first year camper program and basic evening program …€¦ · first year camper program and basic...

R.O.C.K.S. 1

FIRSTYEARCAMPERPROGRAMANDBASICSCOUTSKILLS 1

AQUATICS 1

UNITSWIMCLASSIFICATION 3

SWIMCLASSIFICATIONPROCEDURES 3

POOLRULES 4

CLIMBING 5

ECOLOGY/CONSERVATION 5

HANDICRAFT 5

SCOUTCRAFT 6

SHOOTINGSPORTS 6

C.O.P.E. 10

MOUNTAINBIKING 11

S.T.E.M. 12

MOVIEMAKING 13

ADVANCEMENTSATCAMP 13

HOWTOSUBMIT 14

HELPFULHINTS 14

LEADERAPPRECIATIONLUNCH 15

CAMP-WIDECOOKOUT...“BURGERSONTHELAWN” 15

WORSHIPSERVICES 15

EVENINGPROGRAM 15

OPENINGCAMPFIRE:SUNDAYNIGHT 15

REGIONALCAMPFIRE 15

CLOSINGCAMPFIRE:FRIDAYNIGHT 15

VISITORSTOCAMP 16

CONSERVATIONANDCAMPPROJECTS 17

BRANDING 17

ORDEROFTHEARROW 17

ADULTLEADERPROGRAMS 18

TRAINING 18

UNITDEPOSIT 18

EARLYBIRDDISCOUNTONCAMPFEES 18

SPECIALPROGRAMFEES 18

ADULTLEADERFEES 18

THESHOPATTHEROCK 19

WI-FI 19

2019 Camp Rockefeller Leader’s Guide

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LEADERSINCAMP 20

UNITLEADERS 20

SENIORPATROLLEADER 20

QUAPAWAREACOUNCILCAMPINGPOLICIES 21

BEHAVIORDURINGSUMMERCAMP 22

VEHICLESINCAMP 22

GOLFCARTSFORTHOSEWITHMOBILITYIMPAIRMENTS 22

BICYCLESINCAMP 23

GUSBLASSSCOUTRESERVATIONEQUIPMENTREPLACEMENT 23

COTCOVERREPAIR$35.00EACH 23

DININGHALLPROCEDURES 24

SPECIALDIETARYNEEDS 24

MEDICALFORMS 25

HEALTHANDFIRSTAID 25

CAMPERHEALTHWATCH 25

CAMPSAFETY 25

ACCIDENTINSURANCE 25

ANIMALSATCAMP 25

FIREGUARDPROCEDURES 26

LIQUIDFUEL/PROPANE 26

BUDDYSYSTEM 26

SECURITYINCAMP 26

CAMPINGRESERVATIONPOLICIES 26

SUMMERCAMPWEEKRESERVATION 26

UNITPREPARATIONFORSUMMERCAMP27

CAMPEREQUIPMENTLIST 28

DIRECTIONSTOCAMPROCKEFELLER 29

EACHUNITMUSTPRESENTTHEFOLLOWINGATCHECK-IN: 29

CHECK-INPROCEDURES 30

HEALTHCHECK-IN 30

EARLYANDLATEARRIVALS 30

UNITDEPARTUREFROMCAMP 30

CAMPROCKEFELLERSTAFF 30

COUNSELORINTRAINING(C.I.T.) 31

PROGRAM INFORMATION

R.O.C.K.S.

First Year Camper Program and Basic Scout Skills

The importance of a high-quality first year camper program is not lost at Camp Rockefeller. The first-year camper program at any summer camp is arguably the most important program. This aspect of camp has the potential to influence a Scout’s future in Scouts BSA, both short and long term. A first-year camper program requires patient and caring staff as well as essential program resources and tools and offers instruction in the basic Scout Skills and provides knowledge scouts will need to succeed. Camp Rockefeller is proud to offer our first-year camp program for all first-time campers that need

The R.O.C.K.S. Program is an advancement program for Scouts who have not yet attended a summer camp. These are FULL DAY programs. These scouts will also tour and

participate in other program areas in camp, such as Scoutcraft, Shooting Sports, etc. They will have a chance to experience summer camp.

Scouts in the R.O.C.K.S. program can attend Outpost with the Scoutcraft session one night. If they are planning on attending outpost, Scouts will need to bring:

• water bottle • flashlight • sleeping bag • small tent • rain gear

AQUATICS

There is no better place to “chill out” than our two aquatic areas- the pool and Lake Butler. Stand-up paddle boarding (SUPs), sailing, canoeing, rowing, and kayaking opportunities are to be found on Lake Butler, while our pool provides near limitless opportunities for learning and fun. Aquatics areas are fully staffed to operate in complete compliance with all BSA aquatics standards.

Aquatics merit badges have prerequisites. Please check current Boy Scout Requirement Book. In order to take any Aquatics merit badges, a Scout must have achieved Swimmer in the BSA Swim Test. Swim tests are available during check-in. If a Scout cannot pass the Swimmer’s test, then they will need to reselect merit badge sessions.


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Additional Aquatic Activities

Aquatic Supervision: Adults or youth 15 and up. This is split into two sections, Paddle Craft Safety and Swimming and Water Safety. This course has replaced BSA Lifeguard for unit purposes. This allows your unit to conduct swim tests and other aquatics activities.

BSA Lifeguard: Session will be offered as the need arises. This will be determined from week to week, depending on interest and staff availability. BSA Lifeguard is now a professional level lifeguarding training and not needed at the unit level.

Paddle Craft Safety

BSA Paddle Craft Safety expands Safety Afloat training to include the skills and knowledge needed for a unit leader to confidently supervise canoeing or kayaking excursions on flat water. The following materials are required to conduct the course.

Swimming & Water Rescue

Training for BSA Swimming & Water Rescue provides BSA leaders with information and skills to prevent, recognize, and respond to

swimming emergencies during unit swimming activities. It expands the awareness instruction provided by Safe Swim Defense training. The following materials are required to conduct the course.

BSA Snorkeling: Meets during additional merit badge time

Free Swim: Monday – Thursday during free session and Monday night after dinner. Participation will be limited to the number of lifeguards on duty. Volunteer lifeguards can allow for more participants.

Troop Swim – Tuesday and Thursday evening after dinner. Troop swim is intended for the scouts’ enjoyment and for units to practice safe swim defense principles. This activity is under the supervision of the unit. The unit must provide adult supervision, lifeguards, lookouts and safe swim defense certifications. Multiple units may swim at the same time after consulting with the Aquatics Director. Units must also stay to clean the pool shower houses after their swim.

Mile Swim: Must attend each session. Swimming starts at:

Monday: 6:00 a.m.

Tuesday: 6:00 a.m.

Wednesday: 6:00 a.m.

Thursday: 6:00 a.m.

Friday: 3:00 p.m.


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Pool Shower Hours

Youth (17 and younger): 6:00 a.m. – 10:00 p.m.

Adults (18 and older): 24 hours daily

Youth protection rules must be followed

Separate facilities are available for youth male, youth female, adult male, and adult female.

Unit Swim Classification

The Boy Scouts of America has developed guidelines concerning the swim classification testing, which is usually performed Sunday at check-in at summer camp. The unit’s swim classification test can be completed prior to coming to camp. The following steps must be followed to complete the unit swim classification test prior to camp.

1. The swim classification test must be conducted by one of the following individuals: Aquatics Director BSA (National Camp School Certified), BSA Lifeguard Instructor, BSA Lifeguard, Aquatics Supervisor BSA (Aquatics Supervision Card), Red Cross Lifeguard Instructor, Red Cross Lifeguard, Ellis Lifeguard Instructor, Ellis Lifeguard, YMCA, or Red Cross Water Safety Instructor. When the unit arrives at summer camp, everyone will be issued a buddy tag by the Aquatics Staff under the direction of the Camp Aquatics Director.

2. A copy of the reviewer’s certificate or card must be attached to the Unit Swim Classification Test Record form.

3. Complete the classification test after January 1st of the summer camp year. Inform the Aquatics Director of any illness or injury

that occurs after this date. It is not necessary that the entire unit use this process. Swim checks can still be done at camp upon arrival for part or all a unit.

4. The Unit Swim Classification Test Record must be turned in prior to arrival at camp. Send the completed swim check materials to the Quapaw Area Council Program Director at least two weeks prior to arrival by email to [email protected]., or mail them to the council service center addressed to the attention of the Aquatics Director. Please bring an extra copy the day of arrival.

Swim Classification Procedures

The swim classification of individuals participating in a Boy Scout of America aquatic activity is a key element in both Safe Swim Defense and Safety Afloat, the backbone of scouting aquatics. The swim classification tests should be renewed annually and no more than six (6) months prior to summer camp. Traditionally, the swim classification test has only been conducted at a long-term summer camp, and that option will still be available.

All persons, adults and non-scouts included, participating in BSA aquatics are classified according to swimming ability. The swimming


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test has been developed and structured to demonstrate a person’s swimming ability and to assign the person a water depth that is appropriate to his/her swimming ability.

The various components of each test evaluate the several skills essential to the minimum level of swimming ability. Each step of the test is important and should be followed as listed below.

It is very important that the test be administered exactly as stated. Do not make exceptions or deviations for any reason. If there are any questions, have the Scout retest at camp.

There are three qualification levels in the BSA swim test. The first is the Swimmer, which allow persons to swim in all swim areas and boat in open water. The second is Beginner, which will permit limited boating and swimming, the final is a Non-Swimmer, which will permit wading and boating only with qualified accompaniment in safe watercraft. These qualifications can be found in any Aquatics Merit Badge book, the Boy Scout Handbook, or on www.quapawbsa.org

**NOTE** Camp Rockefeller reserves the right to retest a camper if the Aquatics Staff has any reservations about the swim classification assigned through the unit pre-camp swim test.

Valuables in Pool Area

Scouts are asked to not bring valuables to the pool or shower areas. The aquatics staff is not responsible for lost or stolen items.

REQUIRED/Recommended items: Shower shoes or flip flops, towel, swimsuit, and swim goggles.

Pool Rules

· ALL swimmers must shower with soap before entering the pool.

