1. 2011 Infor
Transcription
1. 2011 Infor
February 15, 2011 Dear 2011 Ozark Camper and Family, Enclosed you will find the following important information: 1. 2011 Information Sheet 2. Health Card and Medication Packet (including the 2011 Medication and Pharmacy Form) 3. Travel Card 4. Camper Policy Agreement, Assumption of Risks and Agreements of Release and Indemnity 5. Camp Essentials Order Form 6. Fee Summary (including 2012 Pre-Enrollment information on back of the form; include appropriate deposit to GUARANTEE a spot in the session of your choice for 2012) 7. Camp Ozark Code of Conduct 8. “Ozark For All” flyer 9. Morning Activities Selection Instructions (NOTE: It is important that you complete the Activity Selection process as soon as possible.) 10. “My Ozark” flyer describing our online camper management system Please return items #2 – #6 by April 1st, 2011 (return the Medication Order Form by May 1st, 2011). Items #7 – #10 should not be returned. Please read all of the information very carefully. If you have any questions about any of the information contained herein, please contact Camp Ozark at (870) 867-4131, or campozark@campozark.com. Items #2 – #6 must be returned to Camp Ozark by April 1st, 2011 (the Medication Order Form is due May 1st, 2011). Also, please note that you may complete the Pre-Enrollment information for 2012 on the back of the Fee Summary, and include the appropriate deposit to guarantee a spot in the session of your choice next summer. Items #7, the Code of Conduct, #8, information regarding the “Ozark for All” program, #9, the Morning Activity Selection Instructions, and #10, the “My Ozark” flyer, are for your information only and need not be returned. No child will be admitted to Camp Ozark unless all of the required information is completed, signed (when necessary) and returned to Camp Ozark. We are very excited about 2011. We look forward to seeing each and every one of you soon. Remember, you must return items #2 – #6 to Camp Ozark by April 1st, 2011. Yours very truly, R. Sam Torn President Ozark Interests, Inc. P.S. If you have not completed your 2011 Application for Enrollment, please do so IMMEDIATELY. We must have this information to complete your child’s registration. CAMP OZARK 2011 INFORMATION SHEET PLEASE KEEP FOR YOUR RECORDS 14-day Sessions 1st Session................................................................ May 29 – June 11 2nd Session............................................................... June 12 – June 25 3rd Session ............................................................... June 26 – July 9 4th Session ............................................................... July 10 – July 23 5th Session ............................................................... July 24 – August 6 7-day Sessions Session A ........................................................ May 29 – June 4 Session B......................................................... June 5 – June 11 Session C ........................................................ June 26 – July 2 Session D ........................................................ July 3 – July 9 Session E ........................................................ July 24 – July 30 Session F ......................................................... August 31 – August 6 21-day Sessions Session G ........................................................June 5 – June 25 Session H.........................................................June 12 – July 2 Session I ..........................................................July 3 – July 23 Session J...........................................................July 10 – July 30 HEALTH FORM Each camper must have a completed health form from a physician. It should be returned to Camp Ozark no later than April 1, 2011. Camper medication must be processed according to the procedures outlined in the Camp Ozark Health Information sheet. ALL HEALTH FORMS MUST BE SIGNED BY A PARENT OR LEGAL GUARDIAN (NO EXCEPTIONS). HOW TO REACH CAMP OZARK Camp Ozark is located 40 miles west of Hot Springs, Arkansas, and six miles west of Mount Ida, Arkansas, on Highway 270. Please make certain that your Camp Travel Card is returned in a timely fashion so that a correct record of each camper’s travel arrangements is on file at Camp Ozark. VISITATION To avoid disturbing the Camp Ozark routine and program, we ask that family and friends NOT visit during camp until Closing Day. For campers attending more than one camp session, parents may visit between sessions. TELEPHONE USE Campers may not bring cell phones to Camp Ozark. In order that the camp routine not be disturbed, campers are not allowed to receive or make telephone calls except in the event of a medical emergency. Parents should feel free to contact the Camp Mom if they need to discuss something relating to their child. STORE DEPOSIT No extra money is needed at camp except for personal items such as toothpaste, shampoo, stamps, camp t-shirts, canteen/snack items, extra crafts items, etc. A deposit should be made in the camper’s store account. $150 is suggested for a 14-day session and $100 for a 7day session. The store account operates in similar fashion to a checking account and the unused balance is refunded. ALL MONEY MUST BE TURNED IN TO THE OFFICE ON THE FIRST DAY OF CAMP. NO MONEY IS ALLOWED TO BE KEPT IN THE CABINS. WHAT TO BRING Listed are items that are ESSENTIAL for Camp Ozark. In choosing your camper’s clothing, keep in mind that because he or she will be involved in energetic activities daily, comfort and freedom of movement are most important. Laundry service will be available on an asneeded basis for all 14-day and 21-day campers. Campers are advised to bring a 14-DAY SUPPLY OF CLOTHING FOR ALL 14AND 21-DAY SESSIONS (laundry will be done for all 21-day campers prior to their last week at camp) AND AN 8-DAY SUPPLY OF CLOTHING FOR ALL 7-DAY SESSIONS. For your convenience, Camp Ozark is offering a pre-packaged camp clothing option that includes everything campers need to bring with the exception of undergarments, swim suits, blue jeans and shoes. See the store order form for further details. (over) ITEMS TO BRING The following list pertains to a 14-day session. Campers attending a 7-day session should adjust some quantities (i.e. T-shirts, socks) as needed. 1 Pillow 14 Pair of shorts (8 pair for 7-day campers) 2 Pillowcases 14 Pair of underclothes (8 pair for 7-day campers) 2 Single sheet sets 1 Pair of flip-flops or sandals for showers 1 Blanket/Quilt and/or Sleeping Bag 14 Pair of socks (8 pair for 7-day campers) 1 Rain coat or poncho 2 Pair good athletic or tennis shoes 4 Towels (2 for 7-day campers) 1 Pair old tennis shoes or water sandals for wading 3 Wash cloths 1 Pair shoes that cover the heel or boots (if you desire to 1 Flashlight or headlamp participate in horseback riding – tennis shoes O.K.) 1 Pen or pencil 1 Water bottle 1 Stationery or postcards with stamps 1 Book (optional for donation to Camp Ozark library) 3 Swim suits (Modest – No two-piece suits) 1 Bottle of bug spray 1 Laundry/Dirty clothes bag 1 Bottle of sunscreen 1 Bible 1 Clip-on fan and extension cord (also sold at the Camp 2 Pair pajamas or nightwear Ozark store) 1 Jacket or Sweatshirt -Golf clubs, guitar, baseball glove, or other equipment as 2 Pair jeans needed for Morning Activities 14 T-Shirts /Tops (*see note) (8 for 7-day campers) -Backpack, duffle bag or similar for the last night at camp -Misc. toiletry articles and shower bag/caddy (able to hold a change of clothes, toiletries, bedding, etc.) LAUNDRY: Laundry will be done on an “as needed” basis. *NOTE: Girls should not bring backless shirts. Nor should they bring halter-tops or tank tops that are low cut, tight or expose the midriff. In addition, clothing which displays profanity or inappropriate content (drugs, alcohol, tobacco, etc.) is prohibited. **NOTE: Please see Camp Ozark 2011 Essentials packet for pre-packaged items available. SPECIAL CLOTHING REQUIREMENTS: Campers are encouraged to dress for our nightly Special Events. Suggestions for Special Event clothing are listed below. (Nothing fancy or extravagant is required or necessary for any of the events listed below.) 14- and 21-day campers will participate in all Special Events. Session A, C and E campers will participate in Special Events #1 – #5. Session B, D and F campers will participate in Special Events #6 – #10. All campers will participate in #11, “Mission Impossible!” 1. 2. 3. 4. 5. Cowboy/cowgirl attire for “Western Night” Nautical, bright or beach wear for “Water World” Holiday attire (red and green) for “Christmas Countdown” Swimwear and your favorite team jersey for “Pump It Up” Your favorite creative costume for “Masquerade” 6. “Hip” clothes for “Planet Ozark” 7. Disney (including Pixar!) clothing for “Escape to Neverland” 8. Red, White and/or Blue Clothes for “RWB Day” 9. “Techno” clothes (neon, etc) or Super Hero gear for “Super Smash Bash” 10. 70’s or Disco costume for “Disco Daze” 11. Fatigue shirt or camouflage for “Mission Impossible” All items/belongings should be brought in a footlocker or duffel-type bag due to cabin space. The footlocker should not be more than 15 inches tall. Other items your camper may wish to bring are optional. Although all necessary equipment for camp activities is provided, campers may bring personal equipment such as ball gloves, cameras, tennis racquets, musical instruments, skateboards, fishing poles, etc. if they so choose. For safety and security purposes, it is required that certain items be stored in a locked equipment storage facility when not in use. Expensive watches or cameras should not be brought. Cell Phones, MP3 or other music players, video cameras, radios, laptops, video games and other similar electronic items are NOT ALLOWED. IF THESE ITEMS ARE BROUGHT TO CAMP, THEY WILL BE TAKEN UP AND HELD IN THE OFFICE UNTIL CLOSING DAY. FIREWORKS, GUNS, AMMUNITION AND KNIVES ARE NOT ALLOWED. FOOD, GUM, CANDY, WATER BALLOONS OR SILLY STRING MUST NOT BE SENT OR BROUGHT TO CAMP. Pets or animals of any kind may not be brought to camp. In order to assure safety and security, Camp Ozark reserves the right to search all personal belongings at any time. Camp Ozark is not responsible for the theft or damage to any personal property. IMPORTANT ***EVERY ITEM THAT YOUR CAMPER BRINGS TO CAMP MUST BE MARKED WITH THEIR FIRST AND LAST NAME. THIS INCLUDES SOCKS, WASH CLOTHS, ETC. EVERYTHING PLEASE!!!! ***CAMP OZARK IS NOT RESPONSIBLE FOR LOST, DAMAGED OR STOLEN PROPERTY. CLOSING DAY We strongly encourage every parent to attend Closing Ceremonies on the last day of your camper’s session. The program begins at 10:00 a.m. (Sessions 1/2/3/4/5 and B/D/E) or 11:00 a.m. (Sessions A/C/E) on closing Saturday morning. There is a special picnic lunch at 11:30 a.m. with your camper’s cabin and counselors ($7.50 per person, advance reservations, please.) NOTE: There is no special picnic lunch for Session A, C or E. HOTEL ACCOMMODATIONS There are many places to stay near Camp Ozark. We suggest that you make your reservations well in advance. First class hotel facilities are available in Hot Springs, Arkansas, 40 miles east of Camp Ozark. In addition, there are several nice lodging, cabin and camping options within 20-30 minutes of Camp Ozark. For more information, refer to the lodging list found at www.campozark.com. Click on “For Parents >> Preparation & Travel Guide.” You may also visit the Chamber of Commerce websites for Mt. Ida (www.mtidachamber.com) and Hot Springs (www.hotspringschamber.com), or any online travel review guide, such as Trip Advisor (www.tripadvisor.com). CAMP OZARK HEALTH INFORMATION (Contains New Policies, Read Carefully) Attached hereto, you will find a CAMP OZARK HEALTH CARD and MEDICATION PACKET. These are the single most important pieces of information that you will provide Camp Ozark in reference to your child. Please take these seriously. Only by your supplying us with ALL of the information required can we best serve your child’s health interests. Please read, understand and comply with all of the instructions and directives listed below regarding completion of the CAMP OZARK HEALTH CARD AND MEDICATION PACKET. INSTRUCTIONS AND DIRECTIVES In conjunction with your physician: 1. Complete the attached HEALTH CARD in its entirety. 2. Upon completion of the HEALTH CARD, make sure that you SIGN THE PARENT’S AUTHORIZATION. NO CHILD WILL BE ACCEPTED FOR ATTENDANCE WITHOUT A COMPLETED, SIGNED HEALTH FORM. (Due no later than April 1st, 2011.) 3. Contact your Insurance company to determine which Hot Springs, AR, hospital (St. Joseph’s Mercy Health Center or National Park Medical Center) is part of your Insurance Company’s network. In case of emergency, your child will be taken to the hospital you designate on the Health Form. 4. OZARK MEDICATION PACKET Any camper who is required to take medication of any kind, prescription or non-prescription, while at Camp Ozark must complete the MEDICATION AND PHARMACY FORM contained within the OZARK MEDICATION PACKET (unless sending your medications directly to Camp Ozark – see Option 1 below.) Due no later than May 1st, 2011. Exceptions a. If injectable medication or inhalers are needed for any acute reaction or condition, such as medication given for allergies, asthma, insect bites or stings, growth hormones, hemophilia, etc., it must be accompanied by a physician’s written authorization as well as the parent’s written requests. Such injectable or aerosol medication should be delivered to Camp Ozark at the time of check-in and must be accompanied by a physician’s authorization and parent’s written request. b. REGULAR ALLERGY INJECTIONS may be delivered directly to Camp Ozark at the time of check-in and must be accompanied by a physician’s written authorization and instructions, explaining specific dosages, required observation time, if any, and possible or potential side effects or reactions. Please provide syringes. OZARK MEDICATION INFORMATION During the summer, Camp Ozark will facilitate the mandatory service of pre-packing campers’ medications in preparation for camp. All pills/capsules (prescription and non-prescription) taken on a routine basis will be individually packaged and sorted according to day and time of administration. If prescription medication is not in pill/capsule form (liquids, eye drops, topical, etc.) they will also be dispensed as indicated. All medication must be delivered to camp before the camper’s arrival. No medications will be allowed to be brought to camp. A $40 handling fee will be charged if medications are brought to camp that are not exceptions (as detailed above). Medications may be delivered to camp using one of the following options: Option 1 Send all routine and PRN medications (in their original container) that your child will require while at camp to Camp Ozark by May 1st, 2011. Please send the exact quantity for your camper’s length of stay. Dispensation instructions must be clear and unambiguous. Please include packaging/shipping/handling fee of $20, made payable to Camp Ozark. This fee may be included on the Fee Summary form (Miscellaneous Fees) or included with your medications. Option 2 Order all routine medications that your child will require at camp using our partner/provider pharmacy according to the following procedure. Please include packaging/shipping/handling fee of $20, made payable to Camp Ozark. This fee may be included on the Fee Summary form (Miscellaneous Fees) or included with your medications. Complete the attached Medication and Pharmacy Form and return it to Camp Ozark no later than May 1 st, 2011. 