JOY Junior High District Youth Gathering October 6-8, 2017- Camp Lutherhoma Camp Lutherhoma Physical Address: 23197 E 742 Rd, Tahlequah, OK 74464, 918-458-0704 Group Registration- For All Groups Attending Registration Information Registration: Due by September 22, 2017, you may register for the full price after this date; however, you WILL NOT receive a t-shirt A participant is a youth or adult from a congregation. All participants from a congregation must register for the same type of cabin. $125.00 per participant for Summer Cabin two night stay $145.00 per participant for Pine or Aspen Retreat Cabin two night stay $75.00/95.00 per LCMS congregation guest participant depending on group cabin choice (non-church member friend of youth who has not attended previously) $75 High School Leader for Summer cabin two night stay and meals & t-shirt After September 22, please contact DCE Suzanne Watt at Christ the Redeemer for registration information (918) 492-6451 You may register your group online at www.lutherhoma.com/orevent.html Or mail copies of your group registration form, group roster, and participant forms and payment to: Camp Lutherhoma/JOY, PO Box 1672, Tahlequah, OK 74465 Payment: Must be in the form of church/youth group check. NO PERSONAL CHECKS will be accepted. Please make checks payable to the Oklahoma District LCMS. If you register online, you may use a credit card. Please note: You may pay a $50.00 nonrefundable deposit per person before September 16. The final balance must be paid in full by September 30. If you register after September 16, the full balance is due at the time of registration. The $50.00 nonrefundable deposit will be retained per individual cancellation. Substitutions will be allowed after September 16; however, t-shirts in a different size may not be available. Confirmation: You will receive an EMAIL containing confirmation and other important gathering information starting September 1st to the email provided as the youth leader/church contact email on the group registration page. This will be your only confirmation. Please print and save this confirmation once it is received. Age & Friend Requirement: JOY is open to junior high school students. This includes students who are in 6 th -8 th grade. The friend rate it meant to be an incentive for LCMS congregation youth to invite a friend outside of your church congregation. This rate is only for outside friends of your youth who are non-members of your church or do not regularly attend your church. The OK District will incur the remaining cost of their registration fee on your behalf. Non-LCMS congregations may register groups at the regular rates. Cabins: When registering please keep in mind, all members of your group MUST stay in the same style of cabin. If your group chooses the retreat cabins all group members must pay the retreat cabin price and vice versa. Retreat cabin stay is located in the Pine and Aspen cabins at the entrance to camp grounds. Stay in these cabins is priced at a higher rate because bed linens and towels are provided for each registered participant. Summer cabin stay is in the smaller cabins on camp grounds in the bunk beds. Participants in the summer cabins must bring their own bedding and towels.
Adult Leaders: All groups are REQUIRED to send adult chaperones with their group. Please check with your church policy manual or church insurance provider to determine the proper age for adult chaperones. At the very minimum you may not send a chaperone under the age of 18; 21 and over is preferred. You may decide the youth to adult ratio for your group; however, we recommend at least 1 adult for every 6 junior high students. Because we are in summer camp/retreat cabins all sleeping cabins will be solely male or female. Male students must have a male chaperone and female students must have a female chaperone. If your congregation is unable to send any chaperone at all or needs one or more male or female chaperones: You may team up with another congregation to have their chaperone(s) supervise your student(s). 1.) When registering, you (Church A) MUST fill out the additional Adult Leader Information form and send it by mail with your registration or by mail after completing online registration. 2.) Complete the form with the congregation name and leader name who will be attached to your registrant (CHURCH B- must correspond male/female) and ensure the student s parents or guardian are aware and agree to this arrangement by signing the form. 3.) Please make sure you speak to that congregation and adult leader ahead of time (CHURCH B) and ensure they are willing and comfortable supervising your student. DO NOT register a student without having adult supervision coordinated. 4.) The congregation accepting responsibility (CHURCH B) will also need to complete the Adult Leader Information form and return it by mail. In it that congregation and leader sign off on assuming responsibility for your student(s). 