When: Aug 11-15

Where: Ojai Valley, Forest Home

Cost: $275

$50 Deposit Due July 13th

Forest Home-655 Burnham Road, Oak View, CA 93022 Tel. 805-715-6060

24821 CHRISANTA DRIVE, MISSION VIEJO, CA 92691 949.951.9678 www.cmvchurch.com

June 6, 2014 Dear Parents, Colossians 2:6-7 says, “Therefore as you have received Christ Jesus the Lord, so walk in Him, having been firmly rooted and now being built up in Him and established in your faith, just as you were instructed, and overflowing with gratitude.” When a parent asks me why they should send their child to camp I say, “Because it will help your Child walk in Christ.” But what needs to happen before someone can walk in Him? They must be firmly rooted in Him or as Paul said it in Galatians, it means to have Christ “fully formed” in you. This means that as we mature in Christ we will not run to our own works to save us or mature us but we will run to Christ. When we do this we know that Christ is then fully formed in us and that we are rooted! If you decide to send your child to camp you can be sure that they will have an opportunity to receive Christ, grow in their understanding of His grace and will be well cared for in a safe and fun environment. At this year’s Rooted Summer Camp our theme is “Knowing God’s Will.” Your child will be learning about what God desires for their life, how God guides His people and and how to make Godly decisions. It is my hope that the Lord would use this time to equip your kids to walk in the light in all the decisions that they make and are going to make. As always we know that it can be difficult to send you child to camp so to help you plan financially there is a payment plan laid out for you in this packet. If the price of this year’s camp is still difficult for you to meet please fill out a scholarship form and please let us know what amount you can afford, then return the form to Allison and we will work something out. We believe so strongly in these events that we have never turned away a single student that has wanted to attend. If you have any further questions about our theme, speakers or schedule after reviewing this packet do not hesitate to give me a call at the church office and thank you for considering sending your child to this life changing getaway! Please join us in prayer as we ask the Lord to save, and strengthen His kids at Rooted Summer Camp 2014! Thank you for allowing us to serve you and your family. In Him, Ryan Day Associate Pastor – Student Ministries

What to Bring Bible [do not forget your Bible!] Skate Boards Pen & writing pad Sleeping bag (and quite possibly an extra blanket or sheet) ** Pillow Toiletries (anything you will need for your personal hygiene. Bring a 5 day supply) Please bring deodorant, shampoo, soap, toothpaste, toothbrush, etc. Medication* (Talk to Allison) Closed toed shoes (necessary for certain activities at Forest Home) Jackets Clothes!!! Please do not forget these. Five day’s worth, and for warm days and for cool

nights! Bathing suit – girls one piece suits (if you have a two piece please bring a cover) Towels bath and pool Boys and Girls bring shorts that are not too short!!! Shirts-No low cut tops, no thin straps Shower sandals Sunscreen Alarm Bug repellant Yourself Flashlight Money to spend for snacks Money for lunch on the way home Did we forget to mention your Bible? (this is a must)

*If you have any medication that you need to take during your stay at camp make sure you notify Allison and include it on your release form.

** We will be sleeping in tent cabins. The weather is warm. There are separate bathrooms and showers. Please pack accordingly.

What not to Bring Alcoholic beverages or drugs of any kind Cigarettes Firecrackers Weapons (this includes pocket knives and bazookas) No lighters No shorts that are to short example bring ones that go to your finger tips The use of media players/iPods is prohibited while at camp Cell Phones—No cell phones. We are here for the Lord!

Dress code NO exposed undergarments [this includes you guys], cleavage, spaghetti straps, tube tops,

immodest tank tops, bare mid-section, short shorts, short skirts, gang-style clothing, or offensive t-shirts. NO tight fitting clothes (this includes muscle T’s, pants, shirts). No dying your hair at camp...