1. Attach a copy of your insurance card, front and back, to the Medication Order Form. 2. Original prescriptions must be sent to Camp Ozark no later than May 1st, 2011, attention to the Ozark Meds File. 3. Camp Ozark will send the partner pharmacy all of the camper’s original prescriptions. Make sure the prescriptions are written exactly as they are to be filled and dispensed; please review all prescriptions you submit. (OVER) Option 2 (cont.) 4. Non-prescription medications and PRN medications that your child will require while at camp must be pre-ordered through the pharmacy or sent to Camp Ozark (in their original container) by May 1st, 2011. If sent to Camp Ozark, you will need to provide a physician’s authorization or clear administration directions written by the parent, as well as the exact quantity for your camper’s length of stay. 5. Approximately two-weeks prior to your camper(s) session, you will receive a medication verification report, asking you to review the medications on file for your camper(s). You will be asked to report any changes directly to Camp Ozark at 870-867-4131, or april@campozark.com. Medicap Pharmacy in Conroe, Texas is the partner/provider for this prescription medication service. Medicap accepts the vast majority of insurance plans. They will verify insurance and then bill for prescription medication. However, parents/guardians will be responsible for co-payments and deductibles, and the cost of any medication not covered by their insurance plan. The pharmacy will bill these charges to the responsible party’s credit card. If the pharmacy is not a provider and is unable to get reimbursed, the parent/guardian will be notified prior to billing. PURPOSE The purpose of the prepackaged medication program is as follows: Eliminate the necessity of children handling and delivering medication Reduce the possibility of medication administration errors Reduce the risk of lost or misplaced medications Medications are ready for dispensation when campers arrive CHECKLIST Option 1 ___ Send all medications (with exact quantity) to Camp Ozark no later than May 1st, 2011. ___ Include physician’s authorization or clear and unambiguous dispensation instructions. ___ Include packaging/shipping/handling fee of $20, made payable to Camp Ozark. Option 2 ___ Obtain original prescriptions for all medications. ___ Make sure prescriptions are written so as to detail exactly how and when your child takes the medication. ___ Attach all original prescriptions to the Camp Ozark 2011 Medication and Pharmacy Form and return by May 1st, 2011. ___ For non-prescription meds/vitamins, a physician’s authorization or clear administration directions written by parent is required. These medications must be sent to Camp Ozark by May 1st, 2011 or ordered by using the Camp Ozark 2011 Medication and Pharmacy Form no later than May 1st, 2011. ___ Include packaging/shipping/handling fee of $20, made payable to Camp Ozark. FREQUENTLY ASKED QUESTIONS 1. Exactly which medications are required to be ordered/administered/delivered using this system? All medication. The only exceptions are injectable medications or inhalers. Injectable medications or inhalers may be brought to Camp Ozark and checked in at the Health Center. 2. If using Option 2, how can Camp Ozark’s partner pharmacy send the medication in advance and bill my insurance? We do not bill the insurance until the day your child begins camp, even though the medications are sent to camp prior to their arrival. 3. If using Option 2, will I pay the same for non-prescription medication? The pharmacy is competitive in pricing; however, there is no way to know if the cost will be exactly the same. 4. What if the prescription changes? Two weeks prior to your camper’s session you will receive a medication verification report asking to verify medications. Please contact Camp Ozark with the updated information at 870-867-4131 or april@campozark.com 5. What is the packaging fee? A $20 fee is charged for the individual packaging and labeling of camper medication by a pharmacist, as well as associated shipping and handling costs. 6. What if I need to contact the partner pharmacy with a question? You may contact the partner pharmacy at 936-494-4002 or stevecindyoatman@juno.com. 2011 CAMPER NAME LAST FIRST Camp Ozark Office Use Only Session Cabin # Temp HV Comments CAMP OZARK HEALTH CARD 155 Camp Ozark Drive, Mt. Ida, AR 71957 Ph. (870) 867-4131 · Fax (870) 867-4344 THIS SIDE TO BE FILLED OUT BY PARENT AND CHECKED WITH PHYSICIAN AT TIME OF EXAMINATION Camper’s Name ___________________________________________ SS# _____________________ Birth Date ____________ Sex ____ Age ______ Mother’s Name ____________________________________________________________ Phone (H) ________________________________________ Home Address _____________________________________________________________ (W) _______________________________________ City ________________________________________ State __________ Zip ___________ (Cell) ______________________________________ Father’s Name _____________________________________________________________ Phone (H) ________________________________________ Home Address _____________________________________________________________ (W) _______________________________________ City ________________________________________ State __________ Zip ___________ (Cell) ______________________________________ If parents are not married to each other, please indicate who has legal custody: Mother ___________ Father __________ Joint _______ If parents cannot be reached in the event of an emergency, please notify: Name _____________________________________________ Phone (H) ________________________________ (W) ___________________________ Address __________________________________________________________________ (Cell) ______________________________________ **INSURANCE INFORMATION (MANDATORY) (Complete information below and attach a copy of both sides of health insurance card) □ Please check the box if you have no health insurance. Hospitalization Insurance Co. ___________________________________________________________ Policy I.D. # ____________________________ Ins. Co. Address ______________________________________________________________________ Phone _________________________________ Group # ______________________________________________________ Member ID # __________________________________________________ Primary Insured Name ________________________Primary Insured’s SS# _____________________ Relationship to Camper______________________ **PRESCRIPTION INFORMATION (MANDATORY IF SEPARATE PROVIDER): (Complete information below and attach a copy of pharmacy insurance card) Prescription Insurance Co. __________________________________________ Policy I.D. # ________________________ Rx PCN # ___________________________ Rx Group # __________________ Rx Bin # _____________ Help Desk Phone ___________________ The following hospital is my preferred “in-network” healthcare provider in Hot Springs in case of emergency (check one): □ St. Joseph’s Mercy Health Center or □ National Park Medical Center HEALTH HISTORY (Check and give approximate dates) * Asthma _____________________________________________ * Drug Allergies ____________________________________________________ * Behavior Issues________________________________________ * Food Allergies ____________________________________________________ * Seizures Disorder ______________________________________ * Insect Allergies ____________________________________________________ * Concussion(s) □ Yes □ No If so, how many?_____________ NOTE: SEE WWW.CAMPOZARK.COM FOR ALLERGY FORM * Other _____________________________________________________________________________________________________________________ Surgery or Serious Injuries (Dates) _____________________________________________________________________________________________ __________________________________________________________________________________________________________________________ Chronic or Recurring Illness ___________________________________________________________________________________________________ * Treatment prescribed for conditions above (please be specific) _______________________________________________________________________ _________________________________________________________________________________________________________________________ IMMUNIZATION HISTORY Required immunizations must be determined locally. This is a record of basic immunizations and most recent booster doses. DTaP Date ______________________________________________ Pneumococcal Date _______________________________________________ Hepatitis A Date __________________________________________ Polio Date ______________________________________________________ Hepatitis B Date __________________________________________ **Tetanus (TDaP) Booster Date______________________________________ Hib Date ________________________________________________ Varicella Vaccine Date ______________ or Chicken Pox Date ____________ Menactra (MCV)(Optional) Date _______________________________ Seasonal Flu Shot Date ______________ H1N1 Flu Shot Date ____________ MMR Date ______________________________________________ Other_____________________________________________________________________________________________________________________ ** Must be current within last 10 years. Please notify the camp if this camper is exposed to any communicable disease during the THREE WEEKS PRIOR TO CAMP ATTENDANCE. (Chicken Pox, Measles, Mumps, Flu, etc.) ATTENTION PARENTS: NO CHILD WILL BE ACCEPTED FOR ATTENDANCE WITHOUT A SIGNED HEALTH FORM PARENT’S AUTHORIZATION: I hereby give my permission to the medical personnel selected by Camp Ozark to provide routine healthcare, to administer medications, both over the counter and prescription, to order X-rays and routine tests, to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child named on this form. In addition, I authorize Camp Ozark or its designees to provide or arrange necessary related transportation for my child. In addition, I authorize the release of all records, X-rays, notes and any other medical information to Camp Ozark or its designees. If my health insurance is not accepted by local providers, for any reason, I will be fully responsible for payment. Parent’s Signature _________________________________________________ Session(s) this camper will be attending (circle all that apply): 1 st 2nd Date _________________________ 3rd 4th 5th | A B C PLEASE RETURN THIS FORM BY APRIL 1, 2011 (OVER) D E F | G H I J CAMPER NAME ______________________________________________ LAST FIRST 2011 ESSENTIAL FUNCTIONS OF A CAMP OZARK CAMPER A successful camper must be able to, above all, function independently in a remote, rustic (with no air conditioning) atmosphere for a one-week to four-week time period. The Camp Ozark program is very active and physically challenging for campers. Daily activities include one hour every day of rigorous (often involving physical contact) team competition, and three hours of group activities, some of which require physical stamina and most of which are conducted outdoors. All swimming is in a spring fed lake with limited visibility. If a camper has a seizure disorder, he/she must wear a life jacket. If a chronic medical condition exists, the campers must be capable of “self-management.” If the camper appears to have any serious behavioral issues or special circumstances involving physical or psychological handicaps, the Camp Director should be notified of this NOW because children who do not have the promise of living cooperatively with other children or safely within our environment cannot be accepted. Full disclosure of such issues or circumstances is required. The existence of a “limiting” condition does not necessarily exclude a child from acceptance into the Ozark program, however, a failure to disclose such a condition will result in automatic dismissal of the camper with no refund of tuition once the condition is brought to light. Does this camper ever exhibit any physical, mental, emotional, psychological or behavioral traits that could prevent him/her from living cooperatively with others? □ Yes □ No If yes, please explain: Are there any issues or circumstances that would prevent him/her from functioning independently and safely according to the essential functions? □ Yes □ No If yes, please explain: HEALTH SCREENING – TO BE FILLED OUT BY LICENSED PHYSICIAN This examination should be performed within twelve months of arrival at Camp Ozark. Examination for any purposes within this period is acceptable; however this Camp Ozark health form must be completed by a physician. School or athletic forms are not acceptable. Examination is for determining fitness to engage in strenuous activities. CODE: √ Satisfactory X Not Satisfactory (explain) O Not Examined Height __________ Weight ____________ Blood Pressure ______________ Hemoglobin (optional) ______________ Urinalysis (optional) __________ Eyes ____________________________________________ Extremities _________________________________________________________ Glasses _________________________________________ Posture (spine) ______________________________________________________ Ears ____________________________________________ Skin _______________________________________________________________ Nose ___________________________________________ Allergy: Please specify and note on front of health form in appropriate location. Throat __________________________________________ ___________________________________________________________________ Teeth ___________________________________________ ___________________________________________________________________ Heart ___________________________________________ General Appraisal ____________________________________________________ Lungs ___________________________________________ ___________________________________________________________________ Abdomen ________________________________________ ___________________________________________________________________ Hernia ___________________________________________ ___________________________________________________________________ (For girls and women) Has this person menstruated? ________________________ If not, has she been told about it? __________________________ If so, is her menstrual history normal? ___________________________________ Special considerations ______________________________________ ___________________________________________________________________________________________________________________________ RECOMMENDATIONS AND RESTRICTIONS WHILE IN CAMP ________________________________________________________________ ___________________________________________________________________________________________________________________________ Swimming, diving ___________________________________________________________________________________________________________ Strenuous activity ____________________________________________________________________________________________________________ I have examined this person herein described and have reviewed his/her health history. It is my opinion that he/she is physically able to engage in camp activities except as noted above. Examining Physician ____________________________________________ M.D. Date __________________ Telephone_________________________ Print Name of Physician ____________________________________________ Email____________________________________________________ Address ______________________________________________________ City/State/Zip _____________________________________________ PARENTS: PLEASE COMPLETE THIS SECTION Dietary Restrictions __________________________________________________________________________________________________________ (Please notify Camp Ozark in writing, in advance, of any major dietary restrictions which require special menu adjustments. Camp Ozark is unable to guarantee that all requests can be met. Each case is considered on an individual basis.) Other Restrictions ____________________________________________________________________________________________________________ List any medications that your child will be taking at camp. You must notify Camp Ozark in writing if there are any changes after this form is returned. Name Dosage Frequency Reason for Taking 1. ________________________________________________________________________________________________________________________ 2. ________________________________________________________________________________________________________________________ 3. ________________________________________________________________________________________________________________________ 4. _________________________________________________________________________________________________________________________ NOTE: If you have listed any medications in the above space, PLEASE COMPLY WITH THE INSTRUCTIONS DETAILED IN THE CAMP OZARK HEALTH INFORMATION FORM. CAMP OZARK MEDICATION Doctor’s Information (Option 2 only) Dear Doctor, Camp Ozark offers families the option of pre-ordering and pre-packaging all camper prescription and over-the-counter camp medications. Medications that are in pill form will be packaged in personalized dosage packets for safer and easier dispensing at camp. All medications will be clearly labeled with the camper name, the name of the medication(s), and dispensing instructions. All medications will be filled in length of stay intervals (6, 13, 20 or 27 days) as a vacation supplement. Please write your prescription accordingly. Parents will need to mail all camper original prescriptions to Camp Ozark by May 1st, 2011 in order to have them filled and shipped directly to camp before the camp session begins. INSTRUCTIONS FOR WRITING CAMPER PRESCRIPTIONS: NON-CONTROLLED MEDICATIONS You may write a length of supply (6, 13, 20 or 27 days). Please verify the patient’s correct length of stay. CONTROLLED MEDICATIONS All Schedule II medications will be filled through Mt. Ida Pharmacy in Mt. Ida, Arkansas. Arkansas law allows these prescriptions to be filled any time within 6 months of the date they are written. Thank you for your help. If you have any questions, please contact: Steve Oatman, Medicap Pharmacy 936-494-4002 or stevecindyoatman@juno.com 2011 Medication and Pharmacy Form (Option 2 only) (Do not complete this form if you are sending all necessary medications to Camp Ozark [Option 1]) 1. 