December 9-11

young life winter weekend:

the best weekend of your life

WINDY GAP
When: Friday, Dec. 9 (3:00pm) through Sunday, Dec. 11 (7:00pm) Where: Windy Gap - 120 Coles Cove Rd., Weaverville, NC 28787 Who: 150 high school students from Wayne County, 300 more from around NC, and your Young Life Leaders! How much? $195 (non-refundable)
Further Information:

How to register: Complete the registration form below, attach $195 (cash or check made out to Young Life with your childs name and school in the memo line), and turn both in to a Young Life leader or mail your money and form to our ofce at: Wayne County Young Life PO Box 1702 Goldsboro NC 27533
For more information, please contact Ben Johnson at johnsonbenk@gmail.com or the YL office at 919.583.8474

Windy Gap: Windy Gap is one of Young Lifes 20 premier camping facilities in North America. Young Life camping involves high adventure, lots of fun, great food and excellent speakers who understand and respect high school students. www.windygap.younglife.org Travel/Transportation: We will be departing from JC Penney parking lot at 3:15pm on Friday, Dec. 9 and returning in the evening (7:00pm) on Sunday, Dec. 11. We will travel via professionally driven Charter Buses. Please let us know if you/your child needs special travel arrangements. Fee: Camp fee includes: transportation, insurance, lodging, meals at camp, t-shirt, and all activities at camp. We are committed to not let money be a reason not to go to camp, please communicate with us early if this is an obstacle. What to Bring: Sleeping bag, pillow, towel, clothes to get messy, WARM clothes, shoes that can get muddy/wet, swimsuit (hot tub), toiletries, spending money for snack bar, camp store, and 2 meals on the way (fast food).

In the event the your child becomes ill or injured while attending Young Lifes Windy Gap fall retreat, we request that Young Life be given permission to take your child to the nearest medical facility or healthcare provider and have the necessary treatment administered. Your signature verifies your child is in good health and capable of participating in strenuous activities. Your signature will also acknowledge your acceptance and understanding of Young Lifes role in the medical treatment of your child. In case of emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give Young Life the permission to act in my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary by Young Life. I hereby give permission to the medical personnel selected by Young Life to order x-rays, routine tests, treatment; maintain and/or releases any medical records necessary for insurance purposes as outlined under the hipaa regulations. *I absolve Young Life from liability in acting on my behalf in this regard. * Young Life is compliant with Health Insurance Portability and Accountability Act (or HIPAA)> To obtain a copy of Young Lifes Notice of Privacy Practice, log onto www.younglife.org or call 719-381-1950.. I hereby grant Young Life the right to use, reproduce, distribute photographs, films, video tapes and sound recording of my child without compensation or approval rights.

Parental Consent for Medical Treatment

Name of Child __________________________________ Gender ____ School __________________________ Grade ______ Parents or Guardians __________________________________________ Address __________________________________________ City _______________________ St. ______ Zip ______________ Phone _____________________ Cell ______________________ *Parent email ______________________________________ *Parents Signature ____________________________________________ T-Shirt Size: ________________________ Emer. Contact Name ____________________________________________ Emer. Contact Phone ________________________ Parents Insurance Co ________________________________________ Insurance Policy Number _______________________ Insurance Address ________________________________________________________________________