nywg encampment guide (2004)

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2004 New York Wing LeadershipEncampment

INFORMATIONBOOKLET

Read this information booklet carefully for a clear understanding of your responsibilities.

Teamwork is the key word for a successful encampment.If you do not understand or if anything in this booklet is unclear,

please contact the Cadet Commander or CadetDeputy-Commander as soon as possible.

If you have received this booklet in the mail, then you are regis-tered for the encampment and we are expecting to see you.

There is a waiting list to attend -

IF YOU ARE NOT COMING, PLEASE CONTACT ASAPMaj Marylou Falco at (518) 785-9385 or [email protected]!!! You may not attend the Encampment unless you are pre-registered.

**PLEASE REVIEW THE REVISED CADET PACKING LIST**



TABLE OF CONTENTSTABLE OF CONTENTSTABLE OF CONTENTSTABLE OF CONTENTSTABLE OF CONTENTS

PAGE #REMARKSREMARKSREMARKSREMARKSREMARKSCADET COMMANDER 2COMMANDANT OF CADETS 3ENCAMPMENT COMMANDER 4

REGISREGISREGISREGISREGIS TRATRATRATRATRATIONTIONTIONTIONTION 5-6

UNIFORMUNIFORMUNIFORMUNIFORMUNIFORM 7-8

IN-PROCESSINGIN-PROCESSINGIN-PROCESSINGIN-PROCESSINGIN-PROCESSING 9

EQUIPMENT LISTEQUIPMENT LISTEQUIPMENT LISTEQUIPMENT LISTEQUIPMENT LIST (CENTER PULL-OUT )

CONTRABAND LISTCONTRABAND LISTCONTRABAND LISTCONTRABAND LISTCONTRABAND LIST 10

OROROROROR GGGGGANIZAANIZAANIZAANIZAANIZATIONTIONTIONTIONTION 11-12

GENERAL INFGENERAL INFGENERAL INFGENERAL INFGENERAL INFORMAORMAORMAORMAORMATIONTIONTIONTIONTION 13-14

AAAAACCOMMODCCOMMODCCOMMODCCOMMODCCOMMOD AAAAATIONS ATIONS ATIONS ATIONS ATIONS AVVVVVAILABLEAILABLEAILABLEAILABLEAILABLE 15NEAR Stratton ANG BaseNEAR Stratton ANG BaseNEAR Stratton ANG BaseNEAR Stratton ANG BaseNEAR Stratton ANG Base

PPPPPARENT INFARENT INFARENT INFARENT INFARENT INFORMAORMAORMAORMAORMATIONTIONTIONTIONTION 15

GRADUGRADUGRADUGRADUGRADUAAAAATION ANDTION ANDTION ANDTION ANDTION AND 15DEPDEPDEPDEPDEP ARARARARARTURE INFTURE INFTURE INFTURE INFTURE INFORMAORMAORMAORMAORMATIONTIONTIONTIONTION

DIRECTIONS TDIRECTIONS TDIRECTIONS TDIRECTIONS TDIRECTIONS TO SO SO SO SO S TRATRATRATRATRATTTTTTTTTTON ANG BASEON ANG BASEON ANG BASEON ANG BASEON ANG BASE 16

IMPORIMPORIMPORIMPORIMPOR TTTTTANT PHONE NUMBERSANT PHONE NUMBERSANT PHONE NUMBERSANT PHONE NUMBERSANT PHONE NUMBERS 17

SELF MEDICASELF MEDICASELF MEDICASELF MEDICASELF MEDICATION RELEASE FORMTION RELEASE FORMTION RELEASE FORMTION RELEASE FORMTION RELEASE FORM 18



First of all, congratulations on your decision to attend the2004 New York Wing Encampment! New York Wing haslong been looked upon to set the standard for leadershipencampments within Civil Air Patrol, and this year will beno exception.

You will be challenged as a cadet, leader and person.There will be an excellent staff to help you learn bothdirectly through your flight staff and training staff, andindirectly by the many executive staff cadets who supportthe program.

The encampment will seem intense, as it should be withthe large amount of materials and activities to be coveredin such a short amount of time. Approach your trainingwith a positive attitude, be willing to work with your fellowin-flight cadets and you will do fine.

Again, congratulations on your decision.

Cadet Lt. Colonel Charles Anderson, CAPEncampment Cadet Commander

A MESSAGEFROM THE

CADET COMMANDER



FROM THE COMMANDANT OF CADETS

Congratulations! On your decision to attend this years New YorkWing Leadership Encampment. Your selection by the NYW LeadershipEncampment staff is a testimony to your outstanding performanceand your future potential for assuming greater responsibilities.

It will be leaders such as you that will keep tomorrow’s Civil Air Patrol strong and ready. Continue to do great things for CAP and youwill be rewarded. We will reinforce the standards expected of Cadetsperforming duties in leadership positions. Your attitude, hard work, fulluse of all available time and teamwork with other cadets and the staff will significantly determine your degree of success and professionaldevelopment while in attendance here.

The encampment will be challenging, exciting, and meaningful. Youwill find this encampment to be intensive in nature as necessary, theobjectives here are designed to further develop your technicalknowledge, confidence, and leadership techniques and enhance your higher personal and professional standards.

The standards of the New York Wing Leadership Encampmentare high. We will expect you to have a positive attitude, be personallycommitted to success here, and obtain a mastering of the “how” of what we teach.

Further, we expect all graduates returning to their squadron toassume and carry out their basic responsibilities and seek out higher responsibilities. I am committed to do everything within my control toensure you successfully complete the encampment.

Once again, I congratulate you on your selection to attend this year’sencampment. This is a momentous occasion of which you should beextremely proud for you are demonstrating your willingness to becomea leader in the Civil Air Patrol. I hope your stay will be beneficial. We willendeavor to provide you with one of the most rewarding experiences.

(Live the Standard).Captain Charles Miller, CAPEncampment Commandant of Cadets



Congratulations on your acceptance to the 2004 New YorkWing Leadership Encampment!

You are about to embark on an important step in your CAPcareer and personal development while taking part in the proudtradition of New York Wing Encampments that dates back to theearly days of Civil Air Patrol.

Throughout the Encampment, you will be challenged to growin leadership, followership, and knowledge through hands-onexperiences and instruction by cadet, senior, and military leaders.

A range of exciting new opportunities will be available to usthis year at Stratton Air National Guard Base including flights in C-130s, a variety of Air Force guest speakers, and tours of the nearbyaerospace museum.

You will also learn from your peers from around the Wing. Asyou work together and learn from each other you will also form closefriendships that will last far beyond this years encampment.

As you learn, practice, and refine your leadership abilities,you will undoubtedly find that while it will not be easy, the experiencebefore you is an extremely valuable one and that the experienceand the lessons learned will stay with you for many years.