2. 3. 4. Please complete the entire form if using Option 2. Attach all prescription(s), a copy (front & back) of your insurance card, and a copy of your prescription card (if you have one). Include $20 shipping/packaging/handling fee. Please make check payable to “Camp Ozark.” Mail to: Camp Ozark, 155 Camp Ozark Drive, Mt. Ida, AR 71957 CAMPER NAME: ______________________________________________ CAMPER DOB (MM/DD/YY): __________________________ PARENT/GUARDIAN NAME: ________________________________________________________________________________________ HOME ADDRESS: ______________________________________ CITY, STATE, ZIP: ___________________________________________ PRIMARY CONTACT NUMBER: __________________________ CELL PHONE NUMBER: _____________________________________ EMAIL: _______________________________________________ ALLERGIES: (please circle one) NO YES If yes, please list: ___________________________________________________________________________________________________________________ PRESCRIPTION MEDICATION ARE YOU ATTACHING PRESCRIPTION(S)? (please circle one) YES NO If yes, how many? _______________ PLEASE NOTE: Prescription medications will be filled and dispensed exactly as written by your doctor. Please review ALL prescriptions you submit. Medications will be administered at meal times and bedtime unless prescribed otherwise by your physician. Medications written to be taken “daily” will be administered in the morning. OVER-THE-COUNTER MEDICATION PARENTS: Please complete the following section ONLY if your child takes over-the-counter (OTC) medications on a regular basis. Camp Ozark maintains a supply of certain common OTC medications that can be dispensed on an as needed basis. Please email april@campozark.com to request a complete list of OTC medications supplied by Camp Ozark. OVER THE COUNTER MEDICATIONS TO BE FILLED BY PHARMACY (those taken on a regular basis) NAME OF PRODUCT (please include specific brand) EXACT DOSAGE AMOUNT EXAMPLE: Claritin Reditabs 10mg/1 pill TIME OF DOSE 8:00 AM All medications will generally be dispensed at mealtimes and bedtime unless otherwise specified by you. INSURANCE AND PAYMENT INFORMATION INSURANCE INFORMATION: Please attach a copy (front and back) of your insurance card and prescription card. CREDIT CARD INFORMATION FOR CO-PAYMENTS AND OTC MEDICATIONS: Please circle which one applies: Visa MasterCard American Express Discover Credit Card Number: ____________________________________ Exp. Date: ____________ Security Code: _______ Name as it appears on card:_________________________________________________________________________ I acknowledge responsibility for the cost of any medicine not covered by my insurance company, for any medication the pharmacy cannot get reimbursed for, as well as any co-payments and deductibles, which I agree will be billed directly to my credit card by the pharmacy. I agree to authorize the pharmacy to contact my insurance company for insurance verification, billing and collections for my child’s medications. Our licensed pharmacy is HIPPA compliant and all personal information received will be solely maintained for the purposes of dispensing prescriptions and insurance collection. Signature of Guarantor: _________________________________________________________________________________ TRAVEL CARD NAME: ________________________________ SESSION: _____________________________ BOY ____________ PARENT’S PHONE: ____________________ GIRL ______________ TRAVEL TO CAMP OZARK (PLEASE CONTACT THE CAMP OZARK OFFICE IF THE FOLLOWING TRAVEL PLANS CHANGE) Check Appropriate Box(es): Camper will travel to Camp by private automobile arriving at Camp no earlier than 1:00 p.m. on Opening Day. (Please don’t arrive earlier than 1:00 p.m. We are unable to begin processing campers prior to that time.) Arrival time may be slightly different for Sessions B, D, F. This information will be provided 2 weeks prior to the start of the camp session. NOTE: Campers may not drive to Camp unaccompanied without prior written consent by Camp Ozark. If a camper is allowed to drive to Camp Ozark, his/her vehicle will be off-limits during the camper’s entire stay at Camp Ozark, including between sessions for multi-session campers. Camper will travel to Camp by commercial airline. Flight must be arranged to arrive in Little Rock between 10:00 a.m. and 1:00 p.m. Opening Day. Camper will be met in Little Rock by a member of the Camp Ozark Staff and transported to Camp. I understand there is a $50.00 charge for this service, one way, including a box lunch. TICKETLESS TRAVEL IS STRONGLY RECOMMENDED. Camper Airline Schedule to Little Rock (if applicable): Scheduled Arrival Date: ____________________ Flight Number: ________________________________________ Scheduled Arrival Time: ____________________ Departure City: ________________________________________ Airline: ____________________________________ Connecting City (if applicable): ____________________________ * Camp Ozark staff members accompany campers on specifically designated commercial flights from Houston and Dallas. Please consult our web site at www.campozark.com for flight details (click “Forms,” located at the top of the page, then “Campers Currently Enrolled”). Camper will travel to Camp Ozark by private aircraft, landing at the Mt. Ida Airport (Bearce), 15 miles from Camp Ozark. Camp Ozark will provide round-trip shuttle service between the Mt. Ida Airport and Camp Ozark. I understand there is a $50 fee for this service. Shuttles between Camp Ozark and the Mt. Ida Airport will begin at 1:00 p.m. and continue through the day. Please notify us when you arrive at the airport. Camper will travel to Camp by chartered bus. Fee for this service varies from city to city and is itemized next to each city listed below. Houston – (Post Oak) ($95.00) New Orleans/Metairie ($95.00) Buses from these cities provided when Houston – North Park Exit (59N) ($95.00) Baton Rouge ($95.00) demand is sufficient.* Dallas ($75.00) Lafayette ($95.00) Memphis ($75.00) Nacogdoches ($95.00) Alexandria ($95.00) Hattiesburg ($95.00) Marshall ($95.00) Shreveport ($95.00) Jackson ($95.00) Texarkana ($75.00) Vicksburg ($95.00) Little Rock ($50.00) Tallulah ($95.00) Oklahoma City ($75.00) I understand that complete information regarding time and place of bus departure will be forwarded to me two weeks prior to my camper’s session date. I also understand that bus reservations are made on a first come, first served basis by return of the Camp Ozark Travel Card and the appropriate one-way bus fare. *NOTE: In cities where demand varies, cost may be higher than the listed fee. Parents will be notified two weeks prior to the camper’s session date if demand from these areas is insufficient, in which case bus fees will be returned and alternate transportation methods will need to be arranged. Camper will travel to Camp by the following other method: _______________________________________________________________________________ PLEASE ENCLOSE ALL APPLICABLE TRAVEL FEES WHEN RETURNING TRAVEL CARDS. PLEASE RETURN NO LATER THAN APRIL 1st, 2011. (OVER) NAME: ________________________________ SESSION: _____________________________ BOY __________ PARENT’S PHONE: ____________________ GIRL _____________ TRAVEL FROM CAMP OZARK (PLEASE CONTACT THE CAMP OZARK OFFICE IF THE FOLLOWING TRAVEL PLANS CHANGE) The Closing Ceremony at Camp Ozark is held at 10:00 a.m. on the last Saturday of each session. The Closing Ceremony schedule for sessions A, C and E may be different. This information will be provided 2 weeks prior to the start of the camp session. Following the ceremony an optional picnic luncheon is served. We strongly encourage all parents to personally pick their camper up at Camp; however, we realize this is not always possible. Check Appropriate Box(es): Camper will be met at Camp by parents and family. We plan to stay for lunch. __________ persons at $7.50 per person (camper excluded). NOTE: Due to ongoing camp activities, the picnic luncheon will not be served for Sessions A, C or E. We will be unable to stay for lunch. Camper will return home by private airplane. Camp Ozark will provide round-trip shuttle service between Camp Ozark and the Mt. Ida Airport. I understand there is a $50.00 fee for this service. Choose one of the following: We will arrive at the Mt. Ida Airport before 8:15 a.m. in order to ride the 8:30 shuttle from the airport to Camp Ozark. We will arrive at the Mt. Ida Airport before 9:15 a.m. in order to ride the 9:30 shuttle from the airport to Camp Ozark. Choose one of the following: We will ride the 11:00 a.m. shuttle back to the airport (departs immediately following the Closing Day Ceremony.) We will ride the 12:00 p.m. shuttle back to the airport (choose this option if you plan on attending the Closing Day picnic.) Camper will be met at Camp by someone other than legal guardian. I hereby give my permission for _________________________________________________ (camper’s name) to return from Camp Ozark with ________________________________________________ (person’s name) and release Camp Ozark from all liability with reference thereto. __________________________________________ Signature of Legal Guardian Camper will return home via commercial airline. Camper will need to be transported to Little Rock and personally placed on a flight. I understand there is a $50.00 fee for this service, one way. TICKETLESS TRAVEL IS STRONGLY RECOMMENDED. NOTE: Some airlines may charge an “unaccompanied minor” and/or a “checked baggage” fee. In such cases, if the fee has not been previously paid, Camp Ozark will pay said fee and parents will be notified of a balance due. Please provide Camp Ozark with a receipt copy of any pre-paid fees. Camper Airline Schedule (Little Rock to home): Flight must depart between 3:00 p.m. and 6:00 p.m. Scheduled Departure Date: ____________________ Flight Number: ________ Confirmation #: _________________ Scheduled Departure Time: ____________________ Final Destination: ______________________________________ Airline: ____________________________________ Connecting City (if applicable): ____________________________ * Camp Ozark staff members accompany campers on specifically designated commercial flights from Houston and Dallas. Please consult our web site at www.campozark.com for flight details (click “Forms,” located at the top of the page, then “Campers Currently Enrolled”). Camper will return home by chartered bus. Fee for this service varies from city to city and is itemized next to each city listed below. Houston – (Post Oak) ($95.00) New Orleans/Metairie ($95.00) Buses to these cities provided when Houston – North Park Exit (59N) ($95.00) Baton Rouge ($95.00) demand is sufficient.* Dallas ($75.00) Lafayette ($95.00) Memphis ($75.00) Nacogdoches ($95.00) Alexandria ($95.00) Hattiesburg ($95.00) Marshall ($95.00) Shreveport ($95.00) Jackson ($95.00) Texarkana ($75.00) Vicksburg ($95.00) Little Rock ($50.00) Tallulah ($95.00) Oklahoma City ($75.00) I understand that complete information regarding time and place of bus arrival will be forwarded to me two weeks prior to my camper’s session date. I also understand that bus reservations are made on a first come, first served basis by return of the Camp Ozark Travel Card and the appropriate one-way bus fare. *NOTE: In cities where demand varies, cost may be higher than the listed fee. Parents will be notified two weeks prior to the camper’s session date if demand from these areas is insufficient, in which case bus fees will be returned and alternate transportation methods will need to be arranged. Camper will return from Camp by the following other method: _________________________________________________________ INCOMPARABLE CAMP OZARK CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY (Requires Signature of Parents or Guardian) To Parents and Guardians of Campers: Following are the CAMPER POLICY AGREEMENT regarding general and specific issues concerning your child(ren) (hereinafter referred to as “Camper”), ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY. Please read these policies and agreements carefully. Please feel free to call Camp Ozark and discuss these policies and agreements or any issues or questions you have regarding these policies and agreements. When you have read and understood the following policies and agreements, please sign both copies of the “CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY” indicating your understanding of said policies and agreements, and your agreement to abide by them with regard to your Camper and yourself, and return one signed copy of all policies and agreements to Camp Ozark no later than the assigned deadline. If you have multiple children attending Camp Ozark, you may sign one copy of all policies and agreements for all of your children. We hope that by reading and understanding these policies and agreements the result will be to help ensure a smooth and satisfactory experience for your Camper at Incomparable Camp Ozark. AN UNALTERED, SIGNED “CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY” IS A REQUIREMENT FOR ATTENDANCE AT CAMP OZARK. THESE POLICIES AND AGREEMENTS MUST BE SIGNED BY BOTH PARENTS OR THE CHILD’S LEGAL GUARDIAN (BOTH REFERRED TO AS “PARENT”). NO CHILD CAN BE ADMITTED TO CAMP OZARK WITHOUT A SIGNED “CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY” ON FILE. CAMPER POLICY AGREEMENT ADMINISTRATIVE ISSUES 1. Applications A fully completed application is a requirement for attendance at Camp Ozark. While the registration deposit is sufficient to reserve a space in a session, the fully completed application is required for final processing. Applications need to be returned, fully completed, to Camp Ozark prior to April 1st, 2011. Final processing, including camper scheduling, cannot be completed without a fully completed application. Returning campers may complete the “Summary Application” furnished by Camp Ozark in lieu of the full application. All new campers must complete the full application. 