· Running is not allowed on the pool deck or shower areas.

· Unhemmed shorts are not allowed.

· Gum, food, and drinks stay outside the pool and shower areas.

· No horseplay allowed.

· Stay off boundary and lane ropes.

· The diving area is for diving only.

· Do not cross over or under the ropes.

· Diving from the edge of the pool is not allowed.

· Lifeguard and staff instructions must be followed.

Buddy Tags

Scouts and leaders are required to have buddies to enter aquatics area.


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CLIMBING

Climbing Merit Badge will be offered at the Camp Rockefeller Climbing Tower.

Climbing Merit Badge is a 3-hour session, which will cover all the requirements for the Merit Badge. There is a limited number of spots available. This program is designed for older scouts who are at least First Class and 13 years old. Free Climb will be offered during each week of summer camp. This is open for anyone 12 years old and First Class or 13 years and older. Climbers must have closed-toe shoes and no slick material shorts.

ECOLOGY/ CONSERVATION

One of the busiest areas of camp is the Logging Camp pavilion. Eco-Con is the place for all

things natural and wild. Specimens and information on Arkansas species of flora and fauna are available. The many merit badges available in this program area offer something for every Scout. Leaders or Units looking for something extra to do will find their list of prospective conservation projects in this area. (Tools and supplies for projects will be arranged after consulting with the Eco-Con Director and Quartermaster.)

Some fishing equipment will be available. A Scout taking the fishing or fly-fishing merit badge is encouraged to bring fishing equipment.

ALL Students must bring a notebook and pen or pencil for all Eco-Con classes.

HANDICRAFT

All handicraft sessions are scheduled*; however, scouts and leaders can always take advantage of the tools and materials to be found at the pavilion.

Handicraft projects may be purchased at The Shop at The ROCK or may be brought from home (typically $4-$10). Some merit badges require more than one project.


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*Basketry merit badge will be an optional session generally taken during free time on Friday afternoon. Scouts will need to bring $15 for 3 basket kits from the Trading Post.

SCOUTCRAFT

The Scout Handbook comes alive at Deep Woods. All the advanced Scout skills, introduced in R.O.C.K.S., are taught in depth at Scoutcraft. Scouts learn all the latest about camping gear and techniques. Special events, like “Fry It Up Friday”, are activities scouts look forward to when enrolled in Scoutcraft. Scouts also learn all about advanced outdoor skills and modern camping technology. The merit badges are designed to build upon the basic Scout skills.

The big event for Scoutcraft is Outpost. Outpost is the ultimate outdoor challenge, which tests all the Scout’s outdoor abilities in a fun way. Scouts will need to bring a water bottle, flashlight, and something to sleep in/on and sleeping bag. Outpost campers will hike one mile to a secluded location, set up their tents and/or lean-to’s, and prepare for feast and fun.

SHOOTING SPORTS

Scouts can expect a slew of shooting sports opportunities. Thanks, in large part to the Jon Steuri Family, Camp Rockefeller is proud to offer trap and skeet shooting. This state-of-the-art complex is the final component of our comprehensive shooting sports program which includes archery, rifle, shotgun, muzzle loading, and pistol shooting. Recreational shooting opportunities occur throughout the week. All ranges are operated under the direct supervision of BSA certified shooting sports directors, NRA instructors and range safety officers. Firearm and range safety are the primary concern of our staff.

There are no age or rank requirements to participate in rifle merit badges. Scouts taking the Shotgun Merit Badge are required to be at least 13. Scouts must be able to physically handle a shotgun and recoil to the instructor’s satisfaction.

Scouts working on Archery merit badge will need to purchase an arrow kit ($2) from The Shop at The ROCK for completion of the badge.


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SPECIALTY PROGRAMS

At Camp Rockefeller, we are pleased to offer several premiere older Scout programs. Through these programs, we hope to reinvigorate a yearning for adventure, the great outdoors, and BSA tradition, while providing vital team building and leadership experiences. Most importantly, there is fun to be had every step of the way! Our older Scout programs are designed to take basic skills already learned in Scouting and push them to the next level. These programs are also appropriate for new older scouts looking for an adventure. Some Specialty programs do require an additional fee.

WHITE RIVER CANOE EXPEDITION

Back by popular demand, Camp Rockefeller is pleased to offer the White River Canoe Expedition again this year. This program is an offsite program design for older Scouts (14 and older) that will leave camp on Tuesday morning and will return Friday afternoon.

This will be over 50 miles of paddling on world class trout fishing waters. Make sure to bring your fishing pole (and license if required).

This will qualify for the 50-miler award.

Requirements for participating in the RIVER adventure:

1. Scouts will need to be at least 14 years old and must qualify as a Swimmer.

2. 1st Class, Canoeing and Camping Merit Badges are highly recommended.

3. Participants must be medically sound for High Adventure activities.

4. Participants must have the items listed on the Personal Gear List.

5. Sunburn and heat related problems have serious long-term consequences. Scouts must be willing to take proper precaution including use of hats, sunscreen and sunglasses.

6. Life jackets (PFD) will be worn at all times while in the canoe.

After the evaluation at the lakefront, if the RIVER staff determines a scout is not prepared for the trip the scout will be directed to plan on doing an alternate activity in camp.

Participants will be provided a yellow dry bag in which

to place all the plastic bags (see checklist). All necessary information will be covered during the preparation.

IMPORTANT: Make sure participants are dressed for the river, well hydrated, and water bottles are full before departing Camp.

All Arkansas Game and Fish Commission rules apply for fishing. If a participant plans to fish during the expedition, a valid fishing license must be purchased prior to arrival (if required by the AGFC).

River conditions can force changes in the itinerary. We may opt to change the put in and take out locations as conditions dictate.


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RULES AND REGULATIONS:

1) GLASS - no glass on or near the water.

2) FOOD/BEVERAGE - must be in sturdy, sealed container. No Styrofoam

3) TRASH - must be in a sturdy container or mesh bag affixed to the canoe.

4) BEVERAGES must be in a floatable holder when not in sealed container.

WHITE RIVER:

• Fish must not be filleted or have head or tail removed. Possession limit: Twice the daily limit Daily limit of 5 trout. Limit may include no more than 1 brown trout (24" or longer), 2 cutthroat trout (16" or longer), and 2 brook trout (14" or longer).

• Rainbow trout restricted only by the 5-trout total daily limit.

• Trout may not be released if it has been on a stringer, in a live well or fish basket.

• Trout may not be used as bait. • Chumming is not allowed • Anglers may use no more than 1 fishing rod or pole

and must attend it at all times. No other devices shall be used to catch fish, except bait tackle to catch bait fish.

• Imported trout (salmonid) and trout eggs must have a disease-free certification.

PERSONAL GEAR NOTES

NOTE: The 2017-RIVER 3 - Personal Gear – Checklist is both a checklist of Arkansas rules and regulations as well as a gear checklist. The spreadsheet has two tabs, RULES and GEAR LIST. Be familiar with both. It will be sent out as camp approaches.

Before coming to camp:We will use a "bags within a bag" approach. Using the attached Personal Gear - Checklist, scouts will place gear items in strong plastic bags. Be sure the bags are protected from puncture during transport.

Please read the following notes then use the Personal Gear list to pack accordingly. The list is classified as to where the item will be when in the canoe. (Wear, Day Pack, Dry Bag, Misc.)

Wear:The scout is expected to be wearing the items listed under the "Wear" category Monday morning. Leave your "class A" clothes in camp. Proper footwear, Sunglasses, sunscreen and hat are required.

Day Pack:A small backpack works well as the Day Pack. It needs to be something that can be attached to the canoe and be zipped to contain contents if the canoe capsizes. It will be accessed frequently while in the canoe and the scout should expect the contents to get wet. Things such as cameras that can be damaged by water should be placed in waterproof containers then kept in the Day Pack when not in use.

Dry Bag:The Dry Bag is a water-resistant bag that will keep the contents dry momentarily but not if subjected to extended submersion. The Dry Bag capacity is about that of a seven-gallon bucket. Use strong plastic waterproof trash bags for each Dry Bag subcategory (a-e). Trash compactor bags work well. Remember, these are to be packed prior to coming to scout camp then placed in the provided Dry Bag at camp Sunday evening.

The plastic bags to go into the Dry Bag are:(a) Clothes.(b) Dirty/wet clothes. This bag will be empty on the first day.(c) Sleeping Gear.(d) Toiletries should have its own small bag.(e) Camp shoes. Optional. These are in addition to the shoes worn during canoeing which will be constantly wet. Make sure the bags are protected from puncture during transport to camp.


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Clothing:Long sleeve shirts and long pants are recommended but not required. Clothing needs to be light weight and quick drying. Cotton is allowed in summer but not recommended. It is suggested that the swim suit be worn in place of underwear while canoeing.

Proper footwear is important to prevent injury. Sandals and other open toe footwear are not allowed. Old tennis shoes work well.

Sleeping gear:Proper sleeping gear is important. It can also be bulky, so a compromise needs to be made between warmth and bulk. Remember all Dry Bag items combined should be about the size of seven-gallon bucket.We will be on gravel bars some nights. A sleeping pad is recommended.

Shelter:Small two-man tents are recommended. Hammocks will not be possible on some nights. Insects can be a nuisance. Be prepared.

Miscellaneous:All Miscellaneous items need to be in bags or otherwise be able to be attached to the canoe to avoid loss in the event of a spill.

State Laws:Be sure to review the applicable laws.

Fishing gear:Fishing is optional and fishing gear must be carried in a compact case when not in use. It is extremely important that we comply with all fishing laws. Those over 15 years of age must have an Arkansas fishing license and if fishing the White River, you will also need a trout stamp. If you need a fishing license you can get it online. http://www.agfc.com/licenses/Pages/LicensesFishingFees.aspx

Go to: http://www.agfc.com/youth/Pages/YouthGetStartedFishing.aspx to find out more information about recommended fishing gear and baits for trout and

smallmouth bass. The White river is one of North America's premier trout fisheries and fish can (usually) be caught with nothing more than a small weight, hook, and a can of cheap kernel corn.