Good luck and best wishes!

Captain Scott Ullery, CAPNYWG Leadership Encampment Commander

A MESSAGE FROM THEENCAMPMENT COMMANDER



REGISTRATION

Cadets are to report to the encampment on Saturday, 25 July 2004,between 1300 and 1600 hours. Cadets who are unable to reportduring this time must notify the Encampment Commander byMonday, 19 July 2004, to make arrangements.

Cadets are to report to the PAVILION at TENT CITY, in the BDUuniform as outlined in CAP Manual 39-1. All cadets should befamiliar with reporting procedures as per Leadership 2000, Vol. 1,Pages 1-9 and must employ them when reporting for in-processing.

No cadets in flight are permitted to arrive early to theencampment or stay late following graduation.There is neither supervision nor any planned activities for these periods.

At registration you must have the following:

Current membership card (If you do not have a currentmembership card, contact Maj Marylou Falco,Encampment Registrar, prior to 19 July 2003)

This booklet minus parents/guardians info section whichincludes contact info and driving instructions

Any outstanding balance of the encampment fee of $175,checks made out to NY Wing Civil Air Patrol

Your BDU uniform on your person(You must report in this uniform)

All required equipment on the 2004 EncampmentEquipment List



The Civil Air Patrol uniform, when fitted and worn properly, is veryimportant in establishing and maintaining good morale and publicopinion. Wearing it correctly brings credit to you, your unit, the entireorganization, and the United States Air Force. This is particularlytrue in New York where there are no active Air Force bases andwe represent the Air Force.

You will wear the uniform of the day as designated by theCommandant of Cadets (including the wear of ribbons).

Uniforms will be clean and pressed, with shoes/boots shined.Shoulder cords, first sergeant diamonds, and sunglasses are notto be worn at the encampment.

Articles such as watch chains, pins, jewelry, handkerchiefs, combs,keys, beepers, and radios will not be worn exposed on the uniform.Pens and pencils must be concealed except when worn in the pencompartment of the left BDU blouse pocket.

Females may wear moderate make-up and clear nail polish.Earrings may be worn in accordance with CAPM 39-1.

Inspections of you and your barracks area will take place severaltimes during the encampment. Your flight staff will instruct you onhow to prepare. Inspections are one way of determining the “honor flight,” so don’t let your flight down!

UNIFORM



2004 New York Wing Encampment Equipment List

What follows is the minimum required equipment list. ALL clothing and equipment must be marked withyour last name first initial and your 6-digit CAPID number using permanent marker or writing onwaterproof tape.

Blues Uniform: BDU Uniform:1 Summer Blue Shirt 1 Summer BDU Blouse

1 Summer Blue Pants or Skirt 1 Summer BDU Pants1 Flight Cap 1 BDU Cover1 Pair Uniform Shoes 1 Pair WELL BROKEN IN Uniform Boots1 Blue tab for blouse (Females Only) 1 Set Blousing Bands (for BDU Pants)1 Blues Belt with shiny chrome buckle 1 Blue BDU Belt with Subdued Black Buckle3 White V-NECK T-Shirts 6 Brown T-Shirts (STAFF: 8 Black T-Shirts)3 Pair Black Socks (females wear with slacks) 6 Pair White or military BDU Socks (STAFF Add 2 pair)3 Pair Neutral Shade Hose (Females only with skirt)1 Hat Device with Backing for Flight Cap

2 1-Quart Military Style Canteens to fit on web beltOR 1 Camelbak

1 Grade Insignia with Backing1 CAP Cut-Out with Backing

1 Web Belt (to Attach Canteens) (Optional if using Camelbak)

1 Set Appropriate Ribbons Toiletries :1 Ribbon Holder with Backing 1 Comb or Hairbrush1 Name Plate with Backing 1 Washcloth1 set Slingshots (a.k.a. garters) (Optional) 1 Bath Towel

Clothing : 1 Pair Shower Clogs or Flip-Flops1 Hair dryer (Optional)1 Soap Bar with Plastic Container1 Small Container Toothpaste

2 Sets of Casual Civilian AttireCivilian attire must be solid colored clothing. Non-military advertising or large logos of any sort willnot be permitted. 1 Deodorant1 Light Jacket, Field Jacket, or Sweater 1 Toothbrush1 Pair Sneakers 1 Small Personal First Aid Kit6 Sets of Underwear (STAFF add 3 pair) 1 Feminine Hygiene Products (Females Only)1 Pair Blue Denim Jeans or Work Pants 1 Container Shampoo1 Set of PT gear

(Solid Colors or Military Logos Only)

1 small packet of Moleskin

(Optional, but HIGHLY Recommended)1 Modest Swim Suit 1 Small Container of Foot Powder (Optional)1 Raincoat or Poncho 1 Set Shaving Items1 Sweat Suit (optional) 1 Small Case or Bag for Toiletries1 Work clothes for painting project 1 Chap Stick (Optional)

Barracks Items : 1 Insect Repellent1 Laundry Bag 1 Sunscreen (Optional)1 Small Sewing Kit 1 Boot Liner eg. “Dr. Scholl’s brand” (Optional)Coat Hangars as necessary for uniforms

Accessories :1 Solid-colored Blanket w/o any print optional 1 3-Hole Punch Spiral Notebook

3 Pens3 Pencils (with pencil sharpener)1 Shoe Shine Kit (polish, brush, rag)1 Flashlight with Extra Batteries and Bulb 1 Camera with Film if needed (optional)Manuals:1 “CAPM 39-1 Uniform Manual” (Optional)1 “Leadership: 2000 And Beyond” (Optional)

1 Sleeping bag or bedding for a Cot: 1 Pillow 1 Pillow Case

Note: Temperatures may be cool. Please planaccordingly. It is recommended that bedding besolid colored without prints, however, it is notnecessary if you do not already have a set.

1 “Drill and Ceremonies Manual” (AFR 50-14) (Optional)



IN-PROCESSING

Upon reporting for registration, cadets will be in-processed, whichinvolves Registration (as described in the Registration Section), areview of any medical conditions, and a contraband search of luggage.

Cadets must list all prescribed medication that they will need tohave during the activity.

Each cadet’s luggage will be inspected during in-processing. Itemsnot on the equipment list will be sent home with the cadet’s parent,if available, or secured until the end of the encampment.

None of the items on the Contraband List are required for theEncampment. Do not bring contraband items to the Encampment.

All Contraband items will be confiscated and held for the durationof the encampment by your TAC Officer.

NOTE TO PARENTS AND GUARDIANS: A member of theencampment staff will be available to answer any questions youmay have during in processing.