2. Deposit Requirements/Cancellations/Deposit Refunds/Tuition Refunds Deposits are required for each camper and for each session to be attended. (For example, if two (2) children from the same family are each attending two (2) sessions, a $900.00 deposit is required.) If cancellations are made after February 1st, 2011, deposits are forfeited. If you cancel after February 1st, 2011 and your camper has never been enrolled in a session for 2011 but remains on the waiting list, your deposit is refundable up until the beginning date of the session for which you are wait-listed. The $25.00 registration fee is non-refundable. If your cancellation is made prior to three (3) weeks (21 calendar days) preceding the session to which you are assigned, you are not liable for the remaining tuition. Cancellations made within the three (3) weeks immediately preceding the session to which you are assigned will result in a forfeiture of tuition. Partial tuition refunds for cancellations due to medical issues are considered on a case-by-case basis. 3. Fee Payment All fees are due and payable to Camp Ozark on or before April 1st, 2011. Should you, for any reason, be unable to complete fee payment by April 1st, 2011, alternate arrangements may be made through the Camp Ozark office. After April 1st, 2011, all enrollments are subject to possible cancellation unless fees have been paid in full, or unless alternate arrangements have been made with Camp Ozark. NON-ADMINISTRATIVE ISSUES 1. Cabin Requests Upon acceptance of a camper’s application, he or she is placed in the proper grouping and cabin according to age, development and school grade. Every effort is made to place campers according to their cabin preference, but final placement is at the sole discretion of the Camp Director. Campers may request to be placed in the same cabin with up to two (2) others campers. All such requests must be made in writing and must be made by both campers. Requested cabin mates must be no more than 12 months apart in age. No more than four (4) campers from the same school group or social group will be placed in the same cabin. Final cabin placement is at the sole discretion of Camp Ozark. In order to be considered, cabin requests must be received no later than two (2) weeks prior to the start of the appropriate session. 2. Telephone Calls Campers are not allowed to bring cell phones to camp, nor are campers allowed to receive or make telephone calls while in attendance at Camp Ozark. Please feel free to call the Camp Mom or a Camp Director if you need to discuss anything relating to your child. (OVER) 3. Visitors Campers are not allowed to receive or have visitors while in attendance at Camp Ozark. There are no exceptions to this policy except in the case of serious illness or death of a family member or other extenuating circumstances. Such exceptions are allowed at the sole discretion of Camp Ozark and must be cleared in advance with Camp Ozark. 4. Attendance Campers must be in attendance during the entire camp session. Campers are not allowed to come and go during a session. Campers are required to arrive on Opening Day and are not permitted to leave prior to Closing Day of the camp session. Exceptions are allowed at the sole discretion of the Camp Director and must be cleared in advance. Camp Ozark reserves the right to not allow campers that leave early to return in future years. 5. E-mails/Faxes Campers are allowed to receive faxes and/or e-mail messages. There is a charge per event for this service. Prepaid unlimited email packages are available through the Camp Ozark store. 6. Food Packages Candy, food and gum are not allowed to be brought or sent to Camp Ozark. All such items will be confiscated and discarded. They will not be returned. 7. Code of Conduct By my signature below, I agree that my camper(s) and I have read, understand and agree to abide by the Camp Ozark Code of Conduct. I also understand that if the Code of Conduct is violated, appropriate consequences such as those enumerated therein, may be enforced. 8. Controlled Substances Alcohol, tobacco or illegal drugs are not allowed at Camp Ozark. Possession or use of any of these substances will result in immediate termination of the camper’s enrollment and the camper will be sent home immediately. 9. Use of Visual Images By my signature below, I hereby give Camp Ozark permission to make visual images (such as photographs or videos) of my child and to use such visual images for display on the Camp Ozark website, in marketing materials or in Camp Ozark videos, and I hereby release Camp Ozark from any and all liability related thereto. 10. Internet Related Policies Camp Ozark views social networking sites (e.g., Facebook, MySpace), personal Web sites, and Web logs positively and respects the right of campers to use them as a medium of self-expression. If a camper chooses to identify himself or herself as a camper of Camp Ozark on these sites, some readers may view the camper as a representative of Camp Ozark. Camp Ozark requires that campers and their families observe the following guidelines when referring to Camp Ozark, its programs or activities, its campers, and/or employees, on these Internet sites. a. b. c. d. e. f. g. Campers must be respectful in all communications and blogs related to or referencing Camp Ozark, its campers, and/or employees. Campers must not use obscenities, profanity, or vulgar language. Campers must not use these sites to disparage Camp Ozark, campers, or employees of Camp Ozark. Campers must not use these sites to harass, bully, or intimidate other campers or employees. Behaviors that constitute harassment and bullying include, but are not limited to, comments that are derogatory with respect to race, religion, gender, sexual orientation, color, or disability; sexually suggestive, humiliating, or demeaning comments; and threats to stalk, haze, or physically injure another camper or employee. Campers must not use these sites to discuss engaging in conduct that is prohibited by Camp Ozark policies, including, but not limited to, the use of alcohol and drugs, sexual behavior, sexual harassment, and bullying. Campers must not post inappropriate pictures of campers or staff members. This category includes, but is not limited to, pictures of campers participating in activities that violate Camp Ozark policy (e.g., alcohol, drugs, and/or sexual behavior), and pictures of campers who are not clothed or partially clothed. Camp Ozark does not host or sponsor a social networking site. The use of our copyrighted camp name or logo is not allowed without written permission. HEALTH AND MEDICAL ISSUES AND RELEASE 1. Health Forms Health Forms and Health Screenings are required of all Ozark Campers. These forms must be returned on or before the assigned deadline. All medications must be ordered using one of the two provided options (see “Health Information”). The “Parent’s Authorization to provide healthcare” section of the Health Form must be signed by a parent or legal guardian. 2. Admittance Campers will not be admitted to Camp Ozark on Opening Day if they are suffering from a fever, contagious disease or other illness or symptoms that might negatively affect the general Camp Ozark population. Should such conditions arise, parents or guardians agree to contact Camp Ozark prior to the child’s arrival at Camp Ozark to discuss alternate arrangements and/or late arrival possibilities. Should such condition not be detected until the arrival of the child at Camp Ozark, by my signature below, I understand and agree that alternate arrangements may need to be made at my expense. Denial of admittance to Camp Ozark based on health issues is at the sole discretion of the Camp Ozark Medical Staff. 3. Injury/Illness Should your child become ill or injured while at Camp Ozark, parents will be notified if, at the sole discretion of the Camp Ozark Medical Staff, such notification is necessary. Notification is usually reserved for emergency situations. If at any time you have a question or concern regarding the health status or safety of your child, please feel free to contact Camp Ozark. We will be happy to discuss said issue with you. 4. Medical Bills The Mandatory Camper Insurance Policy is a no fault, no deductible medical payments policy which covers all medical, x-ray and/or prescription drug expenses up to $2,500.00 should your camper require medical attention while at Camp Ozark. The policy provides primary coverage up to, and including, $50.00 in expenses. After $50.00 the policy is secondary and pays all expenses not covered by your primary health care policy up to $2,500.00 after your primary policy deductible has been met. This policy is required of all campers. ALL CAMPERS MUST HAVE PRIMARY MEDICAL INSURANCE COVERAGE. 5. Medical Release By my signature below, I hereby give my permission to the medical personnel selected by Camp Ozark to provide routine healthcare, to administer medications, both over-the-counter and prescriptions, to order x-rays and routine tests, to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child(ren) named on this form. In addition, I authorize Camp Ozark or its designees to provide or arrange necessary related transportation for me or my child(ren). In addition, I authorize the release of all records, x-rays, notes and any other medical information to Camp Ozark or its designee. I have read the above policies, administrative issues, non-administrative issues, and health and medical issues and release and agree to abide by them to the fullest extent allowed by law. ___________________________________ (typed or printed name of parent or guardian) ___________________________________ (typed or printed name of parent or guardian) ___________________________________ (signature of parent or guardian) ___________________________________ (signature of parent or guardian) ___________________________________ (Date) ___________________________________ (Date) [THE REST OF THIS PAGE IS INTENTIONALLY LEFT BLANK] (OVER) ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY In consideration of the Camper’s opportunity to enroll in Camp Ozark and participate in its activities, by signing below, Parent or Guardian, for himself, herself or themselves, and on behalf of Camper acknowledges and agrees as follows: 1. Activity Permission The Camp Ozark experience has been described in its brochure and other materials, which I (parent and/or legal guardian) have reviewed and discussed with my Camper. I understand that in addition to traditional camping activities, including, but not limited to, sports, horseback trail riding, horsemanship, riflery, archery, crafts, boating and waterfront activities, Camp Ozark offers its campers a challenge course (a series of cables and structures of varying heights, some up to 60 feet, on and through which the camper will walk, swing and otherwise travel, relying on staff for support), water slides and other waterfront devices, rappelling, bouldering, hunter safety, skeet shooting and, through the services of an independent contractor, SCUBA diving. Camp activities are listed on the Camp Ozark website, which has been reviewed by me and my Camper. Most campers pre-select their morning activities using an online Activity Selection process. I understand that the failure to complete the Activity Selection process will result in camp activities being assigned to my camper, regardless of preference. I understand that my Camper may participate in activities located off Camp Ozark property. I understand that my Camper will be participating in strenuous activities that will have inherent and other risks or dangers associated with them. I understand that I may ask any questions of the Camp Ozark Staff to get a full and complete understanding of any such risk or danger associated with any camp activity. I hereby give my Camper permission to participate in all Camp Ozark activities, unless specified in written notice to Camp Ozark by me. I also hereby give my Camper permission to be transported to and from all activities by Camp van, bus and/or boat or by vehicles contracted by Camp Ozark to transport my Camper. 2. Assumption of Risks I understand that Camp Ozark’s activities range from mild to strenuous and, like all outdoor recreation, include inherent and other risks and dangers which can cause sprains, breaks, cuts, bruises, emotional trauma, illnesses and the remote possibility of serious injury or death. I (we) have reviewed Camp Ozark’s brochure, website, and other materials describing the activities offered. I understand the activities and their risks and have discussed them with my Camper. I acknowledge that I have been able to ask questions of the Camp Ozark staff regarding risks or dangers associated with Camp Ozark’s environment and activities. For myself, and on behalf of my Camper, I acknowledge and assume all risks of enrollment at Camp Ozark, inherent and otherwise, and whether or not described above or in the materials provided to me by Camp Ozark. 3. Agreements of Release and Indemnity Further, for myself and on behalf of my Camper, to the maximum extent allowed by law, I release, and agree not to bring any cause of action, against Camp Ozark, its owners, managers, employees, agents, medical personnel, contractors or any related parties for liability or claims of any nature, including loss or damage to property, personal injury or death, suffered by me or my Camper and in any way related to my Camper’s enrollment or participation at Camp Ozark or in its activities. In addition, I agree to indemnify Camp Ozark, its owners, managers, employees, agents, medical personnel, contractors or any related parties (that is defend them, including satisfaction of liabilities, costs and attorney’s fees) from claims brought by Camper, members of Camper’s family and any other person arising out of Camper’s enrollment and participation at Camp Ozark and in its activities. The claims which are the subject of these agreements of release and indemnity include those arising from the negligence, but not the gross negligence or intentionally wrong conduct, of any Released Party. The activities intended to be covered by these agreements of release and indemnity include activities on or off the Camp premises, including transportation to and from those activities and on the Camp Ozark grounds. 