Camp Policy Remember to obey the leaders at all times, even if they are not from your home church. Foul or inappropriate language is prohibited and will not be tolerated. No PDA! There is also

a zero tolerance for any public display of affection. If at any time you are caught with anything listed on this sheet as what not to bring it will

be confiscated and/or your parents may be called to come and pick you up from camp if you fail to follow the rules.

Remember that camp is a time to get away from the distractions of the world and focus on God. Have fun! This is your time to get away!!!!

Tentative Schedule

Monday Aug 11

Tuesday Aug 12 W

ednesday Aug 13 Thursday Aug 14

Friday Aug 15

7:00

Wake-up

Wake-up

Wake-up

Wake-up

7:30

Leader Lead-Prayer time

in tents (Not optional)

Leader Lead-Prayer time

in tents (Not optional)

Leader Lead-Prayer time

in tents (Not optional)

8:00

Breakfast

8:30

Breakfast 9:00 Slide Show

Breakfast

Breakfast 8:45 Challenge Aw

ards

9:00

Early Team Leaving

Session 2- W

elcome

Prayer W

orship M

essage

Break Out Session- Guys -Live Oak Girls -Allen H

all (2 – 3 W

orship songs) 9-10:20 am

Session 5- W

elcome

Prayer W

orship M

essage

Session 7- W

elcome

Prayer W

orship M

essage

10:30

Break 10:30-12:15-Challenge 3

Break Student Testim

onies

10:45

Small Groups

Sm

all Groups Close cam

p in Prayer

11:00 am

Leaders Arrive

Load Busses and Depart

Noon

Students Arrive

Stopping at In N Out

12:30 Depart to Cam

p Lunch

Lunch Lunch

1:30

1:30-3:00 –Challenge 2 1:30- 5:00 Free Tim

e Ziplines, Skate park, etc

1:30-3:00 -Challenge 4

2:00 – 5:00

3:00- 5:00 Free Time

Ziplines, Skate park, etc

3:00-5:00 Free Time

Hum

an Foosball, etc

4:00 Arrive at Cam

p

4:30

Put luggage in tents

5:30

Dinner Dinner

Dinner Dinner

6:30

Pics @ 6:30-7:00

7:00 Slide Show

7:00 Slide Show

7:00 Slide Show

7:00

Session 1-Pastor Ryan W

elcome, Rules-Dan

Open prayer W

orship M

essage

Session 3- W

elcome

Prayer W

orship M

essage

Session 4- W

elcome

Prayer W

orship M

essage-comm

union

Session 6- W

elcome

Prayer W

orship M

essage

9:30 Challenge 1

Free Time-Cam

p Fire &

Smores

Free Time

Free Time/Photo Grab

11:00 Students in tents

Students in tents Students in tents

Students in tents

12:00 Lights Out

Lights Out Lights Out

Lights Out

SUNDAY PAYMENT PLAN FORM

NAME: (Please Print)

1. The payments are to help a family if the camp can’t be paid all at once. Everything will be kept track of and this form is for you to keep track.

__ Deposit July 13th payment $ __________ __ July 20th payment $ __________ __ July 27th payment $ __________ __ Aug 3rd payment $ __________ __ Aug 10th payment $ __________

SCHOLARSHIP FORM

NAME: (Please Print) 1. What type of scholarship do you need (please check one off and write amount requested)

Note: Full scholarships are limited. Please only ask for one if it is absolutely necessary.

Please know that any amount you give is helpful. Partial Scholarships for

example means you can give $10, $15, $20, $25, $30, $35, $40, $50, $100 ext. __ Full Scholarship for $ __ Half Scholarship for $ __ Partial Scholarship for $ (please specify amount needed)

I can give $_______ 2. Please write a brief explanation as to why the scholarship is needed. (Please note: If you are requesting a partial scholarship, you are responsible to pay the balance no later than 2 weeks before the event).