5.) If you plan to check in your student separate from the group they are being supervised by (CHURCH B), the Medication/health/liability forms must be filled out and turned in along with a copy of the student s insurance card upon on site check-in at the beginning of JOY on Friday, September 30 to be given to the congregation and adult leader responsible for your student(s) (CHURCH B). If your student travels to the gathering with that group, please ensure the congregation assuming responsibility has these forms before departure for JOY. As of January 1, 2017, The Oklahoma District LCMS requires that all Oklahoma District congregations obtain criminal, violent and sexual offender background checks for all adult leaders (age 18 and over) that attend District sponsored youth events, including but not limited to the District Youth Gatherings (JOY and OK D in Christ); District service events; and Lutherhaven Retreat Center or Camp Lutherhoma sponsored retreats or camps. Please make sure your church has conducted a background check for all adults who chaperone youth attending these events and maintain this information locally. This is a best practice. If your congregation does not currently obtain background checks for staff or volunteers who work with minors, we highly encourage you move in this direction as soon as possible. You may consider speaking to your church s liability insurance provider for assistance. Thank you for your cooperation! Resources for obtaining background checks: Protectmyministry.com Church Mutual/ Brotherhood Mutual Insurance Companies Shepherd s Watch (Via Group.com) OSBI Please look into your Church Insurance policy as to what they require for your church staff, volunteers and drivers of church owned or rented vehicles. An additional driving record search may be required. Transportation: Groups are in charge of their own transportation to and from the event as well as during the event. We will be doing a service project at Frist Lutheran in Tahlequah on Saturday. Groups will need to provide a way there and back for their registrants.
JOY Junior High District Youth Gathering October 6-8, 2017- Camp Lutherhoma Register by mail using these forms or register online: www.lutherhoma.com/orevent.html Group Registration- Group leaders, please complete this form for your group Basic Information Church Name Youth Leader or Church Contact Name Church Address Church City/State/Zip Youth Leader or Contact Email Address Youth Leader or Contact Phone Number Pastor s Name and Contact (Email or Phone) Signatures Pastor/DCE: As pastor/dce of this congregation, I commit to, Pray for these youth and adults as they prepare for, travel to and attend the JOY Oklahoma District Youth Gathering. Pastor/DCE Signature Payment Type of Registration Number of Participants Cost Total Retreat Cabin X $145.00 Retreat Cabin Friend X $95.00 Summer Cabin X $125.00 Summer Cabin Friend X $75.00 2x or 3x Shirts X $5.00 (each) Total Due Total Paid *Please complete other side of form before returning
Group Roster Please attach additional copies of this roster if more space is needed Name of Participant Male or Female Youth Adult T-shirt Size Total T-shirts All sizes are adult t-shirt sizes S M L XL 2X 3X Please note 2X and 3X shirts are an additional $5 per shirt.
JOY Junior High District Youth Gathering October 6-8, 2017 Camp Lutherhoma Give this form to your adult leader to complete your registration. Due by: Participant Registration- Each student and adult attending must complete this form Personal Information Name Youth/Adult Male/Female Birthdate (xx/xx/xxx) Address T-shirt size (adult sizes only) High School Grad Year City/State/Zip Email Address Phone Number Home Church City Pastor/DCE/Youth Leader Name (Primary Adult who will be attending JOY with your group) Signatures Students: I appreciate the opportunity to attend the JOY Oklahoma District Youth Gathering. I agree to participate fully in all events, be respectful of my adult leaders, and conduct myself in a God pleasing manner during the event. Student Signature Parents/Guardians: I give permission for my son/daughter/ward to participate in the JOY Oklahoma District Youth Gathering. I authorize the adult leader(s) of my son/daughter/ward s congregational group to consent to any medical treatment necessary for my child while attending or traveling to and from the JOY Oklahoma District Youth Gathering. I declare that my child is covered by primary accident and medical insurance and assume all liability for injury to my child. I give the JOY Oklahoma District Youth Gathering the right to use the image and comments of my son/daughter/ward for publicity purposes related directly to the mission of the JOY Oklahoma District Youth Gathering. I understand that I will not be given any creative control over the finished use of the images. Parent/Guardian Signature