Do not bring anything that is not permitted at Camp Rockefeller.

Medical forms and medications will be kept by a designated staff leader. Remember, this is classified as high adventure. For their own safety, those not medically qualified to participate in remote high adventure activities will not be able to be on this trip.

Make sure all personal gear is marked to clearly identify ownership.Scouts without any item listed may be kept from participating on the trip. DOUBLE or TRIPLE check your list.

If you have a small, compact camp chair, you may bring it, space permitting. It is not listed in the Personal Gear list because space is limited. Each canoe has 2’x2’ mats that can be used to sit on in camp.

Group Gear:Food will primarily be of the dehydrated backpacking variety.

Eating utensils are supplied in the group gear.


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Hydration:We will be filtering river water. Each scout will be responsible for having his own water bottles with sufficient water for at least one day. Three or more liters are recommended.

Caffeinated drinks will NOT be provided. Be aware that this can result in the scout getting headaches if he is addicted to caffeinated drinks such as Mountain Dew. The scout will be drinking filtered water. Ice will NOT be available. Hydration is extremely important.

Human Waste:We will be spending three nights in primitive areas that do not have potable water or toilet facilities. We will be using cat holes as prescribed by the national park service. This may involve walking into tick and chigger infested areas. Insect repellent is important. Toilet paper is to be packed out.

Note: Each canoe will have two scouts and will be carrying both personal and group gear.

COVE CREEK TRAPPING COMPANY

In the early days of the United States, brave men and women ventured westward into the wilderness. Using only the items they could carry with them and their survival skills, they travelled into the mountains and thrived.

Travel back in time and learn the same survival skills as these mountain men. These skills will include advanced shelter building, primitive fire building, tracking, animal identification, animal traps and snares, fish trapping, knife and axe throwing, and so much more.

This program is a half day program designed for older Scouts, ages 13 and above. Scouts should be competent in wilderness survival and basic Scouts skills.

C.O.P.E.

C.O.P.E. (Challenging Outdoor Personal Experience) consists of a series of elements and challenges designed to foster problem solving skills, leadership, teamwork, and group interaction. Seven key goals are developed during this experience: Leadership, Trust, Communication, Teamwork, Self Esteem, Problem Solving, and Decision Making.

These goals are accomplished through a challenge by choice program designed to encourage the group to work together, communicate with each other, and trust the group decision as they attempt a solution to the objective.


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The C.O.P.E. program generally consists of Initiative Games, Low Course Elements, and High Course Elements. Each team of participants will move from one level to the next based on their abilities and understanding.

The C.O.P.E. Program is restricted to scouts age 13 and older by the time the Scout arrives at camp. Session size is limited, and all participants MUST have a current medical form signed by a parent and a physician. Required clothing includes closed-toe shoes and no slick material shorts. C.O.P.E. is a five-day program and all participants MUST attend all five days. NO EXCEPTIONS. If a participant completes all requirements before Friday, he must attend all sessions to qualify for a completion certificate because the entire team is necessary to be successful. Project C.O.P.E. provides each participant the opportunity for success as an individual and as a member of a group.

While this activity is challenge by choice, it is physically demanding and requires good endurance and stamina. Be prepared to meet the challenge. Although scouts are excited to participate in C.O.P. E., this program is intended for older scouts. Leaders are encouraged to critically evaluate the maturity level of the scouts interested in participating. If space is available, after all scouts who wish to participate are signed up, a limited number of registered adult leaders will be accepted.

C.O.P.E. t-shirts are available to participants who complete the program at an additional price of $12.00 at The Shop at The Rock.

MOUNTAIN BIKING

The mountain biking program is a challenging and physically strenuous five-day program involving over fifty miles of increasingly difficult, roads and trails. The session meets Monday through Friday at the South Ridge Pavilion. This is a strenuous activity and is recommended only for those persons in good physical condition. This program is for older scouts- at least 13 years old or 12 years old and First Class.

The scouts in the program work toward the Cycling merit badge, including instruction on proper riding technique, trail etiquette, safety, maintenance, and repair. The only requirement which scouts may be unable to complete is requirement nine.

Scouts bringing their own bikes must also bring a helmet and an extra inner tube. If a Scout brings his own bike, it must be a substantial off-road bike and must meet the review by the Mountain Biking Director. The Mountain Biking Director will disqualify any


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bike that does not appear substantial enough to handle the very rough terrain over which this activity covers. All scouts must bring a water bottle.

S.T.E.M.

STEM stands for Science, Technology, Engineering and Math and is a brand-new initiative taken on by the Boy Scouts of America in cooperation with Exxon Mobil to boost interest in these areas.

3D Printer – Camp Rockefeller is proud to show off our STEM’s 3D printer. STEM sessions use it, as well as being available to view during evening programs.

STEM Shoot! This course will allow scouts to explore outer space! Throughout this course, the scouts will have the opportunity to learn about natural celestial objects such as other planets and stars, as well as the technology we use to study them. Scouts will be able to build rockets and attend a Star Party to gain hands on experience using telescopes to view planets and stars, as well as learn how to spot satellites in the night sky. During this session, scouts will be able to earn the Astronomy Merit Badge,

Space Exploration Merit Badge, as well as the NOVA Shoot! Award. Notebooks are required for this course.

STEM Start your Engines! This program will give scouts the opportunity to design a small model vehicle! Throughout the week, they will have the opportunity to learn about circuits by building a model circuit, learn to use soldering equipment safely, as well as explore electricity by designing simple models and reading electricity meters. During this session, scouts will work on their Electronics Merit Badge, Electricity Merit Badge, and the NOVA Start Your Engines Award. A folder or notebook and a simple calculator is highly recommended for this course.

STEM Whoosh! Scouts will spend the week learning all about what engineers do. Through the week, they will get to act as engineers when they design, build, and program a robot. The scouts will have the opportunity to meet an engineer during session to learn what he does. The week will culminate in a showcase of their programmed robots at RoboSlam! On Friday afternoon. The engineering merit badge, robotics merit badge, and NOVA Whoosh! Award will all be available in this course. Notebooks are required for this course.

STEM Designed to Crunch! In this full morning session, scouts will design and build a project, starting with a handmade drawing, moving up to computer aided design, and then finishing by producing an actual product. This week-long project will allow scouts to develop an understanding of the design process as well as the math behind the scenes. They will also have the opportunity to attend a Star Party, explore the functions of a calculator, and


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calculate their own horse power. The scouts will have the opportunity to earn the drafting merit badge, model design and building merit badge, and the NOVA! Designed to Crunch award. Calculators and folders are highly recommended for this course.

Moviemaking

Scouts in Movie Making produce movies, pictures, scripts, etc. Scouts enrolled in Movie Making produce funny and interesting stories about camp each week. They will then edit their masterpiece and produce a movie. Look for previous productions by the scouts in cinematography on the latest camp promotional video.

Cowboy Action Shooting

The program offers a fun and safe introduction to cowboy action shooting with pistols, rifles, and shotguns. While attending camp, Boy Scouts and Venturers 14 years of age or older can take part in a special shooting experience with opportunities to shoot single-action .22-caliber pistols, lever action .22-caliber rifles, and 12-gauge or 20-gauge shotguns. In various old-time western scenarios, Scouts play “good guys” who prove their accuracy by shooting at things like spinning metal targets where they hit the spinner to “ring the bell.” All shooters choose their own cowboy action names before starting so the NRA instructors—dressed in cowboy attire—can call them by those names.

YOUTH REQUIREMENTS: Boy Scouts and Venturers who are over the age of 14, or are 13 and have completed the eighth grade, may participate in this activity. All youth participants are required to have written permission from their parent or guardian before they can take part in the program.

ADVANCEMENTS AT CAMP

Rank advancement and merit badges are often used to measure the success of a Unit. The goal at summer camp is to assist the Unit’s regular instruction program. Council resources allow programs that may not be practical or easy for the individual Unit. This is a supplement to a Unit’s year-round program.

Summer camp should not be viewed as a residential merit badge university. There are many exciting opportunities for scouts to learn the skills necessary for advancement. Many merit badges require skills that take time and practice to become proficient. The staff is chosen and trained to provide the highest quality instruction and will be available to discuss a Scout’s progress upon request.

Rank advancement and merit badges are not awarded by the summer camp staff. Advancement is a function of the Unit and its advancement review policies.

Scouts, who have never attended a summer camp, are encouraged to attend the R.O.C.K.S. Program. It is designed to help these scouts develop the skills to advance to their next rank while having the ability to take some merit badges that interests them.


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SCOUT’S PROGRAM ACTIVITY SCHEDULES

How to Submit

Camp Rockefeller is changing how you register and schedule your sessions for 2019 Summer Camp season. Please visit https://scoutingevent.com/018-camprockefeller2019 to sign up today. Merit badge sessions will open up March 1 for selection.

Units will be able to sign their Scouts up for the merit badge sessions to guarantee them a session. They will also have the ability to make payments using their secure system.

Please contact your District Executive (In Council Units) to receive your login information if you have not received it. Your unit leader will be emailed a copy mid-March.

Please email [email protected] with any questions.

Helpful hints

Some programs have age and rank requirements.

Some activities require more than one session period. These include Rifle Shooting, Shotgun Shooting, Mountain Biking, Climbing, C.O.P.E., R.O.C.K.S, and some STEM sessions.

Astronomy includes an evening program with extra observing time. It is highly encouraged for scouts to be at least 13 years of age to participate in Astronomy but not required.

If a Scout does not pass the swimming classification in the swim test, then the Scout will be rescheduled to an Instructional Swimming session. If the Scout passes those requirements, then the Scout will work on Swimming merit badge the remainder of the week.

Ensure scouts are proficient in basic Tenderfoot through First Class skills before enrolling in advanced merit badge sessions. For instance, if the Scout is struggling with the basic map and compass skills, do not schedule them for orienteering. This type of merit badge session does not teach these basic skills and it is expected they know these skills.

The Mountain Biking activity is strenuous and each day the rides become progressively more difficult. A Scout that is not in good physical condition will have difficulty with these activities.