4. Applicable Law Any dispute of any nature arising out of these policies or agreements or as a result of Camper’s enrollment or participation at Camp Ozark or in its activities shall be brought in the Circuit Court of Montgomery County, Arkansas and Arkansas laws (but not the laws which may apply the laws of another jurisdiction) will control any such dispute between Parent and Camper on the one hand, and any released party on the other. My children who are campers in 2011 are: (1)_________________________________, (2)_____________________________________, FIRST NAME LAST NAME FIRST NAME LAST NAME (3)__________________________________, (4)_________________________________, (5)__________________________________. FIRST NAME LAST NAME FIRST NAME LAST NAME FIRST NAME LAST NAME I have read the above policies, consents, permissions, assumptions of risk and agreements of release and indemnity and agree to abide by them to the fullest extent allowed by law. ___________________________________ ___________________________________ (typed or printed name of parent or guardian) (typed or printed name of parent or guardian) ___________________________________ (signature of parent or guardian) ________________ (date) ___________________________________ ________________ (signature of parent or guardian) (date) PLEASE SIGN BOTH COPIES OF THE CAMPER POLICY AGREEMENT, ASSUMPTION OF RISKS AND AGREEMENTS OF RELEASE AND INDEMNITY. RETURN ONE (1) COPY TO CAMP OZARK PRIOR TO ASSIGNED DEADLINE AND KEEP THE OTHER COPY FOR YOUR FILES. INCOMPARABLE CAMP OZARK CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY (Requires Signature of Parents or Guardian) To Parents and Guardians of Campers: Following are the CAMPER POLICY AGREEMENT regarding general and specific issues concerning your child(ren) (hereinafter referred to as “Camper”), ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY. Please read these policies and agreements carefully. Please feel free to call Camp Ozark and discuss these policies and agreements or any issues or questions you have regarding these policies and agreements. When you have read and understood the following policies and agreements, please sign both copies of the “CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY” indicating your understanding of said policies and agreements, and your agreement to abide by them with regard to your Camper and yourself, and return one signed copy of all policies and agreements to Camp Ozark no later than the assigned deadline. If you have multiple children attending Camp Ozark, you may sign one copy of all policies and agreements for all of your children. We hope that by reading and understanding these policies and agreements the result will be to help ensure a smooth and satisfactory experience for your Camper at Incomparable Camp Ozark. AN UNALTERED, SIGNED “CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY” IS A REQUIREMENT FOR ATTENDANCE AT CAMP OZARK. THESE POLICIES AND AGREEMENTS MUST BE SIGNED BY BOTH PARENTS OR THE CHILD’S LEGAL GUARDIAN (BOTH REFERRED TO AS “PARENT”). NO CHILD CAN BE ADMITTED TO CAMP OZARK WITHOUT A SIGNED “CAMPER POLICY AGREEMENT, ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY” ON FILE. CAMPER POLICY AGREEMENT ADMINISTRATIVE ISSUES 1. Applications A fully completed application is a requirement for attendance at Camp Ozark. While the registration deposit is sufficient to reserve a space in a session, the fully completed application is required for final processing. Applications need to be returned, fully completed, to Camp Ozark prior to April 1st, 2011. Final processing, including camper scheduling, cannot be completed without a fully completed application. Returning campers may complete the “Summary Application” furnished by Camp Ozark in lieu of the full application. All new campers must complete the full application. 2. Deposit Requirements/Cancellations/Deposit Refunds/Tuition Refunds Deposits are required for each camper and for each session to be attended. (For example, if two (2) children from the same family are each attending two (2) sessions, a $900.00 deposit is required.) If cancellations are made after February 1st, 2011, deposits are forfeited. If you cancel after February 1st, 2011 and your camper has never been enrolled in a session for 2011 but remains on the waiting list, your deposit is refundable up until the beginning date of the session for which you are wait-listed. The $25.00 registration fee is non-refundable. If your cancellation is made prior to three (3) weeks (21 calendar days) preceding the session to which you are assigned, you are not liable for the remaining tuition. Cancellations made within the three (3) weeks immediately preceding the session to which you are assigned will result in a forfeiture of tuition. Partial tuition refunds for cancellations due to medical issues are considered on a case-by-case basis. 3. Fee Payment All fees are due and payable to Camp Ozark on or before April 1st, 2011. Should you, for any reason, be unable to complete fee payment by April 1st, 2011, alternate arrangements may be made through the Camp Ozark office. After April 1st, 2011, all enrollments are subject to possible cancellation unless fees have been paid in full, or unless alternate arrangements have been made with Camp Ozark. NON-ADMINISTRATIVE ISSUES 1. Cabin Requests Upon acceptance of a camper’s application, he or she is placed in the proper grouping and cabin according to age, development and school grade. Every effort is made to place campers according to their cabin preference, but final placement is at the sole discretion of the Camp Director. Campers may request to be placed in the same cabin with up to two (2) others campers. All such requests must be made in writing and must be made by both campers. Requested cabin mates must be no more than 12 months apart in age. No more than four (4) campers from the same school group or social group will be placed in the same cabin. Final cabin placement is at the sole discretion of Camp Ozark. In order to be considered, cabin requests must be received no later than two (2) weeks prior to the start of the appropriate session. 2. Telephone Calls Campers are not allowed to bring cell phones to camp, nor are campers allowed to receive or make telephone calls while in attendance at Camp Ozark. Please feel free to call the Camp Mom or a Camp Director if you need to discuss anything relating to your child. (OVER) 3. Visitors Campers are not allowed to receive or have visitors while in attendance at Camp Ozark. There are no exceptions to this policy except in the case of serious illness or death of a family member or other extenuating circumstances. Such exceptions are allowed at the sole discretion of Camp Ozark and must be cleared in advance with Camp Ozark. 4. Attendance Campers must be in attendance during the entire camp session. Campers are not allowed to come and go during a session. Campers are required to arrive on Opening Day and are not permitted to leave prior to Closing Day of the camp session. Exceptions are allowed at the sole discretion of the Camp Director and must be cleared in advance. Camp Ozark reserves the right to not allow campers that leave early to return in future years. 5. E-mails/Faxes Campers are allowed to receive faxes and/or e-mail messages. There is a charge per event for this service. Prepaid unlimited email packages are available through the Camp Ozark store. 6. Food Packages Candy, food and gum are not allowed to be brought or sent to Camp Ozark. All such items will be confiscated and discarded. They will not be returned. 7. Code of Conduct By my signature below, I agree that my camper(s) and I have read, understand and agree to abide by the Camp Ozark Code of Conduct. I also understand that if the Code of Conduct is violated, appropriate consequences such as those enumerated therein, may be enforced. 8. Controlled Substances Alcohol, tobacco or illegal drugs are not allowed at Camp Ozark. Possession or use of any of these substances will result in immediate termination of the camper’s enrollment and the camper will be sent home immediately. 9. Use of Visual Images By my signature below, I hereby give Camp Ozark permission to make visual images (such as photographs or videos) of my child and to use such visual images for display on the Camp Ozark website, in marketing materials or in Camp Ozark videos, and I hereby release Camp Ozark from any and all liability related thereto. 10. Internet Related Policies Camp Ozark views social networking sites (e.g., Facebook, MySpace), personal Web sites, and Web logs positively and respects the right of campers to use them as a medium of self-expression. If a camper chooses to identify himself or herself as a camper of Camp Ozark on these sites, some readers may view the camper as a representative of Camp Ozark. Camp Ozark requires that campers and their families observe the following guidelines when referring to Camp Ozark, its programs or activities, its campers, and/or employees, on these Internet sites. a. b. c. d. e. f. g. Campers must be respectful in all communications and blogs related to or referencing Camp Ozark, its campers, and/or employees. Campers must not use obscenities, profanity, or vulgar language. Campers must not use these sites to disparage Camp Ozark, campers, or employees of Camp Ozark. Campers must not use these sites to harass, bully, or intimidate other campers or employees. Behaviors that constitute harassment and bullying include, but are not limited to, comments that are derogatory with respect to race, religion, gender, sexual orientation, color, or disability; sexually suggestive, humiliating, or demeaning comments; and threats to stalk, haze, or physically injure another camper or employee. Campers must not use these sites to discuss engaging in conduct that is prohibited by Camp Ozark policies, including, but not limited to, the use of alcohol and drugs, sexual behavior, sexual harassment, and bullying. Campers must not post inappropriate pictures of campers or staff members. This category includes, but is not limited to, pictures of campers participating in activities that violate Camp Ozark policy (e.g., alcohol, drugs, and/or sexual behavior), and pictures of campers who are not clothed or partially clothed. Camp Ozark does not host or sponsor a social networking site. The use of our copyrighted camp name or logo is not allowed without written permission. HEALTH AND MEDICAL ISSUES AND RELEASE 1. Health Forms Health Forms and Health Screenings are required of all Ozark Campers. These forms must be returned on or before the assigned deadline. All medications must be ordered using one of the two provided options (see “Health Information”). The “Parent’s Authorization to provide healthcare” section of the Health Form must be signed by a parent or legal guardian. 2. Admittance Campers will not be admitted to Camp Ozark on Opening Day if they are suffering from a fever, contagious disease or other illness or symptoms that might negatively affect the general Camp Ozark population. Should such conditions arise, parents or guardians agree to contact Camp Ozark prior to the child’s arrival at Camp Ozark to discuss alternate arrangements and/or late arrival possibilities. Should such condition not be detected until the arrival of the child at Camp Ozark, by my signature below, I understand and agree that alternate arrangements may need to be made at my expense. Denial of admittance to Camp Ozark based on health issues is at the sole discretion of the Camp Ozark Medical Staff. 3. Injury/Illness Should your child become ill or injured while at Camp Ozark, parents will be notified if, at the sole discretion of the Camp Ozark Medical Staff, such notification is necessary. Notification is usually reserved for emergency situations. If at any time you have a question or concern regarding the health status or safety of your child, please feel free to contact Camp Ozark. We will be happy to discuss said issue with you. 4. Medical Bills The Mandatory Camper Insurance Policy is a no fault, no deductible medical payments policy which covers all medical, x-ray and/or prescription drug expenses up to $2,500.00 should your camper require medical attention while at Camp Ozark. The policy provides primary coverage up to, and including, $50.00 in expenses. After $50.00 the policy is secondary and pays all expenses not covered by your primary health care policy up to $2,500.00 after your primary policy deductible has been met. This policy is required of all campers. ALL CAMPERS MUST HAVE PRIMARY MEDICAL INSURANCE COVERAGE. 5. Medical Release By my signature below, I hereby give my permission to the medical personnel selected by Camp Ozark to provide routine healthcare, to administer medications, both over-the-counter and prescriptions, to order x-rays and routine tests, to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child(ren) named on this form. In addition, I authorize Camp Ozark or its designees to provide or arrange necessary related transportation for me or my child(ren). In addition, I authorize the release of all records, x-rays, notes and any other medical information to Camp Ozark or its designee. I have read the above policies, administrative issues, non-administrative issues, and health and medical issues and release and agree to abide by them to the fullest extent allowed by law. ___________________________________ (typed or printed name of parent or guardian) ___________________________________ (typed or printed name of parent or guardian) ___________________________________ (signature of parent or guardian) ___________________________________ (signature of parent or guardian) ___________________________________ (Date) ___________________________________ (Date) [THE REST OF THIS PAGE IS INTENTIONALLY LEFT BLANK] (OVER) ACTIVITY PERMISSION, ASSUMPTION OF RISKS, AND AGREEMENTS OF RELEASE AND INDEMNITY In consideration of the Camper’s opportunity to enroll in Camp Ozark and participate in its activities, by signing below, Parent or Guardian, for himself, herself or themselves, and on behalf of Camper acknowledges and agrees as follows: 1. Activity Permission The Camp Ozark experience has been described in its brochure and other materials, which I (parent and/or legal guardian) have reviewed and discussed with my Camper. I understand that in addition to traditional camping activities, including, but not limited to, sports, horseback trail riding, horsemanship, riflery, archery, crafts, boating and waterfront activities, Camp Ozark offers its campers a challenge course (a series of cables and structures of varying heights, some up to 60 feet, on and through which the camper will walk, swing and otherwise travel, relying on staff for support), water slides and other waterfront devices, rappelling, bouldering, hunter safety, skeet shooting and, through the services of an independent contractor, SCUBA diving. Camp activities are listed on the Camp Ozark website, which has been reviewed by me and my Camper. Most campers pre-select their morning activities using an online Activity Selection process. I understand that the failure to complete the Activity Selection process will result in camp activities being assigned to my camper, regardless of preference. I understand that my Camper may participate in activities located off Camp Ozark property. I understand that my Camper will be participating in strenuous activities that will have inherent and other risks or dangers associated with them. I understand that I may ask any questions of the Camp Ozark Staff to get a full and complete understanding of any such risk or danger associated with any camp activity. I hereby give my Camper permission to participate in all Camp Ozark activities, unless specified in written notice to Camp Ozark by me. I also hereby give my Camper permission to be transported to and from all activities by Camp van, bus and/or boat or by vehicles contracted by Camp Ozark to transport my Camper. 2. Assumption of Risks I understand that Camp Ozark’s activities range from mild to strenuous and, like all outdoor recreation, include inherent and other risks and dangers which can cause sprains, breaks, cuts, bruises, emotional trauma, illnesses and the remote possibility of serious injury or death. I (we) have reviewed Camp Ozark’s brochure, website, and other materials describing the activities offered. I understand the activities and their risks and have discussed them with my Camper. I acknowledge that I have been able to ask questions of the Camp Ozark staff regarding risks or dangers associated with Camp Ozark’s environment and activities. For myself, and on behalf of my Camper, I acknowledge and assume all risks of enrollment at Camp Ozark, inherent and otherwise, and whether or not described above or in the materials provided to me by Camp Ozark. 