Camper’s Last Name: / First Name (or name to be called):
Male / Female / Age at Camp: / Birth Date: / Grade Passing to:
Camper Lives with Parent/ Guardian Name:
Parent Relationship:
Married / Divorced / Separated / Single / Re-Married / Widowed
If parents are divorced, does non-custodial parent have pickup rights? / Yes / No
Home Street Address:
City: / State: / Zip Code:
Home Phone # / Parent Email:
Mother Occupation: / Work # / Cell #
Father Occupation: / Work # / Cell #
T-Shirt Size:
YM / YL / AS / AM / AL / AXL
Billing & Session Selection
Billing Choice Monthly: / Yes / No / Billing Choice One Lump Sum: / Yes / No
Payment Online / Yes / No / Down payment / Yes / No
Payments / Date / Amt / Final Payment Received / Yes / No
Credit Card Number: / Expiration:
Check # / Check Date: / Amount: / Other:
Session / Session Dates / Details / Cost / Incentives / Cost
O / Monday, May 25th to Friday May 29th: / Staff Only
A / Monday, June 8th to Friday June 12th: / Choose an item. / Choose an item. / Choose an item.
B / Monday, June 15th to Friday June 19th: / Choose an item. / Choose an item. / Choose an item.
C / Monday, June 22nd to Friday June 26th: / Choose an item. / Choose an item. / Choose an item.
D / Monday, June 29th to Friday July 3rd: / Choose an item. / Choose an item. / Choose an item.
E / Monday, July 6th to Friday July 10th: / Choose an item. / Choose an item. / Choose an item.
F / Monday, July 13th to Friday July 17th: / Choose an item. / Choose an item. / Choose an item.
G / Monday, July 20th to Friday, July 24th: / Choose an item. / Choose an item. / Choose an item.
H / Monday, July 27th to Friday, July 31st: / Choose an item. / Choose an item. / Choose an item.
I / Monday, August 3rd to Friday, August 7th: / Choose an item. / Choose an item. / Choose an item.
Bus Transportation for 1 Wk/1 Camper - Huntsville / 2 plus $40 each / $50
Bus Transportation for 1 Wk/1 Camper - Decatur / 2 plus $20 each / $30
Bus Transportation for 1 Wk/1 Camper - Athens / 2 plus $40 each / $50
Bus Transportation for 1 Wk/1 Camper - Hartselle / 2 plus $25 each / $35
Bus Transportation for 1 Wk/1 Camper - Cullman / 2 plus $40 each / $50
TOTAL Cost This Camper
Transportation
Camper is traveling mornings, Daily by: / Camper is traveling evenings, Daily by:
Car/ Driver / Car/ Driver
Bus/ Location / Bus/ Location
Enclose $250 deposit for one, one-week session. Payment in full is due by March 1.
If enrolling after March 1, pay in full.
Make check payable to Camp ADVENTURE @ Coffey Grounds.
Please include camper name and session on checks.
Download all forms to register online at www.coffeygrounds.net (ages 6-18).
Parent/ Guardian ReleaseI have read the Camp ADVENTURE Camper Guidelines and agree to all terms and regulations. I understand there is a certain degree of risk and danger in camp living, activities and trips. My child has permission to participate in all camp programs, activities and trips. This agreement is deemed to be entered into in the State of Alabama and to be governed and enforced pursuant to Morgan County, Alabama law. The camp is granted permission to provide routine health care, administer medications and seek emergency medical treatments for my child if and when necessary.
Signature of Parent/ Guardian with Legal Custody / DatePrinted Name of Parent/ Guardian with Legal Custody
Camper Agreement
I have read (or had read to me) and agree with the regulations in the Camper Guidelines and will commit and agree to follow all rules, regulations and policies to help everyone have a safe, fun time.
Signature of Camper / Date
Frank answers to the following will aid in assuring a happy, meaningful experience for campers. All information will be handled discreetly, but may be shared with camper's counselor. We use some information for statistics about camp.
Other camp(s) attended:
Religious affiliation:
Brothers & ages Sisters & Ages:
Has camper experienced major life changes in the past year (divorce, moving, new sibling/parent, death of loved one)?