3. Pastors comments: Parent/Guardian Name Parent/Guardian Signature Approved Yes No (to be filled out by staff member) Pastors Name Pastors Signature

Event Release for Rooted Summer Camp

I, the parent / guardian of _____________________________________, a minor, give my permission for him/her to travel to Forest Home in Ojai Valley, CA, and participate in the activities of Calvary Chapel Mission Viejo (CCMV). Photography release: I authorize the adults acting as agents of said Church to take and use images (photo and/or video) of said Minor in church promotional media including, but not limited to, brochures, bulletins, flyers, video publications, and the website. In consideration of the images taken and produced I do not require any monetary or financial payment of incentive or benefit but consider the images taken to be a form of service to the church. Medical release: The undersigned parent or legal guardian hereby authorizes the minor listed above to participation in the Calvary Chapel Mission Viejo sponsored activity aforementioned. Authorization is hereby given to secure hospitalization or other medical treatment necessary in case of an emergency. The undersigned releases Calvary Chapel Mission Viejo, any members, or staff from all claims which may hereafter develop and accrue on account of, or by reason of, any injury, loss, or damage which may be suffered, by me, my child, or any member of my family, or to any property because of any matter, thing, or condition whatsoever, and I assume and accept the full risk or danger of any hurt, injury, or damage which may occur through or by reason of any matter, thing, or condition, negligence, or default, of any person or persons whatsoever. This authorization will remain effective while the minor listed on this form is involved or participating in the event’s activities. It shall be effective on the following days: Aug. 11 – Aug 15, 2014, unless it is revoked in writing by the undersigned and delivered to said Church. Parent / Guardian Name and Signature ___________________________ ____________________________ Date _____ / _____ / _____ Parent / Guardian phone(s) (____) ____________, (____) ____________ Alternate emergency contact name __________________________________________ Phone (____) ____________ Medical Insurance Carrier __________________________________________ Policy # ____________________ Phone (____) _____________ Doctor’s Name _____________________________ Phone (____) _____________ Date of last tetanus shot ____ / ____ / ____ Allergies / Comments / Special Instructions __________________________________________ __________________________________________

Signature

Small _____

Medium _____

Large _____

XL _____

XXL _____

Shirt Size

YOUTH REGISTRATIONIn accordance with the American Camping Association and the Laws of the State of California, we must have a Health History/Medical Consent Form completed and signed by the parent or legal guardian for each camper under age 18 attending Forest Home. Your camper cannot begin the program unless this form is completed and the required signatures are provided. Please be aware that Forest Home does NOT provide medical or hospital insurance coverage.

Student Name_____________________________________________ Age _____ D.O.B. __________ Sex____ Ht ______ Wt ______Address_________________________________________________ City ____________________ State _____ Zip____________ Email______________________________ Dates of Camp _________________ Name of Church Group_________________________Status: ____ Camper ____ CCA ____ Counselor ____ KP Grade (For summer camps, indicate grade in Fall) _____________________________Area of Camp: _____ Indian Village _____ Adventure Mountain _____ Creekside _____ Lakeview _____ Forest Center _____Ojai ValleyParent/Guardian Name(s) ______________________________________ Day Time Phone (_______) ____________________________________Evening Phone (______) _________________________________ Mobile Phone or Pager (_______) _____________________________________Emergency Contact (other than parent)__________________________ Relationship to Camper ______________ Phone (_____)____________________Names of anyone other than parent/guardian authorized to pick up or sign camper out of camp__________________________________________________Thank you for selecting Forest Home for your child's camping experience. During their time at camp their photo may be taken which may be used on our website or used in materials to promote Forest Home.

Also, we stay in touch with our alumni campers and guests via print material and emails. If you rather not have your child's photo taken while at Forest Home, please check here: ____

If you do not wish to receive Forest Home updates, please check here:_____ Blessings and may your child's time with us be full of remarkable memories.

MEDICAL CONSENT FORM REQUESTED MEDICAL INFORMATION:Forest Home REQUIRES this information in order to provide appropriate medical care in the event of injury and/or illness while at camp. Forest Home is committed to protecting the confidentiality of this information.