CONTRABAND LIST:

Cadets on staff or in flight must not bring to the encampment,use, or have in their possession any of the following items:(Items will be sent home with parents or confiscated)

· Portable AM/FM Radios· Portable Televisions· Electronic Games· Portable Tape Players· Credit Cards· ATM/Debit Cards

· Cash over $25.00 (No BX available, any excess will be held bythe TAC Officer until the conclusion of the encampment)

· Pagers or Beepers· Cellular Phones· Non Prescription Medicines (except with a doctor’s note)· Illegal Drugs (prescription or over the counter drugs must be

registered with the medical officer)· Tobacco (any form)· Intoxicating Beverages (any form)

· Weapons (e.g. knifes) or Explosives (e.g. firecrackers)· Any Flame Producing Device (including lighter, matches or

flares)· Food (such as snacks, soda, candy, or gum)· Shoulder cords, First Sergeant’s diamonds, or Squadron Hats· CAP Radios* (Some exceptions, see below)· PDAs, Laptops, or Personal Computers (except staff with

permission)Hot plates/coffee makers etc.

* Authorized VHF CAP radios and Family Radio Service (FRS)radios will be allowed by staff only.



ORGANIZATION

A. STRUCTURE:

The encampment is organized as a group with subordinateflights. The flight is the basic training unit of theencampment.

B. CADET STAFF:Cadet staff are the only cadets who will exercise command

authority. Your flight commander and flight sergeant are twohighly qualified cadets who can help you with a problem or answer any questions you may have.

Do not overlook the fact that any cadet or senior, whether or not they have command authority, may be able to help youlearn leadership and drill. Regulations require the earnedgrade be worn during the encampment.

Some staff may not be assigned a position equivalent totheir grade (e.g. a cadet officer could be assigned as a firstsergeant), therefore, colored hats are authorized to beworn by the cadet and senior staff during the encampmentand are identified on the next page:



GENERAL INFORMATION

1. Communications – cadets will not be able to make or receive phone calls, except

in the case of an emergency. We ask that no US postal mail be sent to cadetsduring the encampment because there is no US postal mail delivery to theencampment . Parents needing to communicate with a cadet or CAP personnelshould call the number listed in the Relevant Phone Number section of this

booklet.

2. Transportation to and from – Parents or guardians are responsible for providingtransportation to and from the encampment. In order to get onto Stratton ANGBase, all private vehicles must be registered with the encampment. Cadetstraveling by commercial bus, plane or train must notify the Senior LogisiticsOfficer of their arrival information by 19 July 2004. Keep this book handy withthe encampment phone number, in case no one meets you at the terminal. Also,CAP does not exercise control or supervision over travel performed by members

unless CAP transportation is furnished. CAP does not assume any responsibilityfor travel performed by members to or from special activities.

3. Cadets who drive Privately Owned Vehicles (POVs) to the encampment will notoperate the POV while at the encampment and will surrender ALL ignition keysto the encampment logistics staff upon arrival. Cadets who keep illegally hiddenkeys may be sent home from the encampment at the discretion of the commander.The keys will be returned during out-processing.

4. Money – The encampment fee covers all encampment expenses, there are limitedopportunties to make extra purchases (no Base Exchange). It is recommendedthat you bring no more than $25.00 in CASH for personal expenses. Checks andmoney orders cannot be cashed at the encampment.

5. Responsibility – New York Wing cannot be responsible for any item of personal property brought to the encampment. It is not advisable to bring any item notincluded on the equipment list. All clothing and equipment must be markedwith your last name, first initial and your 6-digit CAPID number using permanentmarker or writing on waterproof tape.

6. Encampment Credit – Cadets who complete 80% of instruction and perform in asatisfactory manner (including conduct and attitude) will receive officialencampment credit with National Headquarters CAP and a Certificate of Accomplishment.

7. Dismissal – Cadets who cannot conform to regulations or who cause a disruption

at the encampment will be subject to disciplinary action including dismissal.Cadets will also be subject to dismissal for the following reasons: destroying or stealing government, CAP, or personal property; actions that jeopardize thesafety of personnel; or using or having in their possession illegal drugs,intoxicating beverages, weapons, tobacco products, explosives, or any flame

producing devices.



8. Withdrawal – If you are unable to attend the encampment, notify the EncampmentRegistrar before the start of the encampment. Any fees paid previously will berefunded. If the encampment Registrar is not notified prior to 19 July 04, a$25.00 cancellation fee will be deducted from the refund. Due to the large waitinglist, it is important to notify the registrar directly as soon as possible.

9. Health and Medical – Personal and dental hygiene are required daily. A medicalofficer will be available for serious illness or accidents. Cadets are expected to bein good physical condition or have a doctor’s statement listing any limitations.Parents will be notified of serious injury or illness.

10. Medications – Cadets whose parents have submitted the Self-Medication ReleaseForm (found on the last page in this booklet), will be responsible for their ownmedication (prescription and over-the-counter). If cadets arrive at the encampmentwith medications (prescription or over-the-counter) for which we do not have asigned parental release form, the cadet will not be allowed to keep the medicationwith them. (The release form should be brought to the encampment with themedications.)

11. Visitors – Visitors, with the exception of graduation, are not allowed (a MilitarySupport Authorization (MSA) must be on file with Stratton ANG Base for all

personnel on site, prior to the start of the encampment). Any non-CAP or non-military personnel who wish to stay overnight must find off-base accommodations(see listing).

12. Laundry – There are no laundry facilities. It is required that cadets bring sufficientclothing that would eliminate the need to do laundry during the activity (seeequipment list section of this booklet).

13. Uniforms – Stratton ANG Base does not sell uniform items. Be sure to arrive at theencampment with both required uniforms. If you do not have all uniforms, pleasecontact your squadron commander to help you get them prior to the encampment. There is no base exchange available.

14. Checklist – Before leaving home for the encampment, be sure you have all requireditems from the Equipment List.

15. Behavior – You are expected to behave in a manner that brings credit to Civil Air Patrol and to yourself. Your conduct, in or out of uniform, reflects good or bad

public opinion of Civil Air Patrol. If you fail to follow encampment policy or commitacts unbecoming a CAP Cadet, you may be subject to dismissal from the

encampment.16. Limits – You may not leave the encampment area without proper authorization. All

areas of the base not specifically covered by orders, are off limits. If authorizedoutside the encampment area, you must remain in the designated area. If you wishto leave the encampment, you must go through channels to the EncampmentCommander.



ACCOMODATIONS NEAR STRATTON ANG

Holiday Inn100 Nott Terrace, Schenectady, NY 12308

Phone:( 518) 393-4141

Days Inn167 Nott Terrace, Schenectady, NY 12308

Phone: (518) 370-3297

GRADUATION AND DEPARTURE INFORMATIONGraduation will be held Saturday, 31 July 2004, at approximately1000 hours with out-processing occurring immediatelythereafter. Parents will be able to view the graduation and Pass-In-Review ceremonies, which will be held at the Aero-Med Bldg.