Student Name: JOY 2017 Medical Questionnaire Primary Emergency Contact: Relationship to Participant: Daytime Phone ( ) Evening Phone ( ) Secondary Emergency Contact: Relationship to Participant: Daytime Phone ( ) Evening Phone ( ) Health Insurance and Policy Information Is this participant covered by health insurance? Yes No If yes, complete the following: Policy Holder s Name: Relationship to participant: Insurance Company Name: Insurance Company Contact Information: Policy # Plan # If possible, please attach a copy of your health insurance card, front and back, to this form before returning it to your church group leader. Medical History Check any of the following that are areas of concern for this student: 1. Does your child have allergies to: Nuts: Food: Insects: Medications: Other: 2. Does your child suffer from, or has ever experienced, or is being treated currently for any of the following: Asthma Epilepsy/Seizures Heart Condition Diabetes Physical Handicap Other or further explanation: 3. Date of last tetanus shot: 4. List current prescriptions/medications and dosage schedule:
5. Does your child wear: glasses contact lenses 6. Please list and explain any major illnesses your child has experienced during the last 12 months. 7. Is your child currently under a doctor s care? Please explain Parental Permission and Medical Release (Please me a copy of this form; one is to be turned in at registration, the other should be kept with the counselor at all times) In consideration for being an accepted for participation in the J.O.Y. Gathering, sponsored by the Oklahoma District LCMS, at Camp Lutherhoma, October 6-8, 2017, I (WE) being 21 years of age release, and forever discharge and agree to hold harmless the Oklahoma District LCMS and Camp Lutherhoma and the directors thereof from any and all liability, claims, or demands for personal injury, illness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child participant that occur while said child is participating in the above described trip or activity. Furthermore, I (WE) on behalf of my (our) child-participant hereby assume all risk of personal injury, sickness, death, damage and expenses as a result of participation in recreation and work activities involved therein. Further, authorization and permission is hereby given to said sponsor organization and youth leaders to furnish any necessary transportation, food, and lodging for this participant. The undersigned further hereby agree to hold harmless and indemnify said church, district, camp, their directors, employee, and agents, from any liability sustained by said church, district, or camp, as a result of negligent, willful, and intentional acts of said participant, including expenses incurred attendant thereto. {(If participant has not attained the Age of 21 years)} I (WE) are the parent (s) or legal guardians of this participant, and hereby grant my (our) permission for him or her to participate fully in said trip, and hereby give my (our) permission to take said participant to the doctor or hospital and hereby authorize medical treatment, including but not limited to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any incur. Further, should it be necessary for the participant to return home due to medical reasons, disciplinary actions, or otherwise, I (WE) hereby assume all transportation costs. Parent/Guardian Signature: Date:
JOY Junior High District Youth Gathering October 6-8 2016- Camp Lutherhoma Adult Leader Information Form- to be completed if you are sending youth who will be supervised by another congregation s adult leaders CHURCH A- Your Congregation s Basic Information- SENDING STUDENT Church Name Primary Youth Leader Coordinating Registration Church Address Church City/State/Zip Youth Leader Email Address Youth Leader Phone Number Congregation Pastor s Name and Contact (Email or Phone) Pastor/DCE/ Youth Leader of Church A: As pastor/dce/youth leader of this congregation, I am entrusting care of the following student(s) to: CHURCH B- Congregation Basic Information- RECEIVING STUDENT Church Name Primary Youth Leader Attending JOY From CHURCH B Church Address Church City/State/Zip Youth Leader Email Address Youth Phone Number Adult Chaperone(s) Name(s) Assuming Responsibility
Please List Here All Students From Church A Being Entrusted to Church B Name of Participant from Church A M/F Name of Adult Leader from Church B Assigned to Participant Signatures Pastor/DCE/ Youth Leader of Church B: As pastor/dce/youth leader of this congregation, I am accepting the responsibility for care and supervision of the above student(s) for JOY 2017 the weekend of October 6-8, 2017. I being 21 years of age release, and forever discharge and agree to hold harmless the Oklahoma District LCMS and Camp Lutherhoma and the directors thereof from any demands for supervision or medical attention, as well as expenses, of any nature whatsoever which may be incurred by the undersigned and the child participant that occur while said child is participating in the above described trip or activity. Church B Pastor/DCE/Youth Leader Signature