Do you carry family medical/hospital insurance? Y / N Insurance Carrier_________________________________________________________________ Policy # _____________________________Name of Responsible Party_____________________________________________________________________________________________Address _____________________________________ Phone (_____) ______________________Relationship to Camper ____________________Name of Family Physician___________________________________________________________ Phone (________)_____________________Name of Family Dentist____________________________________________________________ Phone (________)_____________________Has Camper been recently exposed (within last 3 weeks) to any kind of Communicable Disease?____________________________________

If your child has ANY chronic condition including any of the following: Asthma, Bleeding/Clotting Disorders, Cardiac Problems, Diabetes, Emotional Handicap, Epilepsy, Nervous Disorder, Physical Handicaps, Seizure Disorder, or Requires Injections of any kind, a SPECIAL NEEDS PERMISSION SLIP MUST BE OBTAINED AND SUBMITTED AT LEAST 2 WEEKS PRIOR TO CAMP DATES! If a child with special needs comes to Forest Home without written authorization, the group or party may be asked to return the child to his/her home.

List all medical conditions: physical, emotional, behavioral disorders and learning disabilities. _________________________________________________________________________________________________________________________________________________________________Please List ALL Allergies: Drug______________________________________ Insect/Plant_____________________________________ Food______________________________________ Diet Restrictions__________________________________ List Medications Camper will require while at camp and reason for taking the medicine. ____________________________________________________________________________________________________________________________________________________________________

PLEASE TURN OVER >>>

CAMPER HEALTH HISTORY FORM 1Developed and reviewed by: American Camp Association, American Academy of Pediatrics Council onSchool Health, & Association of Camp Nurses

Camper Name: ________________________________________________First Middle Last

Birth Date: ____________Month/Day/Year

General Health History: Check "Yes" or "No" for each statement. Explain “Yes” answers below.

Has/does the camper:

1. Ever been hospitalized? …………………………. Yes No 11. Had fainting or dizziness? ..................................................... Yes No

2. Ever had surgery? ..............................…………. Yes No 12. Passed out/had chest pain during exercise? ….……………. Yes No

3. Have recurrent/chronic illnesses? .......……….… Yes No 13. Had mononucleosis ("mono") during the past 12 months?... Yes No

4. Had a recent infectious disease? ....... …………. Yes No 14. If female, have problems with periods/menstruation?.…….. Yes No

5. Had a recent injury? ........................... …………. Yes No 15. Have problems with falling asleep/sleepwalking? ............... Yes No

6. Had asthma/wheezing/shortness of breath?...... Yes No 16. Ever had back/joint problems?…….………...……………...... Yes No

7. Have diabetes? .................................. …………. Yes No 17. Have a history of bedwetting?………………….……………... Yes No

8. Had seizures? .................................................... Yes No 18. Have problems with diarrhea/constipation?……………….... Yes No

9. Had headaches? …………………………………. Yes No 19. Have any skin problems?…………………….......................... Yes No

10. Wear glasses, contacts, or protective eyewear? Yes No 20. Traveled outside the country in the past 9 months?.............. Yes NoPlease explain “Yes” answers in the space below, noting the number of the questions. For travel outside the country, please name countries visited and dates of travel.

Parents/Guardians: STOP here. The rest of this is form is completed when the camper arrives at camp. Keep a copy for your records.

Copyright 2008 by American Camping Association, Inc. Page 3/4 Rev. 1/2007 LEE/EAW

What Have We Forgotten to Ask? Please provide in the space below any additional information about the camper’s health that you think important orthat may affect the camper’s ability to fully participate in the camp program. Attach additional information if needed.

Health-Care Providers:

Name of camper’s primary doctor(s): ____________________________________________________ Phone: (________) _______________________

Name of dentist(s):___________________________________________________________________ Phone: (________) _______________________

Name of orthodontist(s):_______________________________________________________________ Phone: (________) _______________________

Mental, Emotional, and Social Health: Check "Yes" or "No" for each statement.

