MASON COUNTY ASSOCIATION FOR SPECIAL CITIZENS 6848 LIEVING ROAD LETART, WV 25253

CAMP SUNSHINE 2015

This year camp will be held on June 29 th July 2nd , 2015 at the 4-H camp at Southside, WV. The phone number for the camp is 675-6117. This is county property and all smoking is prohibited.

Campers must be 6 years of age or older. Mason Co. Special Citizens may attend free of charge. Any out of county residents who participate will be charged a $65.00 fee to attend.

Please read and fill out the application and health/social history form attached. Mail the application to the address listed below A.S.A.P. (NO APPLICATIONS WILL BE ACCEPTED AFTER JUNE 15, 2015/")

MCASC c/o Minnie Fowler 6848 Lieving Road Letart, WV 25253

You will REPORT to camp on Monday June 29, 2015 between the hours of 10:00 12:00 p.m. You will LEAVE camp on Thursday between 1:00 and 2:00 p.m. A LIGHT LUNCH will be served.

The camp staff discourages campers from bringing personal snack items and or pop. All food is provided by Camp Sunshine and all special diets should be listed on the health form.

Special instructions are listed below, please use these to help your child get ready for camp.

If you should have any questions feel free to call 740-416-7915 before 4 p.m. If there is not answer, please leave your number and I will call you back.

WHAT TO BRING TO CAMP

Enough clothing for the 4 days Extra clothing for water activities Jackets (evenings can be chilly) Toilet items- hair brushes, tooth brushes, shampoo, deodorant, towels, wash clothes, soap etc. Bed clothes- pillows, sheets, blankets. Sleeping bags are welcome. (We have very limited supply of these items, and no pillows) Cassette players and tapes must be marked with camper's name. We are not responsible for these items. PLEASE BRING WHITE T-SHIRT TO BE TIE-DYED

(Continues on back)

DRESS CODE:

1. The midriff/waist area must be covered whether sitting or standing. 2. See-through tops or open-sided shirts are to be worn with a shirt underneath. Halter

tops are not permitted. 3. Low-scooped, plunging, or revealing necklines will not be permitted. Cleavage may

not be shown. 4. Shirts, tops, and dresses must have straps at the shoulders of at least one (1) inch in

width and cross the shoulders from front to back. Off-the-shoulder tops do not meet this standard.

5. Lower body attire and dresses shall be no shorter than mid-thigh from knee to hip or not shorter than the reach of the fingertips

6. Oversized clothing or saggy or baggy pants that are a distraction or safety hazard will not be permitted.

7. Undergarments are not to be exposed or worn outside of clothing. 8. Clothing must be intact, without holes, rips, tears, or mutilation, from waist to

mid-thigh. 9. Footwear must be worn at all times 10. If wearing 2 pc bathing suit must wear T-Shirt over at all times.

DO NOT BRING THESE ITEMS TO CAMP/ m

Money (nothing is sold at camp) Stereos, TV's or other expensive items Do not bring aerosol spray or any kind of personal items with a heavy clinging odor. These attract animals and insect and can cause allergic reaction and asthma attacks in fellow campers. All cigarettes must be left at front desk. All vehicles must be parked in front of dining hall. NO VEHICLES ALLOWED IN DORM AREA

COME PREPARED TO ENJOY A FUN WEEK OF ACTIVITIES

WEEK EVENTS

Monday- Wear your favorite Team T-Shirt Tuesday- Mix n Match and Crazy Hair Day Wednesday- Country and Camo Day Thursday- Get up and go Day (Pajama Day)

Once again, feel free to call me should you have any questions at all.

Bonnie 311watt, 11),te./3ident

Mason Co. Association for Special Citizens

HEALTH STATEMENT CAMP SUNSHINE EVENTS

LAST NAME FIRST NAME AGE SEX

List below any physical condition the director of the event should know. (Reporting such conditions will no prevent children from attending and will be kept confidential)

Allergies (Explain) Allergic to any drugs Diabetes

Heart Conditions List any medicine being taken now(aspirin) 1.

Emotional Upsets 2.

Draining Ears 3.

Lack of Coordination

Coffee Drinker YES or NO Tobacco User YES or NO

Other Activities child should not participate in: IMMUNIZATIONS: Date of last Dose

Oral Polio: Tetanus:

*Medicine needs to be in proper containers, labeled with name and scheduled time to take medicines (only enough medicine to last during camp no extras). Any questions call Candy 304-675-6954.

PLEASE BRING WHITE T-SHIRT TO BE TIE-DYED.

*****WE HAVE BUNK BEDS- IF FOR ANY REASON YOUR CHILD SHOULD NOT BE IN TOP BUNK*****

PLEASE EXPLAIN:

He/she (circle one) may participate may not participate in water activities

My child actually can swim can not swim

I hereby understand that the participants will be closely supervised and that if a serious illness or injury develops, medical and /or hospital care will be given; however, I hereby release any member of the staff from liability in case of accidental injury or illness. I hereby further understand that in case of serious injury or illness I will be notified; but if it is impossible to contact me, I hereby give permission for emergency treatment as recommended by the attending physician.

- Signature of Parent

Home Phone Number Work Phone Other Number

In Camp Sunshine events, participants are covered with group insurance.

Programs and activities offered by the Mason Co. Assoc. for Special Citizens are available to all persons without regard to race, color, sex, disability, religion, age, or national origin.

Parent/Guardian Release Form for Photo Recording

1, the undersigned, do hereby grant or deny permission to Camp Sunshine to use the image of my child, , as marked by my selection(s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Camp Sunshine Web site. 0 Deny permission to use my child's image at all..

o Grant permission, I give unrestricted permission for my child's image to be used in print, video, and digital media. I agree that these images may be used by Camp Sunshine

for a variety of purposes and that these images may be used without further notifying me. I do understand that the child's last name will not be used in conjunction with any video or digital images.

Parent/guardian signature Date _I _I_

Minnie Fowler President Camp Sunshine, Mason County Association for Special Citizens 6848 Lieving Rd. Letart, Wv 25253