Cadets in flight will be able to depart from the BARRACKS AREA as soon as they complete their out-processing. Cadetswith air, bus, or train reservations must notify their TAC Officer during the encampment of their requirements.

Cadets on Staff will be staying for the staff banquet on Saturdayevening and cleanup on Sunday morning. The expecteddeparture and pick up time for staff is 1100 on Sunday, 01

August 2004.

PARENT INFO SECTIONThe next few pages contain information that you may need:(1) Graduation information(2) Directions to the Encampment(3) Contact Information Page(4) Self-Medication Release Form

**Cadets are expected to bring this booklet to the encampment,so make sure you have detached these pages or have madecopies.



DIRECTIONS TO STRATTON ANG BASE:

From West :

Take I-90 east to exit 26. Get off onto I-890 east and take it to theErie Blvd. exit. Take Erie Blvd. For about a mile (you will pass fivelights). The fifth light is at Freeman’s Bridge Road. Go across thebridge and through the first light. Take a right at the next light ontoMaple Ave. There will be a Stewart’s Shop at the intersection.Follow Maple Ave. until you see a sign for Stratton. Take a left onto

Air National Guard Rd. and over the train tracks. Take a left intothe base and proceed from there.

From South:

Take I-87 north to I-90 west. Take I-90 west to exit 25 and get ontoI-890 west. Get off at the Broadway exit. Bear to the right off theramp and go straight on Broadway to the third light (State St.).Take a left turn and then your first right onto Erie Blvd. You will gothrough 4 intersections with lights. The forth light is at Freeman’sBridge Road. Go across the bridge and through the first light.Take a right at the next light onto Maple Ave. There will be aStewart’s Shop at the intersection. Follow Maple Ave. until yousee a sign for Stratton. Take a left onto Air National Guard Rd. andover the train tracks. Take a left into the base and proceed fromthere.

From North:

Take I-87 south to the Clifton Park exit (Rte 146). Bear right after the exit going west. After a while you will come up to an intersectionwhere Rte 146 will go to the left (there is a traffic light there). Youwill proceed straight through the intersection. This will becomeGlen Ridge Road. You will go through a few small railroad bridgesand then come upon another intersection. This will be with Maple

Ave. Take a left onto Maple Ave. Follow Maple Ave. until itintersects with Air National Guard Rd. Turn right onto Air NationalGuard Rd. and then take a left into the Base.



IMPORTANT CONTACT INFORMATION

Encampment HeadquartersStratton ANG Base

(After 23 July 04 - during business hours)Office: (518) 344-2488 or (518) 344-2383

Encampment Commander:Captain Scott Ullery, CAP

Phone: (617) 461-3629Email: [email protected]

Commandant of Cadets:Captain Charles Miller, CAP

Phone: (724) 522-9898Email: [email protected]

Cadet Commander:C/Lt Col Charles Anderson, CAP

Phone (585) 599-3661Email: [email protected]

Encampment Registrar:Major Marylou Falco, CAPPhone: (518) 466-9479

Email: [email protected]

Encampment Web Addressfor further information

http://www.NYWGCadets.org



CIVIL AIR PATROLNew York Wing Leadership Encampment

Self-Medication Release Form

Date_________

Cadet’s Name: ____________________________ has been instructed in the proper use of the following medication procedures:(List all prescription medications being brought to the encampment)

_____________________________________

_____________________________________

_____________________________________

(Check any over-the-counter medications being brought to the encampment.)Benadryl Other Antihistamines (e.g. Claritin)Cough & Cold Products AntacidsPeptoBismal EmetrolImodium Ibuprofen

Acetaminophen AspirinMidol Other __________________

I request that the cadet named above be permitted to carry the medicationon their person or to keep same in their locker, as I consider the cadetresponsible. The cadet has been instructed in and understands the purposeand appropriate method and frequency of use.

______________________________ Signature of Parent or Guardian

Please pack all medications in a bag along with this release. Any medications not listed will be confiscated for the durationof the encampment. Also, please do not send more medicationthan is needed for the length of the encampment.



HEADQUARTERSCIVIL AIR PATROL NEW YORK WING

UNITED STATES AIR FORCE AUXILIARY817 STEWART AVE (REAR)

GARDEN CITY NY 11530

23 Feb 2004

MEMORANDUM FOR FIRST TIME IN-FLIGHT ENCAMPMENT CADETS

FROM: 2004 ENCAMPMENT COMMANDERSUBJECT: 2004 New York Wing Leadership Encampment

1) Welcome . With the coming of spring it is once again time to begin thinking about the Encampment season, and I am looking forward toanother excellent year. I am expecting another great turnout this year for in-flight cadets as well as cadet and senior staff. We have manyexciting plans in the works for this year, and you aren’t going to want to miss out! It is my pleasure therefore, on behalf of the WingCommander and New York Wing to invite you to apply now to reserve your spot at this year’s Encampment.

2) Dates and Location . In light of the current world climate that we continue to be faced with, I hope that everyone will understand thatalthough your senior staff and our CAP-USAF Liaison Office are working very hard to prepare for this year’s Encampment, nothing can betaken for granted, and there is always the possibility that the dates and/or locat ion might have to change between now and this summer. Withthis said, I am pleased to announce that the New York Wing of the Civil Air Patrol is planning to conduct its 2004 Leadership Encampmentonce again at Fort Drum in Watertown, New York. The Encampment will run from 24 July to 01 August for in-flight cadets including the

NCO Academy. In-flight cadets are required to arrive and depart on the dates indicated – there will be NO exceptions.

3) Encampment Summary . Encampments are often the most significant and worthwhile event in a CAP Cadet’s career. Encampmentswill usually focus on one of the three missions of CAP: Aerospace Education, Emergency Services, and the Cadet Leadership Program. OurEncampment in New York Wing this year will be a Leadership Encampment, and will provide the opportunity for newer cadets to learn aboutfollowership and leadership by experiencing the life of an airman for a week. New cadets will learn the basics of being a CAP Cadet througha very rigorous training schedule during the week, and by living in military barracks with their fellow cadets. More experienced cadets willhave the opportunity to grow and refine their leadership skills by serving on the cadet staff in a wide variety of positions. An equipment list is

provided with this mailing as a guide to the items required for those attending the encampment.

4) NCO Academy. Once again we will be offering an advanced training track for experienced cadets. The NCO Academy will offer cadetstraining in advanced leadership topics and provide opportunities for cadets to demonstrate their training during the Encampment. The NCOAcademy is intended for cadets returning to the Encampment, however, a limited number of cadets without Encampment experience may becompetitively accepted into the NCO Academy based on demonstrated experience and recommendation from a senior mentor. Applicantswill secondarily be considered for basic in-flight conditions if they are not selected for the NCO Academy.