Any special needs or physical conditions (Medical, ADHD...)
What do you hope camper gains from attending Camp ADVENTURE?
Other suggestions to help camper:
Email addresses of other families who would like to receive information:
Camper Guidelines
CAMPERS: Please read this form or have it read it to you so you will understand and know what is expected while at Camp ADVENTURE. This will help all who attend camp to have a fun and safe experience. Camp ADVENTURE has a “two strikes and you’re out” policy for breaking rules or for making other campers feel emotionally or physically unsafe. (Major infractions are “one-strike”.) Parents will be called after the first “strike”. No refund for campers sent home.
WATER: Swimming and boating are permitted only when lifeguard is on duty. Go on docks only during scheduled activity time with staff present. Let staff know when you are hiking the lake and always have a friend with you.
LAND: Respect the camp buildings and property. Your parents will be charged for any damages done and you are responsible for clean-up (including graffiti, rec hall equipment, sports equipment, etc).
LOCATION: Be where you are supposed to be WHEN you are supposed to be there. This includes activities, meals, canteen/general swim time and with your group. For hiking or exploring during free time, you must have friends and a staff member with you.
LOOKS: Shirts must be worn except during swimming/ water activities. You may go barefoot (it’s summer!) but suggest athletic shoes and shoes for around the water (flip flops, water shoes, crocs). At all times follow the Camp ADVENTURE dress code that emphasizes modesty and good taste.
LOYALTY: Campers are mature young women and men with CLASS: that means no tobacco, illegal drugs, alcohol, pornography, gambling, matches, fireworks, weapons, profanity, or inappropriate sexual behavior or you will be sent home. You can be fined for profanity by being tasked with extra chores.
LOVE: “Do to others what you would have them do to you”. Respect other campers and their property.
WHAT NOT TO BRING:
iPods/MP3s, Electronic Games, Cell phones, Aerosol cans, Weaponry, Food/Gum, TVs, Fans, Radios, Pokemon-type cards, Questionable reading material, Tapes/CDs (unless for Talent Show and must turn in office) and money. If any of these items are brought, they may become camp property and not be returned, even if it is expensive. Exceptions are made only if you turn it in to the office upon your arrival. Leave expensive items at home.
DRESS CODE: No slogans promoting alcohol, sex, tobacco, drugs, profanity or death themes. Stud earrings only. Modest swimsuits for girls (tankinis are allowed); swim trunks instead of briefs for boys. We do enforce a dress code of modesty. No short-shorts or mini-minis. Guys do not go shirtless except at appropriate sports and swimming and your underwear should not show.
TRAVEL: If for any reason you are traveling on camp transportation vehicle rules include staying seated, keeping all body parts inside the vehicle, not throwing anything out of the vehicle, not leaving the vehicle until told that you can and only through the door.
TELEPHONE: Campers cannot receive phone calls and cannot make calls except in case of emergency. At that time they can use an office/counselor phone.
FACTS OF LIFE: Remember that your private areas are PRIVATE at all times. If you ever get injured in those areas though, through sports, etc., you should tell your camp counselor and/or the nurse. Also tell the nurse or a director if anyone – adult or camper – inappropriately touches you or anyone else. We emphasize FRIENDSHIPS rather than “relationships” and we do not allow PDA (public/private displays of affection) that go beyond friendship.
WATERBOTTLES: Campers may bring and carry a filled water bottle to camp to prevent dehydration.
PACKAGES: Campers cannot receive packages.
CLEAN-UP & DIRTBUSTERS: Campers have daily scheduled clean-up assignments at meal time and other activities (setting tables, sweeping the rec hall, picking up litter, etc.). All campers are expected to participate.
OTHER POLICIES: The camp can use any photographs, videos, writings, quotations, etc. of you to promote camp. All personal items and sports equipment are brought at your risk and must be stored where you are told. Camp ADVENTURE is not responsible for personal belongings and money while traveling or in camp or if lost or damaged or stolen. Camp ADVENTURE staff can search your personal belongings if illegal substances, contraband, weapons or theft are suspected.