For Shotgun Shooting, a Scout that is not physically mature will have a very difficult time holding the shotgun for qualifying. It is suggested in addition to the age and rank requirements, that the Scout’s physical strength and arm length are examined to ensure he can handle a shotgun. Likewise, Rifle Shooting, Canoeing, Climbing, and Archery require coordination and strength and should be encouraged for older scouts.

The Unit leader will receive a printed schedule for each for each Scout.


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SPECIAL EVENTS

Leader Appreciation Lunch

Camp Rockefeller’s way to say thank you. This is an opportunity for Camp Rockefeller to offer a break from the heat and to enjoy a fantastic meal provided by a world-class chef. This is also an opportunity to introduce upcoming programs that the Quapaw Area Council has to offer both in-council and out of council leaders.

The Leader Appreciation Dinner is for leaders in camp and not for additional visiting leaders not staying with the Unit. It is not for family members or others not staying at camp.

Camp-Wide Cookout . . . “Burgers on the Lawn”

A traditional, old-fashioned cook-out will be held on the lawn in front of the dining hall. Waiters are not needed; the staff will do everything. However, everyone should assist with the clean-up process and leave the lawn area clean and free of trash.

Worship Services

All services will be held at the Chapel and everyone is encouraged to attend in uniform. Units are always free to conduct services within the campsite.

Evening Program

Opening Campfire: Sunday night

The Sunday night opening campfire will be presented by the camp staff. A Staff guide will arrive at the Unit campsite and lead the Unit to the campfire.

Regional Campfire

Regional campfires are a chance for units to assemble for fun and fellowship. As a group, they will decide what skits and songs will be used for the Friday night campfire. SPLs oversee these campfires and will operate under the supervision of the Unit adult leaders and Camp Staff present.

Closing Campfire: Friday night

Friday night’s campfire features songs, skits, and performances by scouts. This campfire is planned during the SPL meetings. All Units assemble at the Flag Plaza and will be led to the campfire circle.


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Visitors to Camp - FRIDAY FAMILY NIGHT

Note to Scout Leaders: Please share this information with the families of the scouts in your Unit.

Families and guests of scouts who visit Camp Rockefeller are encouraged to do so on Friday Family Night beginning at 5:00 p.m. concluding with the closing campfire.

All visitors must check-in at the Camp Office at the Admin Building before entering camp, and check-out upon leaving camp. Camp Commissioners will be available to assist visitors with this process.

It is important that visitors know and understand Camp Rockefeller is not a city park. Visitors should come prepared to walk reasonable distances to the campsites and program areas. The terrain is uneven, hilly and may be difficult for individuals with mobility issues. Visitors are strongly recommended to wear sturdy shoes (not flip-flops or sandals), a cap or hat, and comfortable clothing appropriate to the weather.

For safety reasons, all vehicles must be parked in the main parking lot. This includes vehicles with valid Disabled Parking Permits. The main camp area is located uphill by a trail or road that is a rather steep grade. Camp Rockefeller staff will attempt to accommodate individuals with obvious mobility issues on a case by case basis.

For the safety of everyone, pets are not allowed at Camp Rockefeller. This provision is also for the safety of the pets.

Visitors are welcome to observe, but may not participate in, Camp Rockefeller program areas.

Family Night visitors are welcome to eat in the Dining Hall according to the camp schedule for meals. Meal tickets can be purchased in the Shop at the Rock. Cost is $10.00 per person. To prepare a sufficient amount of food for the Friday evening meal, Scout leaders are asked to identify the number of their unit’s visitors eating in the Dining Hall on Friday Family Night and report this information to the Camp Commissioner not later than noon Wednesday.

Visitors are welcome to camp overnight Friday in the Short-Term camping area (visitors must bring own camping equipment).

Subject to space availability and for Family Night visitors who need to stay over on Friday evening, rooms may be reserved at the Donald W. Reynolds Scout Training Center at a cost of $50.00 per night. A reservation is required a minimum of two weeks in advance. This will


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be on a ‘as available’ basis. Unfortunately, due to Youth Protection issues, no one UNDER 18, will be allowed to stay.

Only registered boy scouts and unit leaders or parents serving as unit leaders may stay overnight in the troop campsite at any time.

Conservation and Camp Projects

Camp projects must be approved in advance by the camp administration. Unit leaders should contact the camp office for information about doing a camp project. A list of conservation projects is maintained by the Ecology/ Conservation Area Director. Units may make arrangements with the Quartermaster for tools and assistance.

Branding

Check out The Shop at The ROCK on Friday afternoon. There will be an opportunity to get mugs and belts branded with the camp logos.

ORDER OF THE ARROW

Quapaw Lodge will host all members of the Order of the Arrow on Monday night following dinner, outside of the Trading. Order of the Arrow members are also encouraged to wear

the OA sash Friday evening through closing campfire. Remember that the OA sash is only worn with the full uniform.

During the closing campfire Friday night, the Quapaw Lodge will call out the new members selected during unit elections. The unit elections must have occurred between January and May of 2019. If you are attending Camp Rockefeller from out of council and would like your Scouts called out this night, then you must bring a signed letter from your council stating that we may call your Scouts out.

The purpose of the Order of the Arrow:

· Recognize those who best exemplify the Scout Oath and Law in their daily lives and through that recognition cause others to conduct themselves in a way that warrants similar recognition.

· Promote camping, responsible outdoor adventure, and environmental stewardship as essential components of every Scout’s experience, in the unit, year-round, and in summer camp.

· Develop leaders with the willingness, character, spirit and ability to advance the activities of their units, our Brotherhood, Scouting, and ultimately our nation.

· Crystallize the Scout habit of helpfulness into a life purpose of leadership in cheerful service to others.

Since its beginning, our Council has worked to uphold the traditions of the Order of the Arrow in all its activities. Callouts will be held at summer camp. Out of council units must


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present a letter from the home council approving a “callout” from the Quapaw Area Council at Camp Rockefeller.

Adult Leader Programs

Some adult leader programs will be available and announced at check-in. Camp Rockefeller provides ample training to further strengthen your unit’s resources.

Training

Camp Rockefeller offers multiple training opportunities for Leaders while they are in camp. We plan to offer Youth Protection Training, Scoutmaster Training, Introduction to Outdoor Leader Skills, and Aquatics Supervision. Other trainings may be available on a week by week basis. Check with the Camp Director upon arrival to camp.

FEES AND REFUND POLICY

Unit Deposit

The troop site deposit of $200 is applied to the balance of camp fees or may be rolled over to the following year. The deposit is non-refundable if the Unit does not attend camp.

2019 SCOUT FEE

$300

Early Bird Discount on Camp Fees

EARLY BIRD FEE - $250

Take advantage of “early bird” discounts on camp fees.

To qualify for Early bird fees, a unit must:

• Make $100 Deposit per Scout by March 29. • Pay remainder of balance ($150) by 3 p.m., May

1, 2019. • There will be no exceptions.

Special Program Fees

C.O.P.E. $15

Mountain Biking $10.

Rifle/Shotgun Shooting - $20

Some merit badges will need materials that can be brought from home or purchased in The Shop at The ROCK.

Adult Leader Fees

Leader’s fees . . . . . . . . . . . . . . $125 per week

Short-term Leaders . . . . . . . . . . . $10 per meal

Leader’s fees cover the cost of meals through the week.

HOUSING

Scouts and leaders will be housed in wall tents with two scouts or leaders per tent. Units wishing to have enough tents to camp with only one leader per tent, must submit a written request to the Camp Director at least two weeks prior to arriving at camp. Personal


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tents are welcome. These additional tents are available for $25.00 per extra tent, limited by the availability of equipment. (This fee will not apply when units need an extra tent due to gender diversity in the leadership attending camp.) Each tent is also furnished with 2 cots at no additional charge.

REFUND POLICY

• Up to 80% of the registration fee may be refunded. A $40 fee will be retained on all refunds.

• Registration fees are transferrable but refundable except for the following reasons: serious illness or death, transfer, or summer school.

• All refund request will be made using Refund Form (found online and in the appendix) within two weeks of your troop attending camp.

• No shows will not be issued a refund. • No refund is guaranteed. Please do NOT overpay. • The $200 campsite deposit is not refundable in the

event of cancellation. • Refund checks will be mailed to the unit leader.

Please allow at least 3-4 weeks after camp for refunds to be processed.

ACCOMMODATIONS

The Shop at The ROCK

The main camp trading post- “The Shop at The ROCK” – is where scouts, leaders, and visitors will find a wide selection of goods for sale. These items include:

· Souvenirs: T-shirts, caps, postcards, beverage mugs, patches, etc.

· Food and Snacks: ice cream, fruit drinks, soft drinks, candy, etc.

· Personal items: toothpaste, sun block, combs, soap, etc.

· Camping items: water bottles, pocket knives, flashlights, belts, hammocks, etc.

· Handicraft Materials: basketry kits, wood carving items, leather craft, etc.

· Other items: merit badge books, nature books, handbooks, etc.

· The hours of operation will be posted at the entrance doors.

Wi-Fi

Camp Rockefeller has a free network around main camp. This is available to leaders to use if they need to connect to the outside world while at camp. This is true wireless from a


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nearby tower. Speeds may vary due the number of users on the network.

Mail

All scouts and leaders enjoy receiving mail at camp. Please advise parents that all mail must be addressed properly, and mail sent from home later than Wednesday may not arrive until after the Unit departs from camp on Saturday. Mail should be addressed as follows:

Scout’s Name, Unit Number Gus Blass Scout Reservation 408 Scout Drive Damascus, AR 72039

Telephone Service

The Gus Blass Scout Reservation telephone is for Camp business and emergency calls only.

Gus Blass Scout Reservation: (501) 335-7208

Laundry Facilities

There are no public laundry facilities available at Camp Rockefeller. The closest public laundry facilities are in Greenbrier, Arkansas.

Electricity

Electricity is not provided for unit camping. It is unsafe and against camp policy to run extension cords from other facilities for use in the campsite. Generators are not allowed in campsites. Campers using a CPAP machine must provide their own battery to operate the unit independent of an electrical source. Battery recharging can be coordinated with the Camp Quartermaster.