5) Application Requirements .

Al l Appli cants NCO Academy I n-f li ght Cadets• Current membership card at time ofEncampment• Cadet Protection Training (CPPT) if 18or older

• Prior Encampment credit• C/SSgt by 10 Apr 2004

Or• 18 months CAP experience w/ letter of recommendation• C/MSgt by 10 Apr 2004

• Curry Award (C/Amn) by14 Jun 2003

6) Cost . The cost for this year’s Encampment will be $175 for each in-flight cadet. We strongly suggest that all squadrons conduct somefund-raising events during the coming spring to help defer the cost. The Encampment will accept payment by check, money order, or creditcard. Checks and money orders should be included in with the application papers. Those wishing to pay by credit card should fill out andsign the credit card authorization section of the NYWF 31. Only Visa and MasterCard will be accepted. This information will be keptconfidential at all times.

7) Application Forms . The NYWF 31, “Application for New York Wing Encampment,” dated Feb 2003, will be used by all applicants forthe Encampment itself. Copies of the forms are included and will be sent to all squadrons in addition to being posted on both the New YorkWing website at http://nywg.cap.gov/ and the Cadet Programs website at http://www.nywgcadets.org/enc2004/. Applications using incorrector outdated forms may be delayed and could result in non-acceptance. All applying personnel and squadron commanders are requested tomake a special effort to ensure that their forms are legible (typed forms are preferred) so that there are no errors in processing them.



8) Mailing Address . Applicants should only submit ONE copy of each application form to the Encampment Registrar. Applications sent to NY Wing Headquarters or other addresses risk being delayed and could result in non-acceptance. All signed applications must be eithermailed or faxed to the Encampment Registrar at the following address:

2004 NYWG Encampment Registrarc/o Maj Mary Lou Falco2 Mildred LaneLatham, NY 12110 – 3519Fax: (775) 269-8312

9) Application Deadlines . This year we will need all squadrons to be especially attentive to the deadline so that we can better plan for theEncampment and so that we can accommodate with the rules and security measures being set forth by our host facility, Fort Drum. NOLAST MINUTE APPLICATIONS WILL BE ACCEPTED. Cadets who arrive at Fort Drum and have not been pre-registered for theEncampment WILL BE SENT HOME. The Fort Drum security policies require that we provide them with a list of who is attending prior totheir arrival. As a result of increased cadet enrollment this year, we may have limited space, and applications will be accepted on a first comefirst served basis. Upon receipt of your application by the Encamp ment Registrar, you will be sent a confirmation letter to indicate anythingthat we are missing in order to process your application. The following are important dates and deadlines:

12 Jun 2004 24 Jul – 01 Aug 2004POSTMARK DEADLINE Encampment (In -Fligh t and NCO Acad emy C adet s)

• In-flight cadet applications – NYWF 31• NCO Academy applicat ions – NYWF 31(Include brief (1/2 page) summary of relevant CAP and leadershipexperience (resume) and letter of recommendation - NCOA only)

• 24 July – In-flight cadets arrive between1200 and 1600• 01 August – Graduation, in-flight cadetout-processing, and departure to follow immediately

10) Distribution . We are counting on everyone in our Wing to help get the word out about this year’s Encampment and to encourage

everyone to get their applications submitted on time. We are all looking forward to having a terrific Encampment again this year. Thank youfor your support!

Sincerely,

Scott G. Ullery, Capt, CAP2004 Encampment Commander



2004 New York Wing Encampment Equipment List

What follows is the minimum required equipment list. ALL clothing and equipment must be marked with your last name, firstinitial and your 6-digit CAPID number using permanent marker or writing on waterproof tape.

P Blues Uniform: P BDU Uniform:1 Summer Blue Shirt 1 Summer BDU Blouse1 Summer Blue Pants or Skirt 1 Summer BDU Pants1 Flight Cap (service hat optional for officers) 1 BDU Cover1 Pair Uniform Shoes 1 Pair WELL BROKEN IN Uniform Boots1 Blue tab for blouse (Females Only) 1 Set Blousing Bands (for BDU Pants)1 Blues Belt with shiny chrome buckle 1 Blue BDU Belt with Subdued Black Buckle3 White V-NECK T-Shirts 7 Brown T-Shirts (STAFF: 9 Black T-Shirts)3 Pair Black Socks 7 Pair White or military BDU Socks (STAFF Add 2 pair)2 Pair Neutral Shade Hose (Females Only)1 Hat Device with Backing for Flight Cap1 Grade Insignia with Backing

2 1-Quart Military Style Canteens to fit on web beltOR 1 Camelbak and 1 1-Quart Canteen without cover and web

belt (required for graduation)

1 CAP Cut-Out with Backing 1 Web Belt (to Attach Canteens) (Optional if using Camelbak)1 Set A ro riate Ribbons P Toiletries :1 Ribbon Holder with Backing 1 Comb or Hairbrush1 Name Plate with Backing 1 Washcloth

1 set Slingshots (a.k.a. garters) (Optional) 1 Bath TowelP Clothing : 1 Pair Shower Clogs or Flip-Flops1 Hair dryer (Optional)1 Soap Bar with Plastic Container

2 Sets of Casual Civilian Attire (Civilian attire must besolid colored clothing. Non-military advertising or largelogos of any sort will not be permitted) 1 Small Container Toothpaste1 Light Jacket, Field Jacket, or Sweater 1 Deodorant1 Pair Sneakers 1 Toothbrush9 Sets of Underwear (STAFF add 2 pair) 1 Small Personal First Aid Kit1 Pair Blue Denim Jeans or Work Pants 1 Feminine Hygiene Products (Females Only)1 Set of PT gear (Solid Colors or Military Logos Only) 1 Container Shampoo1 Modest Swim Suit 1 Small packet of Moleskin (Optional, but recommended)1 Raincoat or Poncho 1 Small Container of Foot Powder (Optional)

1 Sweat Suit (optional) 1 Set Shaving ItemsP Barracks Items : 1 Small Case or Ba for Toiletries

1 Laundry Bag 1 Shower Cap (Optional ) 1 Small Sewing Kit 1 Set of Makeup (Females Only, Optional)8 Coat Hangars 1 Hair Spray or Hair Gel (Optional)1 Small Laundry Detergent Container (Optional) 1 Chap Stick (Optional)1 Solid-colored Blanket without any print 1 Doctor Scholls Shoe Liner (Optional)

P Accessories :1 3-Hole Punch S iral Notebook3 Pens3 Pencils (with pencil sharpener)1 Shoe Shine Kit (polish, brush, rag)1 Flashlight with Extra Batteries and Bulb 1 Small Container Sunscreen (Optional but recommended)1 Camera with Film (Optional)

1 Set of Non-Fitted Twin Size Bed Sheets:q 1 Bottom Sheetq 1 Top Sheetq 1 Pillowq 1 Pillow Case

Note: It is recommended that all linens be solid coloredwithout prints, but this is not necessary if you do notalready have a set. No sleeping bags will be allowed.