Thank you for taking the time to get familiar with our guidelines. We hope you will commit to follow them to help everyone at camp have a safe, fun time.
2015 Announcements
PARENTS PLEASE READ THIS PAGE CAREFULLY BEFORE SUBMITTING APPLICATION
PHILOSOPHY: Camp ADVENTURE is a traditional summer day camp with moral values. We seek to inspire boys and girls to develop physically, spiritually and socially in a fun, friendly, moral, natural environment.
ADMISSION: Boys and girls in grades 1-11 (ages 6-18).
RISING 10th or 11th GRADERS Leaders-in- Training (rising 10th grade/ 11th grade); they get discounted fees in exchange for some work.
CAMPER GUIDELINES: All campers must read (or have read to them) the Camper Guidelines. When you agree to the waiver, you are stating that your camper has read and agrees to abide by the regulations outlined in the Guidelines.
IF YOU ARE ENROLLING FEBRUARY 1 or after, pay in full.
FEE: Our fee includes one week of activities and is based on age and capabilities. We offer discounts for early registration and multiple campers.
One Week
Adventure Youth (AYs) (~6-10 years): $300
Adventure Tweens (ATs) (~11-14 years): $325
Adventure High School (AHS) (~15-18 years): $350
Adventure Leaders in Training (ALTs) (~15-18 years) fees discounted in exchange for some work: $300 (Must apply and be admitted to this program. See our Leaders in Training web page for information: http://www.coffeygrounds.net/camp-adventure-leaders-in-training.html)
INCENTIVES: Early enrollment discount for all applications and deposits postmarked by January 31, sibling discount after the first child, and discounts for Leaders-in-Training. You can also earn discounts for recruiting new campers if you are a returner. No more than two $25 incentive debits per camper.
TRANSPORTATION: The gate for car riders is open between 7:00 and 8:00 a.m. and 4:30 to 5:30pm weekdays.
For a transportation fee on each weekly session, we will provide bus transportation to specific pickup/drop-off locations in North Alabama. Parents can have the ease of picking kids up in an easier access location for them.
OPEN HOUSE: You may visit our facilities prior to Camp ADVENTURE sessions. Check website for Open House dates and times.
BILLING: A $100 deposit for our one-week sessions must accompany each application and will be credited to tuition. Payments may be made monthly or in one sum. Final payment, or payments in full are due postmarked by March 1. If enrolling after March 1, send payment in full. We accept checks, debit cards and most credit cards. Payment is not confirmed until checks/payments clear. All payments are contingent upon openings available. We have a limited number of available camper slots. Payments can be made online at http://www.coffeygrounds.net/adventure-day-camp-shopping-cart.html
REFUNDS: Your deposit and tuition are fully refundable up to one week before start of first session if you must cancel. We deduct a $35 processing fee. Please note that if you don’t notify us of a cancellation, all monies paid will be forfeited. Because we may turn people away when sessions are filled, there will be no deductions for late arrivals or early departures.
ACTIVITIES: Campers will enjoy activities from such as crafts, survival, swimming, canoeing/kayaking, archery, rock climbing, wake tow, zip line, drama, cooking, woodwork, ropes course (rappelling/rock climbing), paintball, pottery, and more.
LOCATION: Camp ADVENTURE is outside the City Limits of Decatur Alabama adjacent to Interstate 65. We are seven miles from Hartselle, 11 miles from Athens, 12 miles from Madison, 20 miles from Cullman, and 18 miles from Huntsville.
HEALTH: The Camp ADVENTURE infirmary has a full-time health supervisor and provides for on-site needs and we have a relationship with a local medical clinic for other medical requirements. Health issues requiring a doctor, prescriptions, x-rays, or emergency room visits will be billed to parents. A copy of your insurance card must be provided with the health form. Staff members are CPR and First Aid certified.
WEAR/ BRING: Shorts/ T-shirt / bathing suit / towel / socks / athletic shoes / water area shoes. Campers are not to bring electronic devices, cell phones or ipods, etc. and no gum please. Unless special notice is given, money and valuables should be left at home.