LEADERS IN CAMP

Unit Leaders

Current BSA policy requires that each Unit be under the leadership of at least two (2) adults at all times, one at least 21 years of age and the other at least 18 years of age. It is preferable that the Unit’s Scoutmaster attends, but if this is not possible, the Unit Committee names a “Camp” Scoutmaster. Both adults must be registered with the Boy Scouts of America. A parent of a Scout may substitute for the 18 or older adult. The Camp Scoutmaster works with the Senior Patrol Leader in developing the unit’s camp program. The Camp Scoutmaster coordinates all adult leadership in his unit. All unit adult leaders are responsible to the Camp Scoutmaster.

Any leaders coming in or leaving camp must sign in and out at the camp office. All leaders must present a current Youth Protection card upon arrival to camp. Leader accommodations will be the same as for scouts unless prior arrangements have been made. (See Camp Fee section)

Senior Patrol Leader

Each unit’s Senior Patrol Leader (SPL) is part of the Camp Senior Patrol Leader’s Council that meets with the Camp Program Director. The SPL will help plan camp wide events as well as coordinate other unit activities. If the unit’s SPL is not able to attend, a “Camp” Senior Patrol Leader should be appointed.


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Quapaw Area Council Camping Policies

Gus Blass Scout Reservation is guided by the Scout Oath and the twelve points of the Scout Law. All camp participants are expected to live by these principles. Behavior which does not meet the high standards of the Scout Oath and Law is unacceptable. All campers and leaders are asked for their cooperation in helping to maintain these high standards of moral and personal behavior. The following rules have been established for the health and safety of all scouts, adult leaders, camp staff, and visitors.

Quapaw Area Council camping guidelines state:

· 2-Deep Leadership is required at all times.

· Open-toed shoes (sandals, tevas, chacos, BSA, etc.) are not allowed except at the pool/ shower areas. Scouts must wear closed-toe shoes when walking to or from these areas.

· No flames in tents! All bulk flammable fuels must be stored in the fuel box provided by at the camp.

· No weapons, firearms, ammunition or any parts of such at camp. Camp Rockefeller

provides all necessary shooting equipment and ammunition.

· Tobacco use is prohibited by youth campers or by adults in the presence of youth campers and not in any structure, tent, or building. Smokers are also reminded of the ever-present fire danger!

· Vehicles must be parked in the main parking lot at the bottom of the Camp Rockefeller entrance hill. If more information is needed, consult the Camp Director.

· All ATVs are prohibited from use by scouts and adult leaders.

· Posted speed limit of 10 MPH MUST be obeyed.

· No one may ride in the back of a truck or on a trailer.

· RVs are not allowed.

· Pets are not allowed in Camp.

· Only those persons authorized by the Quapaw Area Council Camp Director or Camp Ranger may operate power tools or equipment on the Gus Blass Scout Reservation.

· All personnel arriving at camp or leaving camp must check in and out at the Camp Administration Building.

· Leaders and scouts arriving or leaving the Reservation during the week MUST check in and out at the Camp Administration Building. Scouts are permitted to leave prior to the normal departure day only with a parent or a signed permission slip.


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· All youth and adults MUST shower and change clothes separately. Separate hot shower facilities are provided for youth male, youth female, male adults, and female adults. Adults are defined as 18 years of age and older.

· Alcoholic beverages and illegal drugs are not allowed on camp property. Possession or use of these on The Gus Blass Scout Reservation property will lead to dismissal from the Summer Camp Program without benefit of refund. State and Federal law mandates incidents of this nature be turned over to the proper authorities.

· Fireworks of all types are prohibited on the Gus Blass Scout Reservation.

· Mobile devices are not allowed during sessions.

· Youth Protection Guidelines will be strictly adhered to at all times and any violations of these guidelines must be reported immediately. Everyone’s vigilance is necessary to provide a safe camp for everyone. All registered adult leaders must present a current Youth Protection card upon arrival.

Behavior during Summer Camp

While the behavior of scouts in camp are the responsibility of the unit leadership and the behavioral discipline of the scouts will remain in the hands of that unit’s leadership, the Camp Rockefeller Administration will not tolerate any behavior that is disruptive to the camp program, harmful to others or the camp facilities, or is in violation of state law.

In general, behavior guidelines at camp will be those stated in the “Guide to Safe Scouting”, the Youth Protection Guidelines of the BSA, as well as the Boy Scout Handbook and the Scoutmaster Handbook.

Sale of Products

The selling of products to other individuals outside of one’s own unit is prohibited.

Vehicles in Camp

For the safety of all involved, and to meet BSA National Standards, all vehicles must be parked in the Camp Rockefeller parking lot and not driven around camp. The only exceptions are for official camp service vehicles. Please advise leaders, parents, and visitors of this policy. Also, recreational vehicles, pop-up trailers and similar vehicles are not permitted.

Golf Carts

For those with Mobility Impairments

Policy: Adults leading or participating in camping programs at Quapaw Area Council camps and events may use golf cart type vehicles when there is a physical need documented by the adult’s physician. The


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conveyance can be operated safely and does not put the participant or others at risk. Use of any motorized vehicles at camping facilities must conform to rules and regulations of the Boy Scouts of America and be approved in advance by the Camp Director or Camp Ranger. The Camp Director or Camp Ranger has the authority to immediately revoke the permit for any violations of the procedures or for any safety concerns.

Read the full policy and requirements here or www.quapawbsa.org

Bicycles in Camp

All bicycles will be safety inspected by the Mountain Bike Director.

All riding must be on the road of main camp (from the bridge, around the loop road, to the mountain road). No bicycles will be allowed to be on the trails at camp except on a trail ride supervised by Mountain Bike Director.

• All riding must be approved by the Scout’s adult leader.

• Bicycle riders may not leave main camp except on a trail ride supervised by Mountain Bike Director.

• Bicycle riders must ride with a buddy! • Bicycle riders must wear a helmet and any

other protective equipment as directed by the Mountain Bike Director.

• Bicycle riders must operate the bicycle in a safe manner.

• Pedestrians always have the right-of-way.

• Bicycle riders must obey all traffic signs. • Bicycles may not be ridden after dark. • Scouts must bring their own spare bicycle

tubes

• It is the responsibility of the individual and Unit to keep control and record model and serial number of bicycles.

• Violation of these rules will result in the removal of the Scout’s riding privileges and the bike will be held until the day of the Unit’s departure from camp. Quapaw Area Council is not responsible for lost, stolen or damaged bicycles or personal safety equipment. (It is the responsibility of each unit and individual to keep these items secured.)

Gus Blass Scout Reservation Equipment Replacement

Each year, Gus Blass Scout Reservation replaces and repairs tents, cots, platforms, program equipment, and many other aspects of the camp facilities. Some of the damage is the result of normal wear and tear. When damage beyond the normal wear of equipment and/or facilities, or damage due to vandalism or abuse is evident, the unit and/or persons responsible for the damage will be held responsible for the replacement values of the damaged items. The following is a sample listing of commonly damaged camp property and their replacement values:

Tent Flap Ties $15.00 each

Tent Uprights $25.00 each

Wall Tents $450.00 each

Water Hose $35.00 each

Cot Replacement $110.00 each

Cot Cover Repair $35.00 each

Cot Frame Repair $40.00 each

Cot Ends $20.00 each

Rain Fly (Tarp) $40.00 each


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This is a sampling of the damages and their corresponding replacement costs. It is greatly appreciated for all to limit the amount of damages and in turn will prevent substantial increases in camp fees.

Dining Hall Procedures

Each leader is encouraged to give attention to proper manners among the scouts during meals. All scouts are expected to be clean, courteous, and in appropriate attire and shoes at all meals. Hats and swimming suits are discouraged. The complete Scout field uniform is strongly encouraged at the evening meal. To prevent congestion, backpacks and walking sticks are NOT ALLOWED in the Dining Hall.

The purpose of the dining hall is to provide all meals quickly and efficiently in a clean and safe environment. Compliance with the following procedures will assist with fulfilling this purpose.

Each Unit should assign two (2) waiters for each meal. The Dining Hall Director and Staff will instruct the waiters and supervise their duties while in the dining hall. Waiters will help clean up after the meal.

Meals consist of the main meal, announcements, and meal program. No one

should leave the dining hall until all are dismissed.

A second helping of food, if available, will be served only after all others are served and seconds are called.

Running in the dining hall is not allowed.

The restrooms at the north end of the dining hall are kept open as a courtesy to campers. Units MUST help to keep them clean. Please report any problems to the Dining Hall Director.

Our dining hall serves an approved balanced menu with fresh fruits and vegetables daily. Outpost meals meet the same standards as the dining hall.

Special Dietary Needs

Camp Rockefeller strives to provide well-balanced meals for the duration of summer camp; however, Camp Rockefeller understands that there may be certain food allergies it is not able to accommodate. Therefore, to make it the most convenient for those with a food allergy, Camp Rockefeller is prepared to store any food that a Scout or leader needs to bring in the camps freezer, cooler, and/or storage room and allow a Scout or leader to prepare that food in the camp kitchen as needed. The Scout or leader should label all food containers with name and troop number. Arrangements for a Scout or leader to come into the kitchen and prepare such food before a meal must be made with the Dining Hall Director during check-in procedures on Sunday.


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HEALTH INFORMATION

Medical Forms

Every Scout and adult leader staying in camp must, upon arrival, present a properly completed BSA medical form Parts ABC. The medical form must be signed by an examining physician, the Scout’s parent or legal guardian, and contain health insurance information. The physician’s physical examination must have been conducted within one year of arrival at camp. All participants’ forms will be checked upon arrival at camp. Full examinations are not available. The BSA medical form must be brought to camp by the unit. PLEASE DO NOT MAIL OR DELIVER MEDICAL FORMS TO THE COUNCIL SERVICE CENTER. Scouts and adult leaders may not stay in camp without a properly completed BSA medical form.

Health and First Aid

The Camp Rockefeller Health Lodge is staffed by qualified medical personnel. A local hospital in Conway, Arkansas is open 24 hours a day for emergencies. The camp leader must make arrangements to contact the parent/ guardian of a Scout who must go to the hospital or see a doctor. Camp Administration will work with unit leadership to ensure proper medical attention and/ or transportation is provided. Any Scout needing medical attention at the hospital will contact his parents, if practical, to inform them of the extent of his injuries.