1 “CAPM 39-1 Uniform Manual” (Optional)1 “Leadershi : 2000 And Be ond” O tional1 “Drill and Ceremonies Manual” (AFR 50-14) (Optional)



CONTRABAND LIST:

None of the items on the Contraband List are required for the Encampment. Do not bring contraband items to the Encampment. AllContraband items will be confiscated and held for the duration of the encampment by your TAC Officer. Cadets on staff or in flightmay not bring to the encampment, use, or have in their possession any of the following items:

• Portable AM/FM Radios• Portable Televisions• Electronic Games•

Portable Tape Players • Credit Cards• ATM/Debit Cards• Cash over $45.00 (any excess will be held by the TAC Officer until the conclusion of the encampment)• Pagers or Beepers• Cellular Phones• Non Prescription Medicines (except with a doctor’s note)• Illegal Drugs (prescription or over the counter drugs must be registered with the medical officer)• Tobacco (in any form)• Intoxicating Beverages• Weapons (e.g. knifes) or Explosives (e.g. firecrackers)• Any Flame Producing Device (including lighter, matches or flares)• Food (such as snacks, soda, candy, or gum)• Shoulder cords, First Sergeant’s diamonds (except Encampment First Segeants), or Squadron Hats• CAP Radios* (Some exceptions, see below)• PDAs, Laptops, or Personal Computers (except staff with permission)

* Authorized VHF CAP radios and Family Radio Service (FRS) radios will be allowed by staff only.



HEADQUARTERSCIVIL AIR PATROL NEW YORK WING

UNITED STATES AIR FORCE AUXILIARY817 STEWART AVE (REAR)

GARDEN CITY NY 11530

23 Feb 2004

MEMORANDUM FOR ALL ENCAMPMENT STAFF APPLICANTS

FROM: 2004 ENCAMPMENT COMMANDERSUBJECT: 2004 New York Wing Leadership Encampment

1) Welcome . With the coming of spring it is once again time to begin thinking about the Encampment season, and I am looking forward toanother excellent year. I am expecting another great turnout this year for in-flight cadets as well as cadet and senior staff. We have many exciting

plans in the works for this year, and you aren’t going to want to miss out! It is my pleasure therefore, on behalf of the Wing Commander and New York Wing to invi te you to apply now to reserve your spot at this year’s Encampment.

2) Dates and Location . In light of the current world climate that we continue to be faced with, I hope that everyone will understand thatalthough your senior staff and our CAP-USAF Liaison Office are working very hard to prepare for this year’s Encampment, nothing can be takenfor granted, and there is always the possibility that the dates and/or location might have to change between now and this summer. With this said,I am pleased to announce that the New York Wing of the Civil Air Patrol is planning to conduct its 2004 Leadership Encampment once again atFort Drum in Watertown, New York. The Encampment wil l run from 24 July to 01 August for in-flight cadets including the NCO Academy andfrom 22 July to 02 August for cadet and senior staff. In-flight cadets are required to arrive and depart on the dates indicated – there will be NOexceptions. Cadet Staff are expected to arrive on the evening of July 22 and remain until the morning of August 2nd. Any exceptions must be

approved 'in writing' by the Commandant or myself. Senior Staff are strongly encouraged to arrive and depart on these dates as well. For seniorsunable to attend the entire Encampment, please be very clear on your application as to what dates you will be present.

3) Encampment Summary . For those seniors who are new to Civil Air Patrol and have not yet had the opportunity to attend an Encampment,Encampments are often the most significant and worthwhile event in a CAP cadet’s career. Encampments will usually focus on one of the threemissions of CAP: Aerospace Education, Emergency Services, and the Cadet Leadership Program. Our Encampment in New York Wing this yearwill be a Leadership Encampment, and will provide the opportunity for newer cadets to learn about followership and leadership by experiencingthe life of an airman for a week. New cadets will learn the basics of being a CAP Cadet through a very rigorous training schedule during theweek, and by living in military barracks with their fellow cadets. More experienced cadets will have the opportunity to grow and refine theirleadership skills by serving on the cadet staff in a wide variety of positions.

4) NCO Academy. Once again we will be offering an advanced training track for experienced cadets. The NCO Academy will offer cadetstraining in advanced leadership topics and provide opportunities for cadets to demonstrate their training during the Encampment. The NCOAcademy is intended for cadets returning to the Encampment, however, a limited number of cadets without Encampment experience may becompetitively accepted into the NCO Academy based on demonstrated experience and recommendation from a senior mentor. Applicants willsecondarily be considered for basic in-flight conditions if they are not selected for the NCO Academy.

5) Application Requirements .

All Applicants Cadet Command Staff Cadet Staff

• Current membership card at time of Encampment• Cadet Protection Training (CPPT) if 18 or older

• C/Maj or above by 20 Mar 2004 for CC, DCC, XO• C/SMSgt by 20 Mar 2004 for Group 1 st Sgt


Seni or M embers NCO Academy In-flight cadets• Level 1 and CPPT (Cadet Protection) by 26 Jun2004• NYWG driver’s license


Or• 18 Months CAP experience w/ letter of recommendation• C/MSgt by 10 Apr 2004

• Curry Award (C/Amn) by14 Jun 2004

6) Preparatory Training Workshops . We will again be holding two staff workshops in preparation for the Encampment. The first of theseweekends will be the Leadership Workshop to be held from 23 to 25 April 2004. This will be a training weekend for both cadets and seniormembers interested in at tending as staff. In addition to studying leadership theory and practice, we will also host a mentoring workshop and willcontinue the staff selection process. The second weekend will be the Staff Skills Workshop. This event will be held from 25 to 27 June 2004 andwill focus on preparing cadet staff and their senior member mentors for the jobs that they will fulfill during the Encampment itself. Both eventswill be hosted at Stratton Air National Guard Base in Scotia, NY (directions can be found on the NYWG Cadet Programs website -http://www.nywgcadets.org/dirstratton.html). All attendees must also bring $12 for meals to each event. Both cadets and seniors areSTRONGLY encouraged to attend these worthwhile events. Seniors who are still considering attending the Encampment are especiallyencouraged to come to the workshops to find out more about the nature of CAP Encampments and the opportunities that exist to get involved.More information will follow regarding their specifics. (The Senior Mentor Workshop will be held from 1000 to 1500.)