Has the camper:

1. Ever been treated for attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (AD/HD)? ………………………........ Yes No

2. Ever been treated for emotional or behavioral difficulties or an eating disorder?……............................................................................. Yes No

3. During the past 12 months, seen a professional to address mental/emotional health concerns?……….…………………………………. Yes No

4. Had a significant life event that continues to affect the camper’s life?...................................................................................................... Yes No(History of abuse, death of a loved one, family change, adoption, foster care, new sibling, survived a disaster, others)

Please explain “Yes” answers in the space below, noting the number of the questions. The camp may contact you for additional information.

All prescription medications, over-the-counter medications, vitamins, and herbal products that are provided to First Aid OR Trip Staff to administer to your child MUST be in ORIGINAL containers with labels and dispensing instructions in English. Individuals requiring injections should provide medications, syringes and written instructions signed by the physician.

By signing this form I give my informed consent to the First Aid personnel assigned by Forest

Home, Inc. who are certified in a minimum of CPR and First Aid by a nationally recognized

provider to provide basic First Aid and comfort measures through standardized camp treatment

procedures which includes the use of over-the-counter medications. I understand that it is my

responsibility to make arrangements for a camper with greater health care needs than the First

Aid personnel can provide within their individual certifications, licenses and scopes of practice. I

authorize Forest Home, Inc. to arrange for or provide any necessary related transportation to the

nearest medical facility for urgent or emergency medical treatment if indicated, and I do assume

all responsibility for payment for such treatment. I hereby give permission to the physician

selected by Forest Home, Inc. to secure and administer any and all medical treatment deemed

necessary for my child, including hospitalization. This completed form may be photocopied for

trips away from Forest Home, Inc. properties.

I authorize the use of the following generic, over-the-counter medications as directed by the labels provided by the manufacturer for my child: analgesics, decongestants,

antihistamines, cough suppressant and/or expectorants, throat lozenges or spray, anti-nausea/diarrhea, epi-pen, antacid, antibiotic ointment, hydrocortisone cream, burn

cream, petroleum jelly, chapped skin/lip treatment, antiseptic skin and wound cleansers, ipecac, glucose, laxatives, electrolyte replacement fluids, analgesic balms and gels,

with the exception of____________________________. I understand that these are stocked and dispensed by the First Aid personnel free of charge as needed for the comfort

of my child.

I have requested Forest Home, Inc. to allow my child to participate in any and all activities that may include but are not limited to those outlined in the camp brochure. As a

condition of receiving this benefit, I do hereby agree to the following: I understand that my child’s participation in these activities can expose him/her to dangers both from

known and unanticipated risks. Acknowledging that such risks exist, I on behalf of myself, my child and any other party who may have the right to assert any rights for or

on behalf of my child, do hereby forever release and discharge, indemnify and hold harmless Forest Home Inc., its affiliates, officers, directors, agents, employees, insurers,

successors in interest, attorneys, or any other person or persons associated with any or all of them who might be liable (the “Released Parties”) from and against any and all

claims, causes of action, actions, suits, demands, losses, damages, expenses, costs or liability (collectively, “Losses”) arising from or in connection with my child’s participation

in Forest Home, Inc.’s camp and its activities, including Losses arising from the negligence of any of the Released Parties, whether such Losses arise in connection with bodily

injury (including death), property damage or otherwise (collectively, the “Released Claims”). The Released Claims include Losses arising out of any condition of the premises

at which the camp activities are held or the conduct of any person in connection with the preparation for, supervision of, or conduct of any activity, whether planned or

unplanned. In the event that child abuse is reported while your camper is at Forest Home, we may fully cooperate with Child Protective Services and Law Enforcement for the

best interest of the child.