Camper Health Watch

It is the goal of camp for all scouts to have a safe and healthy experience. It is important, therefore, that both staff and leaders pay attention to the health and attitudes of all

campers to ensure no problems are occurring. Mealtime is the ideal opportunity for health observation. If a Scout is not exhibiting a normal, very healthy appetite for their age group, and food tastes are not involved, it would be prudent to question the Scout as to how they are feeling. In addition, proper hygiene must be encouraged at all times. It is hot at summer camp. Proper hydration of scouts and leaders is important for good health. DRINK PLENTY OF WATER.

Camp Safety

The Boy Scouts of America, Quapaw Area Council, and Gus Blass Scout Reservation have a long and proud record of concern for the safety of its Scout campers and strive to provide a high quality, safe, camping experience. Leadership provided by parents and leaders during Camp creates a safe environment for our youth. The year-round nature of the Scouting program, the patrol method, and boy leadership give leaders a sound basis for determining the trustworthiness and maturity level of all campers within their charge.

Accident Insurance

Camp Rockefeller and Quapaw Area Council insurance coverage is secondary to the participant’s primary insurance plan.

Animals at Camp

For a period longer than one could accurately say, the mountains known today as the Ozarks have been inhabited by creatures of God’s making. However, there are some of these creatures all campers must be cautious of while at camp. Copperhead snakes and other


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venomous snakes, black bears, raccoons, skunks, fox, opossums, squirrels, deer, turkey, armadillos, spiders, chiggers, ticks, wasps, hornets and bees all live on the Gus Blass Scout Reservation. Contact with any wild animal could result in bodily harm or the possibility of disease. This is their environment. Please, leave them alone. Report any personal encounter to the camp Health Officer.

Fireguard Procedures

In case of fire, notify the camp leadership in the Admin Building IMMEDIATELY. Campfires are normally permitted in the sites, but it is the Unit Leader’s responsibility to ensure that proper Scouting safety rules are followed. Refer to handbook for information.

Liquid Fuel/Propane

Quapaw Area Council allows liquid fuel usage under proper adult supervision. Propane fuel is suggested. All bulk and compressed fuels must be stored in the camp flammable storage area.

Buddy System

The buddy system is always in effect. This provides a way for a Scout to secure help should an accident occur. Head counts are important in camp. They should occur at Reveille, Taps, and at all unit formations and activities. Any missing camper must be reported to the Camp Office IMMEDIATELY. Members of the camp staff are search and rescue technicians and will respond to all emergency situations.

Security in Camp

Personal belongings should be secured at all times while at camp. Leaders are encouraged to advise all member of the Unit to keep their belongings in safe locations when unattended. Camp Rockefeller will not be responsible for lost or stolen items.

CAMPING RESERVATION POLICIES

Summer Camp Week Reservation

Campsites will be filled based on size of unit and availability. Camp Rockefeller wants to do its best to ensure all are able to attend the week of camp that best fits each unit’s needs. Camp Rockefeller’s priority is to ensure each unit’s week request is met.

The campsite reservation fee/ deposit will guarantee a reservation at camp. Smaller troops may be grouped together in a campsite. The campsite is assigned based on the size of the unit attending. Using the rough estimates from the Unit Reservation Form and taking into consideration the unit’s preferences, effort will be made to efficiently use the tents.

Unit tent usage will be identified. Signs will be displayed with Unit number for the Unit specific tents.

Sites will also be determined based on estimates of youth, adult male, and adult female attendance on the reservation form and leave a minimum of 2 extra tents per troop when assigning campsites.


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Campsite Reservation for Individuals with physical impairments requiring Accessible Campsites

The designated accessible campsite, North Point A, is available for a Scout or leader who is wheelchair mobile or a Scout with severe physical impairments. Youth Protection Guidelines will be applied to this campsite and followed at all times.

SUMMER CAMP PREPARATION

Unit Preparation for Summer Camp

Preparing for camp is an easy process, but it does require planning ahead. A Unit Leader is the most important link in this preparation. The following checklist is designed to guide the Unit Leader and the Unit Committee in pre-camp planning for summer at Camp Rockefeller.

Immediate Action Required

Reserve your spot at https://scoutingevent.com/018-camprockefeller2019

Confirm Unit reservation during desired week at camp.

Obtain Camp Leadership – 2 adults per unit minimum at all times.

Meet with Unit Committee to discuss summer program plans.

Develop a camp sign-up and budget plan to assist scouts with summer camp fees.

Notify all scouts and adults of Summer Camp dates and encourage their attendance.

Arrange a Parents’ Night meeting with presentation by the District’s Camp Promotion Committee.

January

Begin projects to assist scouts with camp fees.

Obtain campership forms, if needed.

Invite Webelos dens to visit the unit and prepare for summer camp.

Recruit extra leaders.

February

Inform older scouts about the many older Scout programs.

Encourage parents to schedule other summer activities at times other than summer camp.

Review unit finance needs.

Begin arranging unit transportation.

March

Begin scheduling Scouts for sessions at https://scoutingevent.com/018-camprockefeller2019

Continue summer camp promotion with 2nd year Webelos.

Encourage scouts who cannot attend with their unit to attend during a different week as a provisional camper.


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April

Unit leaders begin program planning procedure.

Attend district “free physicals,” where available. Contact the District Camp Promotion Chairperson for more information.

Contact parents of scouts not signed up to attend camp, including Webelos.

May

May 1 – Early Bird Deadline

Register additional scouts going to camp.

Ensure all leadership is committed for the dates of camp.

Determine the wants and needs of patrols and scouts.

Ensure arrangements have been made for medical physicals for scouts and adults.

June

Remind all scouts of dates, arrangements, equipment needs, departure time, physicals, etc., two weeks prior to departure for camp.

Submit balance owed on camp fees to the Quapaw Area Council Service Office.

Confirm final transportation arrangements.

CAMPER EQUIPMENT LIST

• Scout uniforms* • Hiking shoes or boots • Six pairs of socks* • Stamps, envelope* • Extra shirts • Small pillow • Sleeping pad • Sleeping bag • Pajamas • Watch • Toilet kit (*soap, *towel, washcloth,

deodorant, shampoo) • Tennis shoes • Handkerchiefs • Toothpaste & brush* • Pocketknife* • Hat or cap* • Extra pants (long and short) • Boy Scout Handbook* • Flashlight and batteries* • Sunblock* • Hair comb or brush* • Raincoat or poncho* • Clothing repair kit* • Jacket or *sweatshirt • Six pair of underwear • Pencil* • notebook • Water bottle* • Sleeping bag • Swim trunks • Spending money • Completed and Signed Medical Form • Backpack, duffel bag, or camp box to store

personal gear


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Equipment for Lifesaving Merit Badges: button-up long sleeve shirt, long pants, and shoes. Equipment for Boating Sessions/Extreme Aquatics: Water shoes, canvas sneakers, long sleeve shirt, sunscreen, and hat which protects ears from prolonged sun exposure. Optional Equipment • Merit Badge Pamphlets* • Rope for clothesline* • Camera* • Bicycle & Helmet • Bed roll, *cup, bowl, *spoon • (if participating in Outpost • wilderness survival camping) • Insect repellent* • Personal fishing gear (for fishing merit

badge or for use during personal time) • Alarm clock

Please Do Not Bring

• Electronic games • Skateboards • Sheath knives • Valuables • Fireworks/ Guns/ Archery items • Candles • Pets • Glass bottles • Radios • ATV’s, UTV’s or ORV’s • Expensive cameras • CD/ MP3 players • Extension Cords • Generators

*-----Items are usually available for purchase in The Shop at The ROCK

UNIT ARRIVAL AT CAMP

Directions to Camp Rockefeller

From the south (Us Highway 65N): When entering Damascus from the south on Hwy 65, look for the green highway sign for Donald W. Reynolds Scout Training Center and turn left on Arkansas Hwy 124. In .8 of a mile there is another green Donald W. Reynolds Scout Training Center sign, turn right onto Spires Rd. Stay on Spires Rd for .4 of a mile. Turn right onto Hall Hendren Lane.

From the north (US Highway 65S): When entering Damascus from the north on Hwy 65, look for the green highway sign for Donald W. Reynolds Scout Training Center and turn right on Arkansas Hwy 124. In .8 of a mile there is another green Donald W. Reynolds Scout Training Center sign, turn right onto Spires Rd. Stay on Spires Rd for .4 of a mile. Turn right onto Hall Hendren Lane.

Plan to arrive to camp between 1:00 p.m. and 3:00 p.m. Do not go to campsite until the Unit has checked in.

Each unit must present the following at check-in:

· Health and medical records for each Scout and adult in unit.

· Two copies of unit roster of those attending camp, complete with addresses and telephone numbers. One copy is turned in. One copy is for unit’s records.

· Out-of-council unit must have a BSA Tour and Activity Plan and proof of insurance.


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· Youth Protection and BSA Registration cards for all leaders. (All adults must be a registered leader.)

· A copy of swim checks, if completed prior to arriving at camp.

Check-In Procedures

· Check-in instructions and procedures will be provided by one of our friendly Troop Guides.

· All Unit gear should be loaded on one Unit vehicle for transport to the Unit’s campsite. The Unit vehicle is to be immediately returned to the parking lot after unloading. Trailers may be left in the campsite.

· Scouts and all Leaders expecting to use the pool during the week will go to the pool for swim checks.

· Dress in full uniform for flag ceremony and dinner.

Health Check-In

National BSA requires that everyone must complete the Health Check upon arrival and have a complete BSA Health Form Parts ABC.

Early and Late Arrivals

Check-in time at Camp Rockefeller is Sunday 1:00 p.m. to 3:00 p.m. There are no provisions for early arrivals. It is recommended that units consider Saturday camping at Wooly Hollow State Park, just off Highway 65 north of Greenbrier, AR, if overnight accommodations are necessary. Please contact the Quapaw Area Council Program Director if a unit requires a late arrival.