7) Cost . The cost for this year’s Encampment will be $175 per cadet, for both staff cadets and in-flight cadets. We strongly suggest that allsquadrons conduct some fund-raising events during the coming spring to help defer the cost. The Encampment will accept payment by check,money order, or credit card. Checks and money orders should be included in with the application papers. Those wishing to pay by credit cardshould fill out and sign the credit card authorization section of the NYWF 31. Only Visa and MasterCard will be accepted. This information will

be kept confidential at all times. Senior members will need to pay $10 per day up to a maximum of $50 per person. This cost will include mealsand billeting in the barracks.

8) Application Forms . The NYWF 31, “Application for New York Wing Encampment,” dated Feb 2003, will be used by all applicants for theEncampment itself. Copies of the forms are included and will be sent to all squadrons in addition to being posted on both the New York Wingwebsite at http://nywg.cap.gov/ and the Cadet Programs website at http://www.nywgcadets.org/enc2004/. Applications using incorrect oroutdated forms may be delayed and could result in non-acceptance. All applying personnel and squadron commanders are requested to make aspecial effort to ensure that their forms are legible (typed forms are preferred) so that there are no errors in processing them.

9) Mailing Address . Applicants should only submit ONE copy of each application form to the Encampment Registrar. Applications sent to NYWing Headquarters or other addresses risk being delayed and could result in non-acceptance. All signed applications must be either mailed orfaxed to the Encampment Registrar at the following address:

2004 NYWG Encampment Registrarc/o Maj Mary Lou Falco2 Mildred LaneLatham, NY 12110 – 3519Fax: (775) 269-8312

10) Application Deadlines . Once again, this year we will need all squadrons to be especially attentive to the various application deadlines thatare set forth below, so that we can better plan for the Encampment and so that we can accommodate with the rules and security measures beingset forth by our host facility, Fort Drum. NO LAST MINUTE APPLICATIONS WILL BE ACCEPTED. Cadets who arrive at Fort Drum and

have not been pre-registered for the Encampment WILL BE SENT HOME. The Fort Drum security policies require that we provide them with alist of who is attending prior to their arrival. The following is the event schedule and application deadlines. As a result of increased cadetenrollment this year, we may have limited space, and applications will be accepted on a first come first served basis. We understand that SeniorMembers often do not know if they will be able to get vacation time from work during the Encampment week until later in the spring. If this isthe case, we encourage you to submit an application as soon as possible, and describe your situation. Cadets applying for other summer activitiesthat might conflict with the Encampment should apply before the deadline describing their situation if they wish to be considered for a staff

position. Interested senior members are also requested to contact the Commander at ei ther [email protected] or (617) 461-6329 as soon as possible to let him know in what areas you are interested in serving. Upon receipt of your application by the Encampment Registrar, you will besent a confirmation letter to indicate anything that we are missing in order to process your application. The following are important dates anddeadlines:

20 Mar 2004 10 Apr 2004 23-25 Apr 2004 12 Jun 2004POSTMARK DEADLINE POSTMARK DEADLINE Act ivi ty ( Staff ) POSTMARK DEADLINE

• NYWF 17 c for Staff Ski llsWorkshop for Cadets• CAPF 17 for Staff SkillsWorkshop for Senior Members

25-27 Jun 2004 Activity ( Staff )

Cadet Command staff applications for C/CC, XO, DCC, 1st Sgt.

• NYWF 17 c for LeadershipWorkshop• NYWF 96 with attached essay(also email essay to Commander)• Hand carry NYWF 31 forEncampment to the LeadershipWorkshop on 23 Apr 2004

Cadets will not be considered forcommand staff positions withoutthese

Cadet Staff applications:• NYWF 17 c for Leadership Workshop• NYWF 96 with attached essay• Hand carry NYWF 31 for Encampmentto the Leadership Workshop on 23 Apr2004

Cadets will not be considered for staffpositions without these

Senior Member applications:• CAPF 17 for Leadership Workshop• Hand Carry NYWF 31 for theEncampment to the Leadership Workshop

• Leadership Workshop forCadet Staff• Mentoring Workshop forSenior Members

Locat ion: Stratton Air NationalGuard Base, Scotia, NY

Cost is $12 per attendee.

• Staff Skills Workshop for allstaff

Locat ion: Same as for theLeadership Weekend. Cost isagain $12 per attendee.

12 Jun 2004 22 Jul – 02 Aug 2004 24 Jul – 01 Aug 2004POSTMARK DEADLINE Encamp ment ( Staff ) Encampment ( In -Fligh t C adet s )

• In-flight cadet applications – NYWF 31• NCO Academy applicat ions – NYWF 31

(Include brief (1/2 page) summary of relevantCAP and leadership experience (resume) andletter of recommendation - NCOA only)

• 22 July 2004 - cadet and senior staff arriveno earlier than 1900• 02 August 2004 - cadet and senior staff departno later than 1200

• 24 July – In-flight cadets arrive between1200 and 1600• 01 August – graduation, in-flight cadetout-processing, and departure to followimmediately

11) Distribution . We are counting on everyone in our Wing to help get the word out about this year’s Encampment and to encourage everyoneto get their applications submitted on time. We are all looking forward to having a terrific Encampment again this year. Thank you for yoursupport!

Sincerely,

Scott G. Ullery, Capt, CAP2004 Encampment Commander



APPLICATION FOR NEW YORK WING ENCAMPMENTNAME (Last Name, First Name, Middle Initial) JOINED CAP: MMM YY CAPID YEAR

CAP GRADE WING UNIT CHARTER NUMBER REGION ENCAMPMENT LOCATION

Applying As:Basic Cadet

MAILING ADDRESS (Number and Street)

NCO AcademyCadet StaffSenior Staff

(City) (State) (Zip Code)

-This is my first encampment

DATE OF BIRTH: DD MMM YY HEIGHT GENDER HAIR COLOR EYE COLOR SOCIAL SECURITY NUMBER (Required)

- -

SCHOLASTIC ACHIEVEMENT

High School Graduate RELIGIOUS PREFERENCE PRESENT OCCUPATION

College Years Post Graduate Years

ARE YOU INTERESTED IN ATTENDING RELIGIOUS SERVICES?

YES NO(Home Phone):

E-MAIL ADDRESS (Business Phone):

T-SHIRT SIZE (Required) CPPT (18 and Older Only): CompletedWill be completed prior to encampment

(Cell Phone):

SENIORS ONLY: Full-Time or Part-TimeDates I will be at the encampment (Part-Time only):

Basic Cadet Encampment Contract: (You will be asked to sign this when you arrive at the encampment.)

Prior to the encampment: ,if not already at that rank or higher, I will attain the rank of Cadet Airman.