3. Agreements of Release and Indemnity Further, for myself and on behalf of my Camper, to the maximum extent allowed by law, I release, and agree not to bring any cause of action, against Camp Ozark, its owners, managers, employees, agents, medical personnel, contractors or any related parties for liability or claims of any nature, including loss or damage to property, personal injury or death, suffered by me or my Camper and in any way related to my Camper’s enrollment or participation at Camp Ozark or in its activities. In addition, I agree to indemnify Camp Ozark, its owners, managers, employees, agents, medical personnel, contractors or any related parties (that is defend them, including satisfaction of liabilities, costs and attorney’s fees) from claims brought by Camper, members of Camper’s family and any other person arising out of Camper’s enrollment and participation at Camp Ozark and in its activities. The claims which are the subject of these agreements of release and indemnity include those arising from the negligence, but not the gross negligence or intentionally wrong conduct, of any Released Party. The activities intended to be covered by these agreements of release and indemnity include activities on or off the Camp premises, including transportation to and from those activities and on the Camp Ozark grounds. 4. Applicable Law Any dispute of any nature arising out of these policies or agreements or as a result of Camper’s enrollment or participation at Camp Ozark or in its activities shall be brought in the Circuit Court of Montgomery County, Arkansas and Arkansas laws (but not the laws which may apply the laws of another jurisdiction) will control any such dispute between Parent and Camper on the one hand, and any released party on the other. My children who are campers in 2011 are: (1)_________________________________, (2)_____________________________________, FIRST NAME LAST NAME FIRST NAME LAST NAME (3)__________________________________, (4)_________________________________, (5)__________________________________. FIRST NAME LAST NAME FIRST NAME LAST NAME FIRST NAME LAST NAME I have read the above policies, consents, permissions, assumptions of risk and agreements of release and indemnity and agree to abide by them to the fullest extent allowed by law. ___________________________________ ___________________________________ (typed or printed name of parent or guardian) (typed or printed name of parent or guardian) ___________________________________ (signature of parent or guardian) ________________ (date) ___________________________________ ________________ (signature of parent or guardian) (date) PLEASE SIGN BOTH COPIES OF THE CAMPER POLICY AGREEMENT, ASSUMPTION OF RISKS AND AGREEMENTS OF RELEASE AND INDEMNITY. RETURN ONE (1) COPY TO CAMP OZARK PRIOR TO ASSIGNED DEADLINE AND KEEP THE OTHER COPY FOR YOUR FILES. Camp Ozark 2011 Essentials Camp Ozark is proud to introduce its 2011 Camp Essentials Line. All items described below are available for advanced purchase. Items purchased in advance will be available for pick up in the Camp Ozark store on Opening Day. Items can also be ordered through the on-line camp store at www.campozark.com. To order, complete the attached order form and return it to Camp Ozark by April 1, 2011, to insure a complete order. All prices include tax. TRIBAL SHOP TRIBAL TEES Adult Sizes Youth Sizes $13 Adult Sizes Youth Sizes $12 Adult Sizes Youth Sizes $22 OZARK UNDER ARMOUR Adult Sizes Youth Sizes $30 LITTLE MISS TRIBAL Adult Sizes Youth Sizes $15 Adult Sizes Youth Sizes $28 Adult Sizes Youth Sizes $23 One size fits most $20 One size fits most $20 One size fits most $20 One size fits most $20 One size fits most $3 TRADITIONAL TRIBAL Red or navy, 100% cotton, pigment-dyed tee with front tribal chestband design in white. TRIBAL FIRE UP Red or navy, heavyweight, 100% cotton tee with front tribal design in gold. Fire Up! TRIBAL TRACK Black, extra-soft, tri-blend, American Apparel track tee with front tribal distressed design in red or blue and small center back logo. Red or navy, 100% PolyArmour, lightweight, HeatGear®, loose fit tee with Camp Ozark in white. Perfect for tribal competition and the Ultimate Solution! White, 100% cotton, fine jersey, American Apparel tee with full front design in red or royal blue accents. TRIBAL SHORTS LONG TRIBAL WORKOUT SHORTS Champion, 100% nylon, tricot mesh, lightweight, double ply short. Drawstring with 9’’ inseam and tribe in white on left leg. Available in red or navy. TRIBAL MESH CHEER SHORTS Champion, 100% nylon, tricot mesh, lightweight, double ply short. Drawstring with 3’’ inseam and tribe in white on left leg. Available in red or navy. TRIBAL HATS TRIBAL SPORT 100% cotton, white hat with embroidered “C” or “O” on front center and red or navy contrast stitching on bill. TRIBAL CHIC 100% cotton, red or navy hat with pink embroidered “C” or “O” on front with “Camp Ozark” over adjustable closure. Girls just want to compete! TRIBAL EXTREME 100% cotton, red or navy hat with tribal designs on white front panel with back adjustable closure. TRIBAL BUFFALO SPEAR 100% cotton, black or navy hat with Caddo or Osage buffalo spear on center front. Camp Ozark on side with back adjustable closure. TRIBAL ACCESSORIES EYE BLACKS One pair of glare-reducing eye blacks. Pair includes one tribal and one Camp Ozark eye black. Available in Caddo or Osage. 1 (over) UNDER ARMOUR PERFORMANCE BANDS One size fits most $9 One size fits most $8 One size fits most $13 22 inches 25 inches $12 Red or navy, 1’’ performance wristband with “Camp Ozark” in white. PRIDE BAND Two-tone, woven bracelet that proudly displays the name of your tribe! Available in Caddo or Osage. BEADED TRIBAL NECKLACE Red or navy, beaded necklace with “Caddo” or “Osage” pewter charm. Great way to show your loyalty! TRIBAL KNEE SOCKS Red or navy socks with wrap-around, knit-in logo at the top. TRIBAL PACKAGES $60 $55 Boys: Includes 2 tribal shirts, 1 pair of mesh shorts, 1 hat Girls: Includes 2 tribal shirts, 1 pair of mesh cheer shorts, 1 hat FUN TEES Adult Sizes Youth Sizes $17 Adult Sizes Youth Sizes $11 Adult Sizes Youth Sizes $22 WESTERN Adult Sizes Youth Sizes $16 CHRISTMAS COUNTDOWN Adult Sizes Youth Sizes $16 Adult Sizes Youth Sizes $13 Adult Sizes Youth Sizes $18 Adult Sizes Youth Sizes $12 Adult Sizes Youth Sizes $25 Adult Sizes Youth Sizes $16 MISSION IMPOSSIBLE Green camo, heavyweight, 100% cotton tee with center front “Mission Impossible” design. Available in flourescent orange or flourescent pink, glow-in-the-dark ink. Shhhhhhhhh! WATERWORLD White, heavyweight, 100% cotton tee with full front, retro design. Surf’s up! RED, WHITE AND BLUE Navy, extra-soft, tri-blend, American Apparel track tee with full back and front left chest designs in red and white. God Bless America! White, 100% cotton, fine jersey, American Apparel tee with full front “ride our wild bull, Ozark style!” design. Yee Haw! Green, 100% cotton, pigment-dyed tee with full front design. Santa is coming to Ozark! PUMP IT UP Red or royal blue, 100% cotton tank with oversized “Camp Ozark” in full front, white design. PLANET OZARK Neon green, 100% preshrunk cotton tee with chunky 3-D, full front, funky design. MASQUERADE Charcoal, heavyweight, 100% preshrunk cotton tee with front Batman design. DISCO DAZE Tie-dye, heavyweight, 100% cotton tee with black design on full front. Peace, Love & Ozark! Groovy! SUPER SMASH BASH Royal, heavyweight, 100% cotton tee with our own “SUPERDAVE” logo on full front and upper back. 2 ESCAPE TO NEVERLAND Adult Sizes Youth Sizes $18 TOTALLY OZARK Adult Sizes Youth Sizes $17 Adult Sizes Youth Sizes $15 V-NECK Adult Sizes Youth Large $20 LOVIN’ IT OZARK Adult Sizes Youth Sizes $20 SIMPLY OZARK ‘11 Adult Sizes Youth Sizes $9 Adult Sizes Youth Sizes $22 Adult Sizes Youth Large $20 OZARK MOUNTAIN LONG SLEEVE Adult Sizes Youth Sizes $21 SPIRITUAL LONG SLEEVE ‘11 Adult Sizes Youth Sizes $25 Toddler Sizes $13 Toddler Sizes $14 UNDER ARMOUR GOLF POLO Adult Sizes $49 CAMP OZARK CHIC Adult Sizes $21 Adult Sizes Youth Sizes $55 Light blue, 100% cotton, fine jersey, American Apparel tee with vintage map of Camp Ozark where X marks the spot! White, heavyweight, 100% cotton tee with a collage of our 2011 t-shirt designs on front chestband and full back. COLLEGIATE TEE 100% preshrunk cotton, Comfort Colors tee with front chestband design in white. Be true to your school in: maroon, burnt orange, red, purple or navy. Mint, 100% cotton, fine jersey, American Apparel v-neck tee with high, left shoulder Camp Ozark design in teal. Pink, 50% polyester/50% cotton jersey, retro tee with white v-neck collar and sleeve stripes. Girls just want to have fun! White, 100% preshrunk cotton, heavyweight tee with full front design. Available in red, blue, purple or green. BIG DEAL Gray, extra-soft, tri-blend, American Apparel track tee with full back design and front left chest in fluorescent blue and orange. THE SUMMIT Bright blue, 100% cotton, pigment-dyed tee with Camp Ozark logo and Ouachita mountains on full front design. Livin’ the good life! Chocolate, 100% cotton, fine jersey, American Apparel long sleeve tee with full front mountain design and Camp Ozark logo in olive. Kiwi, 100% preshrunk cotton, Comfort Colors long sleeve tee. Camp Ozark on front and summer theme and verse on back. FUTURE CAMPER White, heavyweight, 100% cotton tee. Multi-colored design on front. Perfect for our younger brothers and sisters! TRIBAL FUTURE CAMPER Red or navy, heavyweight, 100% cotton tee with tribal design on front in white. Available in Caddo or Osage. You’re next! Lightweight, HeatGear® polo in traditional fit with UPF 30+ sun protection. Camp Ozark embroidered on left chest. Perfect for Dad! White, 100% cotton, fine jersey, American Apparel v-neck tee with colorful floral design and Camp Ozark logo down front right side. Especially for you, mom! SPECIALTY ITEMS TYR SWIMSUIT 80% Nylon/20% Lycra girl swimsuit. Great for Ultimate Solution! Available in red or navy with Camp Ozark logo in white. 3 (over) Adult Sizes Youth Sizes $40 $30 Adult Sizes Youth Sizes $40 TYR GOGGLES One size fits most $13 CREW SWEATSHIRT Adult Sizes Youth Sizes $23 HOODED SWEATSHIRT Adult Sizes Youth Large $32 UNDER ARMOUR TECH TEE Adult Sizes $30 Adult Sizes Youth Large $35 Adult Sizes Youth Sizes $35 $30 Adult Sizes Youth Sizes $28 Adult Sizes Youth Sizes $25 Adult Sizes Youth Sizes $23 Adult Sizes Youth Sizes $24 JERSEY CHEER SHORTS Adult Sizes Youth Sizes $10 LOUNGE PANT Adult Sizes Youth Sizes $22 UV SUN SHIRT Blocks out 98% of UVA/UVB rays. Available in red/black or royal/black with Camp Ozark in white. Great for the lake and waterfront activities! BOARD SHORTS Micro denier board shorts featuring funky design side panels with 8’’ inseam and adjustable drawstring. Logo on left leg. Available in columbia blue or kelly green. Adjustable, anti-fog goggles available in red or blue. Gray, 50% cotton/50% polyester, fleece crew sweatshirt with oversized Camp Ozark in black. 50% cotton/50% polyester, fleece sweatshirt with front pouch pocket and drawstring hood. Available in gray, navy or red with Camp Ozark arched across front. Gray, ArmourStretch® tee with soft, cotton-like feel. Camp Ozark logo on front chestband. It’s always about Maximum Effort! TRACK JACKET Asphalt, 100% California-combed cotton, American Apparel zippered jacket. Stretch fit featuring white accent piping with Camp Ozark logo. SHORTS & PANTS UNDER ARMOUR ZONE SHORTS Lightweight, HeatGear®, 100% polyester, superior moisture control with 9’’ inseam. Logo on left leg. Available in black, navy or red. EL MESH WORKOUT SHORTS Champion, 100% nylon, tricot mesh, lightweight short with 9’’ inseam. Logo on the left leg. Available in black only. MESH WORKOUT SHORTS Champion, 100% nylon, tricot mesh, lightweight short with 6’’ inseam. Logo on the left leg. Available in black, navy or red. CAMP OZARK GIRLS MESH CHEER SHORTS Champion, 100% nylon, tricot mesh, lightweight short with 3’’ inseam. Logo on the left leg. Available in navy or red. RUNNING SHORTS Soffe shorts with breathable mesh side panels and contoured piping. Built-in polyester liner with adjustable drawstring. Logo on the left leg. Available in black, red or royal. Soffe, 50% polyester/50% cotton jersey, knit shorts with elastic waistband, 3’’ inseam and v-notch leg. Camp Ozark design on left leg. Available in navy, red, oxford gray or pink. Lightweight, 100% cotton, seersucker pant with Camp Ozark logo on upper left leg. Available in pink or blue. 4 HATS Adult Size Youth Size $20 One size fits most $20 One size fits most $20 One size fits most $20 UNDER ARMOUR PINK LADY One size fits most $30 LOST CAMO HAT One size fits most $20 FRAYED PATCH HAT One size fits most $15 SKI CAP One size fits most $10 CAMO HAT 100% cotton, unconstructed camo hat with Camp Ozark arched over green logo patch embellishment. Adjustable buckle closure. GIRLY CAMO HAT 100% cotton, unconstructed camo hat with Camp Ozark arched over pink logo patch embellishment. Adjustable buckle closure. ALL-STAR HAT Light gray, 100% cotton, unconstructed hat with Camp Ozark in navy and white. Adjustable buckle closure. COLLEGIATE HAT 100% cotton, unconstructed Alternative Apparel hat. Available in maroon, burnt orange and red with Camp Ozark logo in white, khaki with navy logo and gold with purple logo. Pink, HeatGear® stretch honeycomb fabric with adjustable back closure. Camp Ozark on front in navy and white. Too cute! 100% cotton, unconstructed, Lost Camo hat with wax cotton front panel and bill. Camp Ozark embroidered in orange. Adjustable buckle closure. Stone, 100% cotton, unconstructed hat with adjustable buckle closure. Camp Ozark logo patch on front. Gray, no cuff, basic beanie with Camp Ozark logo in black. CAMP STUFF UNLIMITED EMAIL PACKAGE $20 Send unlimited emails to your camper from unlimited sources for one low price. Parents, grandparents and big sis can all send emails to your camper. Regular price $1 per email. $25 SESSION DVD A closer look at the entire session your camper attends. Pre-order now and receive your DVD at the end of the session. $15 SONGS OF OZARK A songbook containing a collection of lyrics from all-time favorite songs from Lifeline. HYDRATION PACK $40 RED WHITE & BLUE SWEATBAND $6 Stay hydrated with this padded airflow, mesh back, adjustable strap, 1.5 liter hydration pack with Camp Ozark logo on front, additional storage zippered pocket. 2’’ 2-ply, red, white and blue striped heavyweight headband. Camp Ozark logo on front in gray. $7 CROAKIES The original eyewear retainer, 3/4’’ wide, black neoprene rubber with Camp Ozark in white. A “must have” for keeping your sunglasses on while at the lake! 5 (over) $18 CLIP-ON FAN Create a personal, cool breeze with this 6’’, two-speed, clip-on fan. SWEATSHIRT BLANKET $30 CAPTAIN’S CHAIR $38 Gray, super-soft fleece blanket with red and navy Camp Ozark design. Curl up in this! Black, folding chair featuring two cup holders, zippered mesh pocket and nylon carrying bag. Camp Ozark logo on back in white. Perfect seat for any game! FLIP FLOPS Black and lime, fabric print Camp Ozark flip flops with black, 100% rubber straps and rubberized EVA soles. Adult Sizes Youth Sizes L.L. BEAN BACKPACK $18 $60 Black, deluxe backpack with large center compartment and front pocket organizer featuring the Camp Ozark embroidered logo. $12 DRAWSTRING BACKPACK Nylon, double cord, drawstring backpack with Camp Ozark logo on front. Available in pink, green or neon green. $11 CAMP COLLAGE PILLOWCASE 100% cotton, custom pillowcase with colorful “all-things-Ozark” design! Great commemorative keepsake for the cabin to sign! BLOB SOCKS Lightweight, 75% polyester/25% stretch nylon, no-show socks in “the blob” colors with Camp Ozark in white. Adult Size Youth Size $7 $5 GOLF TOWEL White, terrycloth golf towel with grommet. Camp Ozark logo in navy and red. Fore! $25 BEACH TOWEL Green or orange, 30’’ x 60’’ velour, beach towel with tone-on-tone Camp Ozark logo. Great for the lake. $12 LAUNDRY BAG Natural, laundry bag with Camp Ozark logo in navy for your dirty duds! $26 APPLIQUED PILLOWCASE 100% cotton, percale pillowcase with large appliqued “Camp Ozark” across front in assorted color and fabric letter options. $4 BANDANA 100% cotton, 22” x 22” themed print bandana with Camp Ozark logo in white. Available in red western print, navy western print or camoflauge print. $22 TERVIS TUMBLER The perfect double-wall, insulated 24 oz cup to keep your drinks cold or hot longer. Features a custom Camp Ozark patch and spill-proof lid. A must have! $8 COOLING NECKWRAP 100% cotton, lightweight wrap containing cooling crystals that turn into gel when immersed in water. Soak in water for 5 minutes to keep cool for hours! Can be tied around the neck or head. No refrigeration necessary. Reusable, washable, and available in assorted colors. 