I further understand and acknowledge that I make this release in full accord and satisfaction of and in compromise of any and all Released Claims. I represent and

acknowledge that I have read and understand this form and the release granted above and warrant that all statements made herein are true to the best of my knowledge. I

have read and understand this entire form and by signing below agree to the terms herein.

Signature of Parent or Legal Guardian______________________________________________________ Date____________________

Revised 01/05/2013IMMUNIZATIONS: Please �ll in the immunization informationbelow or attach a recent copy of your child’s immunization record.

1. Are all immunizations up to date: �Yes �No

2. Polio (OPV or IPV)—Date: ____________________

3. DTP/DTap/DT/TD (Diphtheria, Tetanus and Acellular Pertussis or

Tetanus and Diptheria only)—Date: ____________________

4. MMR (Measles, Mumps, Rubella)—Date: ____________________

5. Hepatitis B—Date: ____________________

6. Varicella (Chicken Pox)—Date: ____________________

PERSONAL BELIEFS AFFIDAVITI hereby request exemption of this child from the immunizationrequirements for camp entry because all or some immunizationsare contrary to my beliefs. I understand that in case of an outbreakof any one of these diseases, the child may be temporarily excludedfrom attending for his/her own protection.

Signature: _____________________________________________

Date: _________________________________________________

The Bubble Rollers®

Waiver, Release, Hold Harmless, and Indemnification Agreement As consideration for being allowed to enter the play area and/or program with Emerald Isle Entertainment dba The Bubble Rollers™ the undersigned, on his or her behalf, and on the behalf of the Participants(s) identified below, acknowledges, appreciates, understands, and agrees to the following:

1. Represent that I am the participant or the parent or legal guardian of the Participant(s) named below or I have obtained permission from the parent/legal guardian of the Participant(s) named below to execute this agreement on their behalf.

2. I acknowledge and understand that there are risks associated with participation in Emerald Isle Entertainment dba The Bubble Rollers™ activities and the use of the play area and inflatable equipment including but not limited to: concussions, fractures, scrapes, cuts, bumps, fainting, vomiting, paralysis, or death. The activity may result in injuries or aggravation of previous injuries including but not limited to back and neck injuries, whiplash, sprains, dislocations or fractures.

3. Participants must be in good health with no existing injuries. No pregnant women or anybody wearing a cast or any medical devise or who has had an injury in the past 12 months should participate.

4. I, for myself and the Participant(s) named, willingly assume the risks associated with participation and accept that there are also risks that may arise due to OTHER PARTICIPANTS which I also willingly assume.

5. I agree that the Participant(s) named, and I shall comply with all stated and customary terms, directions, rules, and verbal instructions as conditions for participating in any ride, attraction, party and/or program with Emerald Isle Entertainment dba The Bubble Rollers™.

6. I, for myself, the Participant(s) named, our heirs, assigns, representatives, and next of kin agree to hold harmless and indemnify Emerald Isle Entertainment dba The Bubble Rollers™, and their respective predecessors, parent, subsidiaries and affiliates, officers, and employees from any and all injuries, liabilities or damages from participation.

7. I additionally agree to indemnify Emerald Isle Entertainment dba The Bubble Rollers™ for any defense cost or expense arising from any and all claims, injuries, liabilities or damages arising from participation.

8. I, the undersigned, give permission to Emerald Isle Entertainment dba The Bubble Rollers™, and/or parties designated by the foregoing to photograph the person named below and use such photographs in all forms of media, for any and all promotional purposes including advertising, display, audiovisual, exhibition or editorial use. I agree to receive email offers and event details.

9. I am of physical ability to participate and am legally competent to understand and complete this agreement. I hereby executed this agreement without coercion.

Parent / Guardian Name (please print): Parent / Guardian Signature: Date: Address City State Zip Emergency Contact Number: ( ) Email Address;: / / / / Participant Name Date Participant Name Date / / / / Participant Name Date Participant Name Date