During the encampment:I will participate actively in all training activities, consistently performing to the highest standards for Civil Air Patrol Cadets.I will consistently adhere to the Civil Air Patrol Manual 39-1 in a constant state of readiness for inspection.I will maintain my quarters and personal gear in accordance with the Cadet Standard Operating Procedures andSupplements. My quarters and gear will be in a constant state of readiness for inspection.I will accept and complete all academic assignments in a timely, correct, and concise manner.

By the conclusion of the encampment:I will be able to demonstrate satisfactory performance of basic drill movements, and customs and courtesies outlined in

AFMAN 36-2203 and the Encampment OIs.I will be able to perform as part of a team, cooperating with and supporting other members of the team.

PAYMENT OF ENCAMPMENT FEES: I have included payment of $ in the form of: Cash: Check: Money Order: Credit Card:

If Paying by Credit Card Visa MasterCard

Account Number Expiration Date: (MMM YY)

Name on Credit Card:Signature of Card-holder

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CIVIL AIR PATROL RELEASE AGREEMENT (ALL MUST SIGN)

KNOW ALL MEN BY THESE PRESENTS that I am submitting my application for Civil Air Patrol Special Activities or Encampments, and I hereby volunteerentirely upon my own initiative, risk, and responsibility for an assignment to participate in this activity of encampment at the first available opportunity and with fullknowledge that such activity may include:

1. Traveling by land, sea, or air in US military, commercial, or privately owned vehicles from regular place or residence to the site of the activity orencampment, travel incident to the activity or encampment, and subsequent return to place of residence.

2. Participation in aeronautical activities as a passenger or student trainee in US military, commercial, or privately owned aircraft.3. Living for a period of one week or more on diminished rations and minimal shelter simulating actual survival conditions.4. Being quartered and/or subsisting away from regular or normal place of residence for an extended period of time.5. Remaining with the cadet group I am assigned to at all times during the activity or encampment.6. Acting as a spokesman for Civil Air Patrol, rendering reports on the activity or encampment.7. Refraining from argumentative discussions concerning governmental policies.

In consideration of the permission extended to me by the Civil Air Patrol/United States of America through its officers and agents to participate in saidactivity/encampment or activities/encampments, I do hereby for myself, my heirs, executors, and administrators release and forever discharge the Civil Air Patrol,Inc./United States of America, and all its officers, agents, and employees acting official or otherwise, from any and all claims, demands, actions, or causes ofaction, on account of my death or on account of any injury to me or my property which may occur as a result of the negligence of the Civil Air Patrol/UnitedStates of America, its agents or employees during said activity/encampment or activities/encampments or continuances thereof, as well as all ground and flightoperations incident thereto.

DATE SIGNATURE OF APPLICANT

RELEASE BY PARENTS OR GUARDIAN (ONLY IF UNDER 18)

KNOW ALL MEN BY THESE PRESENTS: WHEREBY my child has applied for the activity or encampment referred to above, In consideration of the permissionextended to my child by the Civil Air Patrol/United States of America through its officers and agents to participate in said activity/encampment oractivities/encampments, I do hereby for myself, my heirs, executors, and administrators release and forever discharge the Civil Air Patrol, Inc./United States of

America, and all its officers, agents and employees acting official or otherwise, from any and all claims, demands, actions or causes of action, on account of thedeath or on account of any injury to my child which may occur as a result of the negligence of the Civil Air Patrol/United States of America, its agents oremployees during said activity/encampment or activities/encampments or continuances thereof, as well as all ground and flight operations incident thereto. Inaddition, by my signature below, I certify the applicant:

1. Is my minor child or ward.2. Has no history or injury or disease which might be affected by this activity except those previously noted in the Medical Information section of this form.3. Will follow all rules, regulations, and directives as established by the Civil Air Patrol, Inc., activity project officer or encampment commander, or other staff

members. If not following the above mentioned rules, regulations, and directives he/she may be sent home at the discretion of the project officer,encampment commander or activity directory at my expense.

However, in case of injury, disease or other illness, permission is hereby granted to treat the applicant as required, and if the applicant is released from theactivity before recovery from said injury, disease, or illness, further treatment will be provided by myself.

DATE WITNESS FOR FATHER’S SIGNATURE FATHER OR LEGAL GUARDIAN

WITNESS FOR MOTHER’S SIGNATURE MOTHER OR LEGAL GUARDIAN

SQUADRON CERTIFICATION

I certify that the above information is correct and that all requirements f or attendance will be completed by the required dates.

SQUADRON COMMANDER

WING CERTIFICATION (Required for applicants who are not members of New York Wing)

This applicant has my permission to attend the NYW Encampment.

WING COMMANDER

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MEDICAL INFORMATION - TO BE COMPLETED BY ALL APPLICANTS

NAME OF PARTICIPANT (Last Name, First Name) CAPID

DO YOU CURRENTLY USE ANY MEDICATION? (Including eye drops) NO YES (List any medication taken and the reason in the remarks section.)

HAVE YOU HAD OR BEEN INVOLVED IN AN ACCIDENT IN THE PAST 2 YEARS? NO YES (Explain the extent of your injuries and treatment required in the remarkssection.)

HAVE YOU HAD OR HAVE NOW ANY OF THE FOLLOWI NG? (If yes is answered on any items, please explain why in the remarks section with dates and physician(s) consulted (ifany). Items not specifically noted below having the potential t o interfere with performance during the special activity or encampment s hould be documented in the remarks section.)

NO YES Frequent or severe headaches NO YES Ear infections NO YES Chronic diseases like Diabetes or Bronchitis

NO YES Dizziness or fainting spells NO YES Rupture NO YES Girls only - Menstrual cramps

NO YES Unconsciousness for any reason NO YES Positive TB skin test NO YES Other illness or accidents

NO YES Eye trouble, excluding glasses NO YES Epilepsy or fits NO YES Military rejection or medical discharge

NO YES Hay fever NO YES Kidney stones or blood in urine NO YES Rejection for life insurance

NO YES Sugar or albumin in urine NO YES Motion sickness NO YES Admission to hospital

NO YES Heart trouble NO YES Nervous trouble of any sort NO YES Record of traffic convictions

NO YES High or low blood pressure NO YES Any known allergies NO YES Record of other convictions

NO YES Stomach trouble NO YES Any drug or narcotic habit NO YES Attempted suicide

NO YES Asthma NO YES Chronic or recurring injuries NO YES Medical treatment within the past 5 years otherthan regular office visits or physicals

IMMUNIZATIONS

FAMILIY PHYSICIAN (Name, address, and phone number)

INSURANCE INFORMATION

Medical LiabilityCompany Company

Policy Number Policy Number

EMERGENCY ADDRESSEE - PARENT, GUARDIAN, OR CLOSEST RELATIVE TO BE NOTIFIED IN CASE OF EMERGENCY

Name Relationship

Address Day Telephone Night Telephone

REMARKS

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nywg encampment guide (2004)

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