6 $22 COOKBOOK The latest edition to celebrate our 60th anniversary. Cinnamon Rolls and Chocolate Milk...SECONDS!, is filled with Camp Ozark and familyfavorite recipes. WATER BOTTLE $15 NOTECARDS $10 BPA-free, Camelbak® water bottle with flip-up straw. Camp Ozark logo in white. Available in assorted colors. Custom Camp Ozark notecards available in commemorative Camp Ozark, FIT and Summer 2011 theme designs. $10 TRAILER HITCH Show your Camp Ozark pride when you are on the road with this custom trailer hitch! Perfect for the new driver! JEWELRY $27 OZARK LOGO CHARM Sterling silver Camp Ozark logo charm that can be worn on a necklace or bracelet. CROSS CHARM This sterling silver crafted piece signifies the Christian foundation on which Camp Ozark is built. Charm can be worn on a necklace or bracelet. Enjoy this timeless piece! $27 STERLING SILVER CABLE CHAIN $30 Your favorite Camp Ozark charms can be attached to this beautiful sterling silver chain. 18” in length. LEATHER CORD WITH CHARM $47 STERLING SILVER CROSS RING $25 Your favorite Camp Ozark charm attached to an adjustable leather cord. A camper favorite! Available with the Logo or Cross charm. Sterling silver ring featuring a 5mm cut out cross. Band width graduates from 3-7mm at center. Available in whole sizes, 6-9. $49 OZARK CUTOUT RING Sterling silver ring with Ozark spelled out in tempered letters. Available in whole sizes, 4-10. VINTAGE WRAP BRACELET $17 Brown, leather wrap bracelet with foil-stamped Camp Ozark. The perfect accessory! $13 GIRLY NECKLACE Hand-stamped Camp Ozark on girly, pewter charm. Attached to a pink leather cord with adjustable lobster claw closure. $43 BOOKMARK Camp Ozark cross and dove in sterling silver on a ribbon bookmark; 12” long. Available in red, blue or white. 7 (over) CARE PACKAGES Order a Camp Ozark care package to let your camper know you are thinking about them! We offer a variety of packages tailored to your camper’s age, gender and interests. Mission Impossible packages can be picked up in the store on Opening Day of the session. All other packages will be delivered in the middle of your camper’s stay with an enclosure card from the sender. Birthday packs are delivered on day specified. CRAZY FOR CAMP -- Includes a t-shirt and a variety of items that may include: interactive toys, sports toys, strategy games, cards, brainteasers and much more! $55 MISSION IMPOSSIBLE -- Don’t get caught! Mission Impossible shirt, camo hat and more packaged in a camo drawstring backpack to help make your mission a success! $55 SECRET AGENT -- Things a secret agent needs to carry out a mission! Includes an invisible writer pen, periscope and retrovision glasses just to name a few! $40 BIRTHDAY BASH -- Cookie cake, party supplies and a gift for your camper packaged in a beach ball pinata for a memorable birthday at Camp Ozark! $40 BEAT THE HEAT -- Stay extra cool in your cabin and outdoors with our products: beach towel, sunscreen, water bottle and a cooling neckwrap! $55 MVP -- Calling all sports fans! Custom tribal eye blacks, Under Armour performance bands, slam dunk basketball and more to help you stay on top of your game! $45 DREAM ON -- Help your camper snuggle in and sleep tight! Camp Ozark sweatshirt blanket, Camp Ozark socks and book light wrapped in a custom pillowcase. Cozy! $55 CHATTER BOX -- Don’t miss out on this package full of fun activities for your girl. Includes Girls Just Wanna Have Fun madlibs, autograph book and much more! $35 BON VOYAGE -- This package will be delivered to your camper prior to Closing Day. Includes travel games and activities packaged in a Camp Ozark drawstring backpack for the journey home. $30 CLEAN MACHINE $35 Essential shower products for keeping clean at Camp Ozark. Includes shampoo, soap, soap holder, toothbrush, toothbrush holder, and deodorant packaged in a shower tote. All that you need! ULTIMATE PACKAGES THE WHOLE ENCHILADA Items needed for the Camp Ozark experience…labeled and waiting when your camper gets to camp. Includes linens, towels, sleeping bag, 12 basic Camp Ozark shirts, 12 basic Camp Ozark shorts, Camp Ozark sweatshirt, bath house kit, poncho, flashlight, writing supplies and stamps, laundry bag, Bible and water bottle, all in a Sterilite trunk. Does not include underwear, socks, swimsuit, Special Event shirts, jeans, pj’s or shoes. It’s golden! $525 THE PREMIUM WHOLE ENCHILADA $650 The Whole Enchilada in a custom Camp Ozark trunk. Available in red or blue. MUST ORDER BY APRIL 1, 2011. HALF ENCHILADA $375 All the splendors of the Whole Enchilada with only 6 shirts and 6 shorts! Perfect for a one-week camper! THE PREMIUM HALF ENCHILADA $500 The Half Enchilada in a custom Camp Ozark trunk. Available in red or blue. MUST ORDER BY APRIL 1, 2011. SPECIAL EVENT PACKAGE $150 10 Camp Ozark tees specially designed for Special Events. SPECIAL EVENT ACESSORIES PACKAGE Cool items to wear at special events including themed sunglasses and “props” that add to the festive special events. 8 $35 CAMP OZARK 2011 ESSENTIALS ORDER FORM CAMPER NAME ________________________________ BIRTHDAY __________ BOY ___ GIRL ___ SESSION(S) _______________________ TRIBE: FIRST-YEAR ___ CADDO ___ OSAGE ___ Size orders are approximate. Exchanges may be made in camp store upon availability. SIZING CHART SHIRT SIZES Adult: XS (30-32) S (34-36) M (38-40) L (42-44) XL (46) Youth: --------------- ------------ M (10-12) L (14-16) XL (18-20) Toddler: 6 MO 12 MO 2 T 4 T 6T SHORT SIZES Adult: XS (24-26) S (28-30) M (32-34) L (36-38) XL (40-42) Youth: -------------- ------------ M (10-12) L (14-16) -------------SWIMSUITS (*chest measurement) Adult: 30* (3-4) 32* (5-6) 34* (7-8) 36* (9-10) 38* (10-12) 40* (13-14) Youth: 22* (6) 24* (7) 26* (8) 28* (10) SHOE SIZES Adult: XS (6-7) S (8-9) M (10-11) L (12) Youth: M (12-2) L (3-5) HAT SIZES Adult: One size fits most (7 1/4 - 7 5/8) Youth: One size fits most (6 3/4 - 7 1/8) SOCKS Adult: One side fits most (9-11) Youth: One size fits most (7-9) ITEM TRIBAL SHOP TRADITIONAL TRIBAL ACADDO AOSAGE TRIBAL FIRE UP ACADDO AOSAGE TRIBAL TRACK ACADDO AOSAGE OZARK UNDER ARMOUR ACADDO AOSAGE ALITTLE MISS CADDO ALITTLE MISS OSAGE LONG TRIBAL WORKOUT SHORTS ACADDO AOSAGE TRIBAL MESH CHEER SHORTS ACADDO AOSAGE TRIBAL SPORT HAT CADDO OSAGE TRIBAL CHIC HAT CADDO OSAGE TRIBAL EXTREME HAT CADDO OSAGE TRIBAL BUFFALO SPEAR HAT CADDO OSAGE EYE BLACKS UNDER ARMOUR PERFORMANCE BANDS PRIDE BAND BEADED TRIBAL NECKLACE SIZE (Circle Preference) QUANTITY PRICE TOTAL ORDERED S S M M L L XL, XL, Y-L Y-L Y-M Y-M _________ $13 ________ _________ $13 ________ S S M M L L XL, XL, Y-L Y-L Y-M Y-M _________ $12 _________ $12 S S M M L L XL, XL, Y-L Y-L Y-M Y-M _________ $22 ________ _________ $22 ________ S S S S M M M M L L L L XL, XL, XL, XL, Y-L Y-L Y-L Y-L Y-M Y-M Y-M Y-M _________ _________ _________ _________ S S M M L L XL, XL, Y-L Y-L Y-M Y-M _________ $28 ________ _________ $28 ________ S S M M L L XL, XL, Y-L Y-L Y-M Y-M _________ $23 ________ _________ $23 ________ $30 $30 $15 $15 ________ ________ ________ ________ ________ ________ ONE SIZE FITS MOST ONE SIZE FITS MOST _________ $20 ________ _________ $20 ________ ONE SIZE FITS MOST ONE SIZE FITS MOST _________ $20 ________ _________ $20 ________ ONE SIZE FITS MOST ONE SIZE FITS MOST _________ $20 ________ _________ $20 ________ ONE SIZE FITS MOST ONE SIZE FITS MOST CADDO OSAGE CADDO OSAGE CADDO OSAGE CADDO OSAGE _________ _________ _________ _________ _________ _________ 1 $20 $20 $3 $9 $8 $13 ________ ________ ________ ________ ________ ________ (over) ITEM CADDO KNEE SOCKS OSAGE KNEE SOCKS TRIBAL PACKAGES BOYS: SHIRT SIZE SHORT SIZE GIRLS: SHIRT SIZE SHORT SIZE FUN TEES MISSION IMPOSSIBLE ORANGE MISSION IMPOSSIBLE PINK WATERWORLD RED, WHITE AND BLUE WESTERN CHRISTMAS COUNTDOWN PUMP IT UP RED PUMP IT UP ROYAL PLANET OZARK MASQUERADE DISCO DAZE SUPER SMASH BASH ESCAPE TO NEVERLAND TOTALLY OZARK COLLEGIATE TEE MAROON BURNT ORANGE RED PURPLE NAVY V-NECK LOVIN’ IT OZARK SIMPLY OZARK ‘11 BIG DEAL THE SUMMIT OZARK MTN LONG SLEEVE SPIRITUAL LONG SLEEVE ‘11 FUTURE CAMPER CADDO FUTURE CAMPER OSAGE FUTURE CAMPER UNDER ARMOUR GOLF POLO CAMP OZARK CHIC SPECIALTY ITEMS TYR SWIMSUIT CADDO RED CADDO RED OSAGE NAVY OSAGE NAVY UV SUN SHIRT RED UV SUN SHIRT RED UV SUN SHIRT ROYAL UV SUN SHIRT ROYAL BOARD SHORTS BLUE BOARD SHORTS GREEN TYR GOGGLES CREW SWEATSHIRT HOODED SWEATSHIRT GRAY HOODED SWEATSHIRT NAVY HOODED SWEATSHIRT RED SIZE (Circle Preference) 22 INCHES 25 INCHES 22 INCHES 25 INCHES QUANTITY PRICE TOTAL ORDERED _________ $12 ________ _________ $12 ________ AAAA- S S S S M M M M L L L L XL, XL, XL, XL, Y-L Y-L Y-L Y-L Y-M Y-M Y-M Y-M _________ $60 ________ AAAAAAAAAAAAAA- S S S S S S S S S S S S S S M M M M M M M M M M M M M M L L L L L L L L L L L L L L XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-M Y-M Y-M Y-M Y-M Y-M Y-M Y-M Y-M Y-M Y-M Y-M Y-M Y-M _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ $17 $17 $11 $22 $16 $16 $13 $13 $18 $12 $25 $16 $18 $17 ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ AAAAAAAAAAAATTTAA- S S S S S S S S S S S S 6mo 6mo 6mo S S M M M M M M M M M M M M 12mo 12mo 12mo M M L L L L L L L L L L L L 2T 2T 2T L L XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, XL, 4T 4T 4T XL XL Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L Y-L 6T 6T 6T XXL Y-M Y-M Y-M Y-M Y-M _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ $15 $15 $15 $15 $15 $20 $20 $9 $22 $20 $21 $25 $13 $14 $14 $49 $21 ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ AYAYAYAYAA- 30 22 30 22 S XL S XL S S 34 26 34 26 36 28 36 28 38 40 38 40 Y-M Y-M S S S S XL, XL, BLUE XL, XL, XL, XL, Y-L Y-L AAAA- 32 24 32 24 M L M L M M RED M M M M Y-L Y-L Y-L Y-L Y-M _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ $55 $55 $55 $55 $40 $30 $40 $30 $40 $40 $13 $23 $32 $32 $32 ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ 2 Y-M Y-M Y-M Y-M Y-M Y-M M M L L L L L L _________ $55 ________ ITEM UNDER ARMOUR TECH TEE TRACK JACKET SHORTS AND PANTS UNDER ARMOUR ZONE SHORTS BLACK BLACK NAVY NAVY RED RED EL MESH WORKOUT SHORTS BLACK MESH WORKOUT SHORTS BLACK NAVY RED GIRLS MESH CHEER SHORTS NAVY RED RUNNING SHORTS BLACK RED ROYAL JERSEY CHEER SHORTS NAVY RED OXFORD GRAY PINK LOUNGE PANT PINK LOUNGE PANT BLUE HATS CAMO HAT GIRLY CAMO HAT ALL-STAR HAT COLLEGIATE HAT MAROON UNDER ARMOUR PINK LADY HAT LOST CAMO HAT FRAYED PATCH HAT SKI CAP CAMP STUFF UNLIMITED EMAIL PACKAGE SESSION DVD SONGS OF OZARK HYDRATION PACK RED WHITE & BLUE SWEATBAND CROAKIES CLIP-ON FAN SWEATSHIRT BLANKET CAPTAIN’S CHAIR FLIP FLOPS L.L. BEAN BACKPACK DRAWSTRING BACKPACK CAMP COLLAGE PILLOWCASE BLOB SOCKS GOLF TOWEL BEACH TOWEL GREEN BEACH TOWEL ORANGE LAUNDRY BAG SIZE (Circle Preference) QUANTITY PRICE TOTAL ORDERED _________ $30 ________ _________ $35 ________ AA- S S M L L XL XL, A- S M L XL A- S M L XL A- S M L XL A- S M L AAA- S S S M M M AA- S S AAAAAAAAA- Y-L Y-L Y-M Y-L Y-M Y-L Y-M _________ _________ _________ _________ _________ _________ XL, Y-L Y-M _________ $28 ________ L L L XL, XL, XL, Y-L Y-L Y-L Y-M Y-M Y-M _________ $25 ________ _________ $25 ________ _________ $25 ________ M M L L XL, XL, Y-L Y-L Y-M Y-M _________ $23 ________ _________ $23 ________ S S S M M M L L L XL, XL, XL, Y-L Y-L Y-L Y-M Y-M Y-M _________ $24 ________ _________ $24 ________ _________ $24 ________ S S S S S S M M M M M M L L L L L L XL, XL, XL, XL, XL, XL, Y-L Y-L Y-L Y-L Y-L Y-L Y-M Y-M Y-M Y-M Y-M Y-M _________ _________ _________ _________ _________ _________ $10 $10 $10 $10 $22 $22 ________ ________ ________ ________ ________ ________ GOLD _________ _________ _________ _________ _________ _________ _________ _________ _________ $20 $20 $20 $20 $20 $30 $20 $15 $10 ________ ________ ________ ________ ________ ________ ________ ________ ________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ _________ $20 $25 $15 $40 $6 $7 $18 $30 $38 $18 $60 $12 $11 $7 $5 $25 $25 $12 ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ A- ONE SIZE FITS MOST Y- ONE SIZE FITS MOST ONE SIZE FITS MOST ONE SIZE FITS MOST BURNT ORANGE RED KHAKI ONE SIZE FITS MOST ONE SIZE FITS MOST ONE SIZE FITS MOST ONE SIZE FITS MOST 1 A- 2 3 4 S PINK 5 M A L GREEN ADULT 3 B C XL, D Y-L E F Y-M NEON GREEN YOUTH $35 $30 $35 $30 $35 $30 ________ ________ ________ ________ ________ ________ (over) ITEM SIZE (Circle Preference) APPLIQUED PILLOWCASE BLUE/TIE-DYE PINK/PURPLE ORANGE/CAMO GREEN/PINK BANDANA RED NAVY CAMO TERVIS TUMBLER COOLING NECKWRAP COOKBOOK WATER BOTTLE CAMP OZARK FIT SUMMER 2011 NOTECARDS TRAILER HITCH JEWELRY OZARK LOGO CHARM CROSS CHARM STERLING SILVER CABLE CHAIN (18”) LOGO CROSS LEATHER CORD WITH CHARM 6 7 8 9 10 STERLING SILVER CROSS RING 4 5 6 7 8 9 10 OZARK CUTOUT RING VINTAGE WRAP BRACELET GIRLY NECKLACE RED BLUE WHITE BOOKMARK QUANTITY PRICE TOTAL ORDERED _________ _________ _________ _________ _________ _________ _________ _________ $26 $4 $22 $8 $22 $15 $10 $10 ________ ________ ________ ________ ________ ________ ________ ________ _________ _________ _________ _________ _________ _________ _________ _________ _________ $27 $27 $30 $47 $25 $49 $17 $13 $43 ________ ________ ________ ________ ________ ________ ________ ________ ________ CARE PACKAGES Please write message for enclosure card: Mission Impossible packages, Special Event Acessories packages and Enchiladas are available on Opening Day. All other care packages will be delivered in the middle of your camper’s stay. If multiple packages are ordered, the packages will be delivered on different days. AS M L XL, Y-L Y-M _________ $55 ________ CRAZY FOR CAMP BOY W/ SHIRT AS M L XL, Y-L Y-M _________ $55 ________ CRAZY FOR CAMP GIRL W/ SHIRT S M L XL, Y-L Y-M _________ $55 ________ MISSION IMPOSSIBLE ORANGE W/ SHIRT AAS M L XL, Y-L Y-M _________ $55 ________ MISSION IMPOSSIBLE PINK W/ SHIRT _________ $40 ________ SECRET AGENT _________ $40 ________ BIRTHDAY BASH Date to be delivered: _________ $55 ________ BEAT THE HEAT CADDO OSAGE FIRST-YEAR _________ $45 ________ MVP ADULT SOCKS YOUTH SOCKS _________ $55 ________ DREAM ON _________ $35 ________ CHATTER BOX _________ $30 ________ BON VOYAGE BOY GIRL _________ $35 ________ CLEAN MACHINE ULTIMATE PACKAGES _________ $525 ________ WHOLE ENCHILADA AS M L XL, Y-L Y-M SHIRT SIZE AS M L XL, Y-L Y-M SHORT SIZE RED TRUNK BLUE TRUNK _________ $650 ________ PREMIUM WHOLE ENCHILADA AS M L XL, Y-L Y-M SHIRT SIZE AS M L XL, Y-L Y-M SHORT SIZE ________ $375 ________ HALF ENCHILADA AS M L XL, Y-L Y-M SHIRT SIZE AS M L XL, Y-L Y-M SHORT SIZE _________ $500 ________ RED TRUNK BLUE TRUNK PREMIUM HALF ENCHILADA AS M L XL, Y-L Y-M SHIRT SIZE AS M L XL, Y-L Y-M SHORT SIZE _________ $150 ________ SPECIAL EVENT PACKAGE AS M L XL, Y-L Y-M SHIRT SIZE _________ $35 ________ BOY GIRL SPECIAL EVENT ACESSORIES PACKAGE TOTAL (All prices include tax) RETURN THIS FORM TO CAMP OZARK BY APRIL 1, 2011 FOR CAMP OZARK OFFICE USE ONLY ________ I, ___________________________________________ have received all items listed above and accept responsibility for them. I understand Camp Ozark is not responsible for those items lost or stolen. 