicant would be: ? Excellent Good Fair Poor Do you feel confident that this applicant will represent you and your church in a responsible and Godly way? Yes Do you recommend this applicant without reservation? Yes

No

No

Comments: ______________________________________________________________________________________ ______________________________________________________________________________________ Applicant’s Name: _________________________________________________________________________________ How long have you known this applicant?_______________________ Does the applicant work well with others?

Always Usually Rarely

Does the applicant currently work with children at your church?

Yes

No

Explain_________________________________ Do you think this applicant would be: ? Excellent Good Fair Poor Do you feel confident that this applicant will represent you and your church in a responsible and Godly way? Yes Do you recommend this applicant without reservation? Yes

No

No

Comments: ______________________________________________________________________________________ ______________________________________________________________________________________

Medical Form

CAMP # ___________

***This form is 2 sided***

Office Use Only

This form is required for all campers and staff.

MEDS

To provide enough time for processing, all Medical Forms are due at the time each church sends in their registration to the OCM Office.

Please fill out in INK.

Church City

HOLDS

Church Name

Camper/Staff Name (First, Middle Initial, Last)

Gender (Circle One)

Male

Female

2016-2017 Grade

Date of Birth (mm/dd/yyyy) Age

Address

City, State, Zip

Emergency Contact Information Name:

Relationship:

Cell Phone (

)

Work Phone —

(

)

Home Phone —

(

)

—

If the camper/staff member does not have Health Insurance, please write “N/A” for “Insurance Provider.”

Insurance Provider

Policy #

Physician Name

Phone # (

Allergies (Please check all that apply and list treatment required.)

Type Animal:

Food:_________________ Insect Bites:

Group #

Treatment

)

—

May the staff member/child listed above be given over-the-counter, non-prescription medications or applications, not to exceed recommended dosage for stomach discomfort, burns, cuts, insect bites, rash, scrapes or other minor ailments?

YES

NO

List Exceptions:

Medicine/Drugs: _______________________ _______________________

Plants: Pollen: Other: Other:

Date of Last Tetanus Date of Last Immunization

Both sides of the form must be completed & signed in INK!

CAMPER NAME_____________________________________ CHURCH & CITY________________________________________ ALL MEDICATION MUST BE IN THEIR ORIGINAL CONTAINERS WITH A CURRENT/CORRECT LABEL. Please only send the amount needed for the length of camp.

Pills sent in plastic baggies or weekly dose containers will not be given.

Expired medication will not be given.

All inhalers, nasal sprays, and epi-pens must be in the original box with the prescription label.

(If the box is not available, ask the pharmacy to print a label.)  All camper/staff medications and vitamins must be administered by the First Aid Staff in the First Aid Station.

NO MEDICATION (INCLUDING VITAMINS) WILL BE ADMINISTERED UNLESS LISTED ON THIS SIGNED FORM.     

Name of Medication

Dosage

Time to be Given

How Taken

Comments for First Aid Staff: (Please attach another piece of paper, if more room is needed to list meds or comments.)

MEDICAL RELEASE STATEMENT and Camp Policies and Procedures Agreement For CAMPERS or STAFF MEMBERS UNDER THE AGE OF 18: I, the parent/legal guardian of ____________________________(camper’s/staff member’s name), authorize the camp first aid personnel to administer the medications listed above. I hereby authorize camp personnel to obtain medical care, if necessary. My signature authorizes emergency treatment in the event of illness/injury when I am not immediately available. I understand, if necessary, the camper will be taken to a nearby hospital and will be attended by a physician on call. I further understand that I will be responsible for any medical expenses incurred. I also hereby authorize this document to be released to first responders and emergency personnel. I understand that any person with a fever, rash, pink eye, head lice, or other signs of illness will be sent home. I further understand that parents are responsible for their child’s transportation in the event of an illness or injury. I also agree with and support the enforcement of the Camp Policies and Procedures.

Signature of Parent/Legal Guardian____________________________________________

Date ___________________________________

For STAFF MEMBERS 18 yrs. or Older: I, ____________________________, authorize the camp first aid personnel to administer the medications listed above. I hereby authorize camp personnel to obtain medical care, if necessary. My signature authorizes emergency treatment in the event of illness/injury if I am unconscious or unable to consent to treatment. I understand, if necessary, I will be taken to a nearby hospital and will be attended by a physician on call. I further understand that I will be responsible for any medical expenses incurred. I also hereby authorize this document to be released to first responders and emergency personnel. I understand that any person with a fever, rash, pink eye, head lice, or other signs of illness will be sent home.

I further understand that I am responsible for my own transportation in the event of an illness or injury. I also agree with and support the enforcement of the Camp Policies and Procedures.

Signature of Staff Member_______________________________________________________

Date __________________________________