UNIT DEPARTURE FROM CAMP

· Two Unit Leaders report to Administration Building immediately after breakfast for checkout. One leader checks out, receives advancement records and patches, and pays any outstanding bills. The other leader will take a Troop Guide back to the campsite for inspection and inventory.

· Units return to campsite after breakfast to pack.

· Unit Leader and Troop Guide inspect and inventory campsite after site is clean.

STAFF OPPORTUNITIES

Camp Rockefeller Staff

Gus Blass Scout Reservation is proud of the staff members and each year it is of utmost importance to select scouts who can provide each Unit with the ultimate Summer Camp experience. Any Scout or knowledgeable individual who would be an asset to the program, please submit a name and other relevant information. Completed staff applications are due in early January. Applications can be found in the Appendix and at www.camprockefeller.org. Requirements for employment are as follows:

· Be 16 years of age by June 1. (Some 15-year old’s may be hired.)

· Be registered or willing to register with the Boy Scouts of America.

· Live by the principles set forth in the Scout Oath and Law.


31

· Have a recommendation from the Scoutmaster.

Not all applicants will be hired. Being a member of the Camp Staff is very demanding but is also very fun and fulfilling.

Counselor in Training (C.I.T.)

The C.I.T. program is an opportunity for a Scout to experience the role of a camp staff member for one week. There is no cost to the C.I.T. participant. The participant will work under the direction of camp staff Area Directors. The participant will also camp in the regular camp staff area.

C.I.T. participants should be at least 15 years of age. (A few 14-year old’s may be selected.) As with regular staff applicants, not all C.I.T. applicants will be given positions.

Submit the names of any Scout interested in a C.I.T. position to the Quapaw Area Council Scout Service Center. No C.I.T. may serve during the same week their own unit would be attending.

C.I.T. applicant should submit the Counselor In Training Application

Always check www.camprockefeller.org for the most up to date information for 2019!

Quapaw Area Council Boy Scouts of America

Camp Rockefeller STAFF APPLICATION

Gus Blass Scout Reservation

(RETAIN THIS SHEET FOR YOUR OWN USE)

To all Scouts and Scouters: Opportunities to serve Scouting by being a member of the Camp Rockefeller Camp Staff are available to outstanding members of the Boy Scouts of America. Competition for employment is keen, the jobs are demanding, and the experience is exhilarating. The minimum age is sixteen. In a few cases, some mature fifteen years old may be considered. Applicants must be a registered member of the Boy Scouts of America. The principle of the Scout Oath and Law must be practiced as a way of life. The Staff must set an example of excellence in Scouting which includes the proper wearing of the Camp Rockefeller Staff Uniform. Salary is based on the position’s responsibility with consideration given to the individual’s experience and level of responsibility. A picture of you included with the application is recommended. References are important and a must! Applications will not be considered without references. Review the jobs listed and indicate your first four (4) job preferences on the application. Contracts, based on needs, will be offered upon successful completion of the personal interview and only to those applicants willing to commit to working for the entire camping season. There are no ‘short term’ positions available. CIT Applicants must fill out a CIT Application.

The 2019 tentative contract period is from Friday May 31, 2019 through July 15, 2019. Mail your completed application to: 2018 Camp Staff Quapaw Area Council 3220 Cantrell Road Little Rock, AR 72202


Camp Rockefeller Staff Application

Basic Personal Information Date: _____________________

Name:_______________________________________ Date of Birth:___________________________

Shirt Size: Age as of June 2, 2018:

Address: _______________________________________________________________________________

City:_______________________________________________ State:__________ Zip:_______________

Telephone: ( )_____________________ Mobile Phone: ( )________________________

E-mail:_____________________________________________

Temporary Address (if applicable)

__________________________________________________________________________________________

Last date at this address:_________________

Current Scouting Information Place a check mark next to the current type of unit in which you are registered

____Troop ____Team ____Crew ____Ship ____Not Registered

Unit Number:____________ District:___________________________ Rank:________________

Indicate the length of time for your involvement with the following levels of Scouting

Cub Scout:_______ Boy Scout:_______ Venture:_______ Adult Leader:_______

Current Leadership position held:__________________________________________________

Place a check mark next to your level of OA membership

_____Ordeal _____Brotherhood _____Vigil Honor

Why do you want to work at camp?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Positions Available:

Minimum Age of 21 Aquatics Director Business Manager Camp Director Camp Commissioner Chaplain Cook C.O.P.E. Director HandiCraft Director Program Director Range Officer Shooting Sports Director Trading Post Mgr.

Minimum Age of 18 Asst. Commissioner Asst. Cook Dining Hall Steward Eco/Con Director Health Officer Office Manager Quartermaster R.O.C.K.S. Director ScoutCraft Director Shooting Sports Staff S.T.E.M. Director

Minimum Age of 16 Aquatics Staff C.O.P.E. Staff Eco/Con Staff First Aid Instructor HandiCraft Staff Mountain Biking Staff R.O.C.K.S. Staff ScoutCraft Staff S.T.E.M. Staff Trading Post Staff

Positions Preference:

I am interested in the following camp positions. They are listed in order of my preference.

1. _______________________________________________

2. _______________________________________________

3. _______________________________________________

4. _______________________________________________

Having reviewed the minimum age requirements for the above camp positions, I will meet the minimum age for the positions I am applying for by June 9, 2018.

Yes _____________ No ____________ List the top ten merit badges and/or programs you feel most confident in teaching.

1. ________________________________________________________ 6. __________________________________________________________

2. ________________________________________________________ 7. __________________________________________________________

3. ________________________________________________________ 8. __________________________________________________________

4. ________________________________________________________ 9. __________________________________________________________

5. ________________________________________________________ 10. __________________________________________________________


Areas of Knowledge, Experience, and/or Merit Badges:

Indicate with a check mark what merit badges (MB), experience, or training you have completed.


MEDICAL EXPERIENCE

______ Medical Student

______ Paramedic

______ Medical Doctor

______ Advanced First Aid Certificate

______C.P.R.Training

______ Nursing

Student ___LPN ___ RN___

______EMT

UNIT POSITIONS PREVIOUSLY HELD

______SPL

______ASPL

______Patrol Leader

______Asst. Patrol Leader

______Scribe

______Quartermaster

______Webmaster

______Historian

______Jr. Asst. Scoutmaster

TRAINING EXPERIENCE

______National Youth Leadership Training

______NYLT Staff

______National Leadership Seminar

______Counselor-In-Training

______Leave No Trace Trainer

______AGFC Hunter Safety

______Archery Instructor Certification

______NRA Instructor

______Wood Badge

______Wood Badge Staff

______Scouter’s Key

______Commissioner College

______Philmont Training Center

Philmont Training Course _________________

______National Camp School Certification

Certification Area: _______________________

Certification Date: _______________________

Camp Staff Experience:

Camp Year Position


Education:

Name of College / School: __________________________ Grade Completed: ___________

Course/ Major: _______________________________________________

Extra - Curricular Activities:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Leadership Positions:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Honors & Recognitions: _______________________________________________________________________________________________________________________________________________________________

REFERENCES REQUIRED: Adult member of your troop, team, or post, or current employer: Name: _______________________________________ Phone #: ____________________

Address: ___________________________________________________________________

City: _______________________________ State: ____________ Zip: _________________

Position or Title: _______________________________________

Community Leader (youth leader, religious leader, civic leader): Name: ________________________________________ Phone #: _____________________

Address: ___________________________________________________________________

City: _______________________________ State: ____________ Zip: _________________


Teacher, supervisor, or associate: Name: ________________________________________ Phone #: ____________________

Address: ___________________________________________________________________

City: _______________________________ State: ____________ Zip: _________________



Applicants are considered for all positions without regard to race, color, religion, sex,

national origin, age (except where required by BSA standards), marital status or handicap. Due to the strenuous nature of some camp staff positions, medical certifications must be met by all camp

staff members.

DECLARATION OF PRINCIPLES:

The principles of the Boy Scouts of America are based on the Scout Oath and Scout

Laws and one is committed to the goal of teaching young people to make ethical

decisions for the rest of their lives.

Do you agree with this declaration of principle? YES _______ NO _______ Where you referred or recommended for hire by a Camp Commissioner, Director, or Staff member? YES _______ NO _______ If yes, by whom were you recommended? ____________________________________ ____________________________________________________________________________

Unit Leader Signature of Endorsement Date

_____________________________________________________________________ Applicant Signature Date

______________________________________________________________________ Parent Signature Date

(Parent’s signature required if applicant is under 18 years of age) --------------------------------------------------------------------------------------------------------------------- Date of Interview: ___________________________________________

Considered for: _____________________________________________

Interviewed by: _____________________________________________

QUAPAW AREA COUNCIL BOY SCOUTS OF AMERICA CAMP ROCKEFELLER

SUMMER CAMP REFUND REQUISITION

GL CODE: _____________________________

Name of Scout Reason Not in Attendance Unit Price Total

G R A N D T O T A L :

Send Check to:_____________________________ _________________________________________ _________________________________________ _________________________________________

FOR ACCOUNTING DEPARTMENT USE ONLY

Date Received:__________________________

Requested by:_________________________ Date: _________ Cacmp Approval:_____________________Date:_________ Council Approval:____________________________________ ________________________________________

Scoutcraft = Deep WoodsROCKS = RidgetopEco/Con = Logging CampHandicraft = HillsideMountain Biking = SouthridgeClimbing/COPE = Climbing PavilionShooting Sports = Shooting Sports ComplexSTEM = Hendren Family Facility

CampsiteSmall Tents

Large Tents

Small Tent Cots

Large Tent Cots Min

Large Tent Cots Max

Bear Creek 16 4 32 8 12Buzzards Roost A 7 2 14 4 6Buzzards Roost B 10 2 20 4 6Buzzards Roost C 8 2 16 4 6Deer Run A 10 2 20 4 6Deer Run B 10 2 20 4 6Eagles Nest A 10 2 20 4 6Eagles Nest B 8 2 16 4 6Lakeview 16 2 32 4 6Mountain View A 6 2 12 4 6Mountain View B 10 2 20 4 6North Point B 12 2 24 4 6Pine Ridge A 10 2 20 4 6Pine Ridge B 8 2 16 4 6Rabbit Run A 16 3 32 6 9Rabbit Run B 13 2 26 4 6Rim Rock A 9 2 18 4 6Rim Rock B 8 2 16 4 6River Bend A 12 2 24 4 6River Bend B 12 2 24 4 6Rockwall A 9 2 18 4 6Rockwall B 10 2 20 4 6Turkey Flat A 12 2 24 4 6Turkey Flat B 12 2 24 4 6

254 51 508 102 153

Part A: Informed Consent, Release Agreement, and Authorization

Full name: ________________________________________

DOB: ________________________________________

High-adventure base participants:Expedition/crew No.: _______________________________or staff position: ___________________________________

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Complete this section for youth participants only:Adults Authorized to Take to and From Events:

You must designate at least one adult. Please include a telephone number.