4 Camp Ozark Code of Conduct This page should be read and understood by both Parents/Guardians and Campers. If, after reading this page, you have any questions regarding the Camp Ozark Code of Conduct, please don’t hesitate to contact the Camp Ozark office. Camp Ozark strives to create a camp environment where campers feel secure while having an enjoyable and meaningful time. One of the ways in which we seek to achieve this goal is through the concept of “ValuesBased Camping.” Through this concept, Camp Ozark strives to help our campers in the following ways: * Develop a more positive self-esteem * Develop greater self-confidence * Interact with positive, Christian role models * Become more independent * Learn the importance of friendship * Develop interpersonal relational skills In order for the implementation of “Values-Based Camping” to be most effective, and to help ensure a secure and enjoyable camp environment for all campers, Camp Ozark has identified certain expectations/rules, which all campers must observe. We also think it is important that both parents and campers be aware of these expectations/rules prior to arriving at Camp Ozark. In addition, the expectations and rules of camp will be reviewed with your camper at the beginning of each session. Please review these expectations/rules with your camper. 1. 2. 3. 4. 5. 6. 7. 8. Campers are to respect other campers and staff, as well as their belongings. Campers must be respectful in their expression through apparel, language, gestures, or writing. Inappropriate or offensive language is not allowed. Bullying or abuse, in any form, is not allowed. Bullying and abuse can be both physical and emotional. Use and/or possession of drugs, alcohol, tobacco, knives, firearms (except in authorized camp activities) and other items deemed dangerous is strictly forbidden. Violation of this policy will result in immediate dismissal from camp. Campers must keep prescription and non-prescription medicine at the health center. Special circumstances must be cleared by the camp’s health center. Cell phones and other mobile communication devices are strictly prohibited. Other electronics, such as iPods, video games, computers, etc., are also prohibited. Any such item brought to camp will be taken up and returned on Closing Day. Camp Ozark is not responsible for the theft or damage to any personal property. Campers will be expected to participate in all scheduled Camp Ozark program activities unless exempt due to health or parental restriction. Inappropriate physical contact with other campers or staff is not allowed. Camp Ozark rules and regulations are to be followed at all times. In order to serve all of our campers and provide a positive experience for them, Camp Ozark implements a thorough system of camper monitoring. If it is determined that a camper is failing to adhere to the Camp Ozark Code of Conduct, or is in any other way creating an environment detrimental to the overall camp experience, Camp Ozark reserves the right to enforce consequences designed to correct such behavior. Consequences may include, but are not limited to, such things as: limitation of privileges, verbal and/or written warnings, parental notification, or, in extreme cases, expulsion from Camp Ozark. Additionally, campers who repeatedly fail to adhere to the Code of Conduct may run the risk of not being allowed to attend Camp Ozark in the future. Once again, if you have questions regarding the Camp Ozark Code of Conduct, please don’t hesitate to contact the Camp Ozark office. There is no replacement for the values and self-worth that are instilled through a loving, nurturing, and mentoring relationship with college counselors committed to serving children. We hope you will consider partnering with us to help change young lives and plant seeds that will have an eternal impact. Every child you sponsor is a life changed. Camp Ozark Foundation, Inc. • 155 Camp Ozark Drive • Mount Ida, AR 71957 • 870.867.4131 Ozark for All plant a seed watch it grow Name Address City E-mail State ZIP Phone Sponsor a child: $400 Sponsor a cabin: $4000 One time gift of: $ ______________ Recurring gift of: $ _______ Make checks payable to: Camp Ozark Foundation, Inc Memo: OFA Annual Fund Credit Card Option - Please deduct the above amount from my credit or debit card. (please print clearly) Card Number: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ CSV ___ ___ ___ ___ Card Type: Visa MC Exp Date: _____/_____ If recurring gift, please deduct on the: _____ of each month Cardholder Name:______________________________________ Signature ___________________________________ You will receive a receipt for your tax deductible donation. CAMPER NAME _______________________________ SESSION _______________________________ TELEPHONE (______)________________________ FEE SUMMARY (This form MUST be completed and returned to Camp Ozark) 1. STORE DEPOSIT (Suggested amounts: $150 for 14-day session, $100 for 7-day session) SELECT ONE: Donate unused portion to the Camp Ozark Foundation Refund unused portion to me by check 1. ___________________ 2. TRAVEL FEES (Bus, Airport Transportation, etc.; See “Travel Card”) 2. ___________________ 3. CLOTHING ORDER (See “2011 Camp Essentials Order Form”) 3. ___________________ 4. AWARDS DAY LUNCH FEE $7.50 per person x ___________ people (Camper does not pay) (NOTE: No picnic provided for Sessions A, C or E) 4. ___________________ NOTE: Reservations for Awards Day Picnic must be made and paid for in advance. No tickets are available the day of the picnic. 5. BALANCE OF TUITION **(Due by April 1, 2011) Please refer to the following chart as an aid in determining your tuition balance. (For example, if you are attending a 14-day session, and have made a $225.00 deposit payment, your tuition balance is $2,070.00.) $225 deposit 7-Day Session $1,195 - $225 = $970 14-Day Session $2,295 - $225 = $2,070 21-Day Session $3,490 - $225 = $3,265 6. MANDATORY CAMPER INSURANCE POLICY*** (Not optional) NOTE: Camper insurance is $20.00 per camper, per session. 5. ___________________ 6. ___________________ 7. MISCELLANEOUS FEES 7. ___________________ Specialized Classes: SCUBA ($220), Advanced Water Skiing/Wakeboarding ($150), Golf ($30 per trip) Medication shipping/handling fee ($20) 8. STAYOVER FEE (Only if camper is staying an additional session.) $70.00 8. ___________________ 9. 2012 DEPOSIT (The only way to GUARANTEE a spot in the session of your choice for 2012.) $225 per session per child (Complete back of page and place total here.) 9. ___________________ SUBTOTAL ……….. ____________ 10. OPTIONAL CHARITABLE CONTRIBUTION (Tax-deductible) OZARK FOR ALL – assists underserved children to attend Camp Ozark (see enclosed flyer) Help fund a camper - $400.00 Help fund a cabin - $4,000.00 OZONE MINISTRIES – year round ministry program for middle and high school students 10. $100.00 ___ ____ _ ___ _________ _____ $100.00 TOTAL ……………_____________ **Tuition: If you have any questions concerning your tuition balance, please contact Camp Ozark at 870-867-4131 during regular business hours, or email us at campozark@campozark.com. All fees are due and payable to Camp Ozark on or before April 1, 2011. Should you, for any reason, be unable to complete fee payment by April 1, 2011, alternate arrangements may be made through the Camp Ozark office in Mount Ida. ***The Mandatory Camper Insurance Policy is a No-Fault, No-Deductible Medical Payments policy which covers all medical, x-ray and /or prescription drug expenses up to $2,500.00 should your camper require medical attention while at Camp Ozark. See the Camper Policy Agreement for more details. Please add the $20.00 fee per session to your total when computing your Fee Summary. NOTE: All Fees and Forms should be mailed by April 1, 2011 directly to the following address: CAMP OZARK 155 Camp Ozark Drive Mount Ida, AR 71957-8309 CAMP OZARK 2012 Pre-enrollment Information Complete this form and return the appropriate deposit prior to April 1, 2011 to GUARANTEE a spot in the session of your choice. 2012 SESSION DATES 14-day Sessions 1st Session................................................................ June 3 – June 16 2nd Session............................................................... June 17 – June 30 3rd Session ............................................................... July 1 – July 14 4th Session ............................................................... July 15 – July 28 5th Session ............................................................... July 29 – August 11 7-day Sessions Session A ................................................ June 3 – June 9 Session B................................................. June 10 – June 16 Session C ................................................ July 1 – July 7 Session D ................................................ July 8 – July 14 Session E ................................................ July 29 – August 4 Session F ................................................. August 5 – August 11 21-day Sessions Session G ........................................................June 10 – June 30 Session H.........................................................June 17 – July 7 Session I ..........................................................July 8 – July 28 Session J...........................................................July 15 – August 4 Camper 1: Name Circle desired session(s): 7-day Sessions: A B C M D E F 14-day Sessions: 1st 2nd 3rd 4th 5th F Date of Birth 21-day Sessions: G H I J Camper 2: Name Circle desired session(s): 7-day Sessions: A B C M D E F 14-day Sessions: 1st 2nd 3rd 4th 5th F Date of Birth 21-day Sessions: G H I J Camper 3: Name Circle desired session(s): 7-day Sessions: A B C M D E F 14-day Sessions: 1st 2nd 3rd 4th 5th F Date of Birth 21-day Sessions: G H I J Camper 4: Name Circle desired session(s): 7-day Sessions: A B C M D E F 14-day Sessions: 1st 2nd 3rd 4th 5th F Date of Birth 21-day Sessions: G H I J Please complete the information for each child to be pre-enrolled for 2011. There is a $225.00 deposit and registration fee per child per session. Please enter the appropriate amount in the space provided on item #9 of the fee summary sheet. 1 child = $225.00 2 children = $450.00 3 children = $675.00 4 children = $900.00 To pre-enroll a camper for 2012, please complete the information above and return it to CAMP OZARK along with a $225.00 deposit and registration fee per child per session. By pre-enrolling for 2012 you will be GUARANTEED a spot in the session of your choice. The $200.00 deposit is refundable until February 1, 2012. After February 1, 2012, the $200.00 deposit is non-refundable in the event of cancellation for any reason. The $25.00 registration fee is non-refundable. Tuition for 2012 will not be determined until August 2011. A slight increase in tuition is expected. Camp Ozark’s Helpful Reminder List Things to do now: ______ 1. Complete the Morning Activities selection process as soon as possible. Please see the instruction sheet included in this packet. Remember, the sooner you complete your activity selections, the better your chance of getting all or most of your desired choices. ______ 2. Make an appointment for your camper(s) to get a Physical examination. ______ 3. If choosing Medication Option 2 (see “Health Information” form, Option 2), make arrangements to obtain original prescriptions from your Physician for any medications your camper(s) will require while at camp. Things to remember when sending in the Camper Packet: ** Remember all Forms and Fees are due April 1st, 2011 (Medication and Pharmacy Form due May 1st, 2011.) ______ 1. SIGN THE FRONT OF THE HEALTH FORM; make sure the Physician has signed the form, as well. Attach or fill in the necessary immunization information. Make sure your current insurance information is completed and a copy of your insurance card is attached. Check with your insurance company to determine which Hot Springs, AR, hospital is an “in network” provider, in case of emergency. This form does not need to be notarized. As always the Health Form must be completed in its entirety. ______ 2. If choosing Medication Option 2 (see “Health Information” form, Option 2), COMPLETE THE 2011 CAMP OZARK MEDICATION PACKET, INCLUDING THE MEDICATION AND PHARMACY FORM (if applicable). Be sure to attach original prescriptions for any medications your camper will need. ______ 3. Complete the Travel Form, front and back, and include all travel information in regards to travel to and from Camp Ozark. ______ 4. Please sign both copies of the CAMPER POLICY AGREEMENT, ASSUMPTION OF RISKS AND AGREEMENTS OF RELEASE AND INDEMNITY, and send one (1) copy back to Camp Ozark. Keep one (1) copy of the form for your records. ______ 5. Please read the CAMP OZARK CODE OF CONDUCT form and review it with your camper(s). ______ 6. Complete the 2011 Application for Enrollment. If our records indicate we do not have a completed Camp Ozark 2011 Camper Application Form, your packet will contain a Summary Application Form and instructions on how to complete your Application for Enrollment. ______ 7. Always remember to enclose your payment with the Fee Summary information. ______ 8. Complete the 2012 Pre-Enrollment information on the back of the Fee Summary sheet, and include the appropriate deposit, which will guarantee you a spot in the session of your choice next summer. MORNING ACTIVITY SELECTION CAMP OZARK 2011 Morning Activities are primarily designed for the camper to learn or improve upon a skill from one day to the next. Camp Ozark creates a personalized Morning Activity schedule for each camper. These personalized schedules are created using each camper’s preferred activities, which are selected online. Each scheduled activity will meet daily for the duration of one week. Campers will participate in three periods of activities each day. Therefore, two week campers will generally participate in six Morning Activities, while one week campers will participate in three Morning Activities. NOTE: All activities are staffed and open recreationally every afternoon during our camp-wide free time known as Mish Mash. In addition, all campers are automatically scheduled to go to the lake with their cabin at least once during the session. Please follow the instructions below in making your Morning Activity selections as soon as possible. The sooner you complete your online activity selection, the better your chance of getting all or most of your desired choices. If, for any reason, you are unable to utilize our online Activity Selection feature, call Camp Ozark at 870-867-4131, between 8:00 a.m. and 5:00 p.m., Monday-Friday, and we will be glad to assist you in selecting your activities. Instructions Each camper will select 15 classes in which they are most interested, and place these classes in order of preference. 1. All activities are selected through your personal My Ozark account on our website www.campozark.com. You must have a My Ozark account to select Morning Activities. If you have already created a My Ozark account, proceed to the next step. If you have not created a My Ozark account, one has been created for you. Please contact Camp Ozark for instructions to access your My Ozark account. 2. Login to your My Ozark account at www.campozark.com. Your camper(s) will be listed on your My Ozark Dashboard. 3. Click the Activity Selection button found under your first camper’s name. NOTE: You will need to select activities separately for each camper listed. 4. Review the instructions, then click “Continue.” 5. Click on a group to browse the activities listed under that group. Campers may choose any number of activities from any group. 6. Click on any activity for a description. If you would like to add the activity to your list, click the “Select This Activity” button. You may also select the activity without viewing its description by simply clicking the star located in the corner of each activity. 7. Continue browsing activities until you have selected 15 activities. 8. Once 15 activities have been selected, click on the “Rank Selections” tab. You may then drag your activities to re-arrange them in order of preference from 1-15. You may also delete any activity from the list by placing your mouse over the activity and clicking the “X.” This will allow you to replace any activity with another choice. 9. Once you are satisfied with your activities and their order of preference, click the “Submit Activity Selection” button. 10. Return to your activity selections at any time to add, delete or re-order your activities.
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