I understand that, if any information I/we have provided is found to be inaccurate, it may limit and/or eliminate the opportunity for participation in any event or activity. If I am participating at Philmont, Philmont Training Center, Northern Tier, Florida Sea Base, or the Summit Bechtel Reserve, I have also read and understand the supplemental risk advisories, including height and weight requirements and restrictions, and understand that the participant will not be allowed to participate in applicable high-adventure programs if those requirements are not met. The participant has permission to engage in all high-adventure activities described, except as specifically noted by me or the health-care provider. If the participant is under the age of 18, a parent or guardian’s signature is required.

Participant’s signature: ________________________________________________________________________________________ Date: ______________________________

Parent/guardian signature for youth: _____________________________________________________________________________ Date: ______________________________

(If participant is under the age of 18)

Second parent/guardian signature for youth: ______________________________________________________________________ Date: ______________________________

(If required; for example, California)

Name: ______________________________________________________

Telephone: __________________________________________________

Name: ______________________________________________________

Telephone: __________________________________________________

Adults NOT Authorized to Take Youth To and From Events:

Name: ______________________________________________________

Telephone: __________________________________________________

Name: ______________________________________________________

Telephone: __________________________________________________

Informed Consent, Release Agreement, and Authorization

I understand that participation in Scouting activities involves the risk of personal injury, including death, due to the physical, mental, and emotional challenges in the activities offered. Information about those activities may be obtained from the venue, activity coordinators, or your local council. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and the standards of conduct.

In case of an emergency involving me or my child, I understand that efforts will be made to contact the individual listed as the emergency contact person by the medical provider and/or adult leader. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical providers are authorized to disclose protected health information to the adult in charge, camp medical staff, camp management, and/or any physician or health-care provider involved in providing medical care to the participant. Protected Health Information/Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities.

(If applicable) I have carefully considered the risk involved and hereby give my informed consent for my child to participate in all activities offered in the program. I further authorize the sharing of the information on this form with any BSA volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Scouting activities.

With appreciation of the dangers and risks associated with programs and activities, on my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, or loss that may arise against the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with any program or activity.

I also hereby assign and grant to the local council and the Boy Scouts of America, as well as their authorized representatives, the right and permission to use and publish the photographs/film/videotapes/electronic representations and/or sound recordings made of me or my child at all Scouting activities, and I hereby release the Boy Scouts of America, the local council, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I further authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the BSA, and I specifically waive any right to any compensation I may have for any of the foregoing.

NOTE: Due to the nature of programs and activities, the Boy Scouts of America and local councils cannot continually monitor compliance of program participants or any limitations imposed upon them by parents or medical providers. However, so that leaders can be as familiar as possible with any limitations, list any restrictions imposed on a child participant in connection with programs or activities below.

List participant restrictions, if any: None

________________________________________________________

! !

Part B: General Information/Health History

Full name: ________________________________________

DOB: ________________________________________


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680-001 2014 Printing

Age: ___________________________ Gender: ________________________ Height (inches): __________________________ Weight (lbs.): ____________________________

Address: ________________________________________________________________________________________________________________________________________

City: __________________________________________ State: __________________________ ZIP code: ______________ Telephone: ______________________________

Unit leader: ________________________________________________________________________________ Mobile phone: _________________________________________

Council Name/No.: __________________________________________________________________________________________________ Unit No.: ____________________

Health/Accident Insurance Company: _________________________________________________ Policy No.: ___________________________________________________

Please attach a photocopy of both sides of the insurance card. If you do not have medical insurance, enter “none” above.

In case of emergency, notify the person below:

Name: ___________________________________________________________________________ Relationship: ___________________________________________________

Address: ____________________________________________________________ Home phone: _______________________ Other phone: _________________________

Alternate contact name: ____________________________________________________________ Alternate’s phone: ______________________________________________

! !

Health HistoryDo you currently have or have you ever been treated for any of the following?

Yes No Condition Explain

Diabetes Last HbA1c percentage and date:

Hypertension (high blood pressure)

Adult or congenital heart disease/heart attack/chest pain (angina)/heart murmur/coronary artery disease. Any heart surgery or procedure. Explain all “yes” answers.

Family history of heart disease or any sudden heart-related death of a family member before age 50.

Stroke/TIA

Asthma Last attack date:

Lung/respiratory disease

COPD

Ear/eyes/nose/sinus problems

Muscular/skeletal condition/muscle or bone issues

Head injury/concussion

Altitude sickness

Psychiatric/psychological or emotional difficulties

Behavioral/neurological disorders

Blood disorders/sickle cell disease

Fainting spells and dizziness

Kidney disease

Seizures Last seizure date:

Abdominal/stomach/digestive problems

Thyroid disease

Excessive fatigue

Obstructive sleep apnea/sleep disorders CPAP: Yes £ No £

List all surgeries and hospitalizations Last surgery date:

List any other medical conditions not covered above

Part B: General Information/Health History

Full name: ________________________________________

DOB: ________________________________________


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Allergies/MedicationsAre you allergic to or do you have any adverse reaction to any of the following?

Yes No Allergies or Reactions Explain Yes No Allergies or Reactions Explain

Medication Plants

Food Insect bites/stings

List all medications currently used, including any over-the-counter medications.

CHECK HERE IF NO MEDICATIONS ARE ROUTINELY TAKEN. IF ADDITIONAL SPACE IS NEEDED, PLEASE INDICATE ON A SEPARATE SHEET AND ATTACH.

Medication Dose Frequency Reason

YES NO Non-prescription medication administration is authorized with these exceptions:_______________________________________________

Administration of the above medications is approved for youth by:

_______________________________________________________________________ / _______________________________________________________________________

Parent/guardian signature MD/DO, NP, or PA signature (if your state requires signature)

Bring enough medications in sufficient quantities and in the original containers. Make sure that they are NOT expired, including inhalers and EpiPens. You SHOULD NOT STOP taking any maintenance medication unless instructed to do so by your doctor.! !ImmunizationThe following immunizations are recommended by the BSA. Tetanus immunization is required and must have been received within the last 10 years. If you had the disease, check the disease column and list the date. If immunized, check yes and provide the year received.

Yes No Had Disease Immunization Date(s)

Tetanus

Pertussis

Diphtheria

Measles/mumps/rubella

Polio

Chicken Pox

Hepatitis A

Hepatitis B

Meningitis

Influenza

Other (i.e., HIB)

Exemption to immunizations (form required)

Please list any additional information about your medical history:

_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________

DO NOT WRITE IN THIS BOX Review for camp or special activity.

Reviewed by: ____________________________________________

Date: ___________________________________________________

Further approval required: Yes No

Reason: ________________________________________________

Approved by: ____________________________________________

Date: ___________________________________________________

Part C: Pre-Participation PhysicalThis part must be completed by certified and licensed physicians (MD, DO), nurse practitioners, or physician assistants.

Full name: ________________________________________

DOB: ________________________________________


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680-001 2014 Printing

! ! You are being asked to certify that this individual has no contraindication for participation inside a Scouting experience. For individuals who will be attending a high-adventure program, including one of the national high-adventure bases, please refer to the supplemental information on the following pages or the form provided by your patient.

Examiner: Please fill in the following information:

Yes No Explain

Medical restrictions to participate

Height/Weight RestrictionsIf you exceed the maximum weight for height as explained in the following chart and your planned high-adventure activity will take you more than 30 minutes away from an emergency vehicle/accessible roadway, you may not be allowed to participate.

Maximum weight for height:

Height (inches) Max. Weight Height (inches) Max. Weight Height (inches) Max. Weight Height (inches) Max. Weight

60 166 65 195 70 226 75 260

61 172 66 201 71 233 76 267

62 178 67 207 72 239 77 274

63 183 68 214 73 246 78 281

64 189 69 220 74 252 79 and over 295

Examiner’s CertificationI certify that I have reviewed the health history and examined this person and find no contraindications for participation in a Scouting experience. This participant (with noted restrictions):

True False Explain

Meets height/weight requirements.

Does not have uncontrolled heart disease, asthma, or hypertension.

Has not had an orthopedic injury, musculoskeletal problems, or orthopedic surgery in the last six months or possesses a letter of clearance from his or her orthopedic surgeon or treating physician.

Has no uncontrolled psychiatric disorders.

Has had no seizures in the last year.

Does not have poorly controlled diabetes.

If less than 18 years of age and planning to scuba dive, does not have diabetes, asthma, or seizures.

For high-adventure participants, I have reviewed with them the important supplemental risk advisory provided.

Examiner’s Signature: ___________________________________ Date: _______________

Provider printed name: ________________________________________________________

Address: ______________________________________________________________________

City: _____________________________________State: ____________ ZIP code: _________

Office phone: _________________________________________________

Normal Abnormal Explain Abnormalities

Eyes

Ears/nose/throat

Lungs

Heart

Abdomen

Genitalia/hernia

Musculoskeletal

Neurological

Other

Height (inches):__________________ Weight (lbs.):__________________ BMI:__________________ Blood Pressure:__________________/__________________ Pulse:__________________

Yes No Allergies or Reactions Explain Yes No Allergies or Reactions Explain

Medication Plants

Food Insect bites/stings

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