CAMP LUMINOUS
Incredible Value — Incredible Fun!
SEE THE COMPLETE YOUNGLINGS AND PADAWANS SCHEDULES HERE
     The inspiration of George Lucas has captured the imaginations of generations, the most recent being our kids and grandkids. The brilliant spiritual allegory of The Star Wars Universe is perfect for our aim, thus, our brand new four-day kids' camp, Camp Luminous!
     Camp Luminous is completely unique, designed by some of the leaders of the Six Crows Alliance community, who will be serving as our Jedi Masters. They will lead the programs, and also serve as the mentors for a small group of campers assigned to each of them. Our Jedi Masters are community leaders and spiritual adepts who have for many years worked with children in assorted fields and volunteer roles including child care, Sunday school, foster care, Boy Scouts, Junior Achievement; Big Brothers/Sisters, safe houses, Six Crows Gathering children's programs, and as parents and grandparents.
     Our ratio will be at least 1:7 (one caretaker for every seven children).We are still recruiting volunteers to assist. If you are good with children and would enjoy helping out, please contact us at kids@sixcrows.org. Parents who are not ready to send their younger children on their own, or whose children are not ready, are invited to sign up as an assistant and attend with their child.
     We will have an EMT on the premises. Background and Sexual Offender Registry checks will be made routinely on all volunteers.
     Camp Luminous is a rustic camp with outdoor kitchen and shower. Camping is in tents. Our counselors will be bunking in or near tents housing younglings and padawans.
     Our children are the future. What better way to help guide them toward a personal code of honor and self-empowerment, than through the greatest adventure of their summer! Check out the schedules and you will be incredulous at the value. Six Crows Alliance is thrilled to be able to subsidize Camp Luminous and make it affordable for all in these times.
REGISTRATION
We're excited to have your children/youths join us for our all out first Camp Luminous July 21-24, 2011. Please help us take good care of your campers by providing the following important information. You may register up to four campers on this form. If you are registering more than four campers from the same family, you will need to complete this form in full again.

Once you submit, you will be taken to a payment screen, where you may enter member discount or other special code information if applicable, and submit payment.
NOTE: ALL * ARE REQUIRED FIELDS
CONTACT AND FAMILY INFORMATION
* Parent/Guardian 1 Parent/Guardian 2
* Address Address (if different)
* Email Email
* Telephone Days Telephone Days
* Telephone Evening Telephone Evening
   Please provide details about custody arrangements during camp if applicable.
   Please tell us about family circumstances of which we should be aware if applicable.
* Emergency Contact (Additional to parents)   * Telephone
CAMPER INFORMATION — CAMPER 1
* NAME OF CAMPER      * Date of Birth      * Gender F  M
* Has this camper attended away camp before? Y   N        If yes, please describe his/her experience below.
* Doctor Name and Location       * Telephone
* Health Insurance Provider       * Policy No.
* Does the camper have any allergies? Y  N    * Is an epipen prescribed? (If yes, be sure to bring it) Y  N  If yes, please list allergies below, and also indicate intolerances to any foods.
Please list any medications your child will be taking at camp. These should be delivered to the intake worker in their original containers with clear dosing instructions, all contained in a single clear plastic bag, clearly marked with the camper's name.
If the camper is or may be restricted or limited in any physical activities, please explain in detail.
If applicable, please provide details about any behabioral issues and tell us how we can best facilitate your child's experience.
CAMPER INFORMATION — CAMPER 2
* NAME OF CAMPER      * Date of Birth      * Gender F  M
* Has this camper attended away camp before? Y   N        If yes, please describe his/her experience below.
* Doctor Name and Location       * Telephone
* Health Insurance Provider       * Policy No.
* Does the camper have any allergies? Y  N    * Is an epipen prescribed? (If yes, be sure to bring it) Y  N  If yes, please list allergies below, and also indicate intolerances to any foods.
Please list any medications your child will be taking at camp. These should be delivered to the intake worker in their original containers with clear dosing instructions, all contained in a single clear plastic bag, clearly marked with the camper's name.
If the camper is or may be restricted or limited in any physical activities, please explain in detail.
If applicable, please provide details about any behabioral issues and tell us how we can best facilitate your child's experience.
CAMPER INFORMATION — CAMPER 3
* NAME OF CAMPER      * Date of Birth      * Gender F  M
* Has this camper attended away camp before? Y   N        If yes, please describe his/her experience below.
* Doctor Name and Location       * Telephone
* Health Insurance Provider       * Policy No.
* Does the camper have any allergies? Y  N    * Is an epipen prescribed? (If yes, be sure to bring it) Y  N  If yes, please list allergies below, and also indicate intolerances to any foods.
Please list any medications your child will be taking at camp. These should be delivered to the intake worker in their original containers with clear dosing instructions, all contained in a single clear plastic bag, clearly marked with the camper's name.
If the camper is or may be restricted or limited in any physical activities, please explain in detail.
If applicable, please provide details about any behabioral issues and tell us how we can best facilitate your child's experience.
CAMPER INFORMATION — CAMPER 4
* NAME OF CAMPER      * Date of Birth      * Gender F  M
* Has this camper attended away camp before? Y   N        If yes, please describe his/her experience below.
* Doctor Name and Location       * Telephone
* Health Insurance Provider       * Policy No.
* Does the camper have any allergies? Y  N    * Is an epipen prescribed? (If yes, be sure to bring it) Y  N  If yes, please list allergies below, and also indicate intolerances to any foods.
Please list any medications your child will be taking at camp. These should be delivered to the intake worker in their original containers with clear dosing instructions, all contained in a single clear plastic bag, clearly marked with the camper's name.
If the camper is or may be restricted or limited in any physical activities, please explain in detail.
If applicable, please provide details about any behabioral issues and tell us how we can best facilitate your child's experience.
PARENT/GUARDIAN CONSENT, CONFIRMATION, AND INFORMATION
Check if you have a tent that your camper(s) are willing to share with other campers who do not have one. (Your help is appreciated. We will contact you to discuss.)
Check if, as a parent or guardian, you would like to sign up as an aide. (Your help is appreciated. We will contact you.)
* I am a parent or legal guardian of the minor(s) named in this registration form. I have read, understand, and agree to the Camp Luminous Terms of Attendance as detailed below:
I hereby give consent for my child(ren) to participate in Camp Luminous and all activities according to the registration information I have provided here. I agree to notify the camp if my child(ren) are exposed to any infectious diseases during the week leading up to camp. In case of medical emergency, I give permission to a physician selected by the camp to treat my child(ren) named on this form, including hospitalization, medication, injection, anesthesia, and surgery. I understand that every effort will be made in an emergency to immediately contact a parent/guardian or if we cannot be reached, the emergency contact named here. I give permission to the EMT on duty at Camp Luminous to apply first aid and treat my child(ren) for minor emergencies. I understand that camp counselors and camp assistants may also treat minor emergencies, counsel, and express reasonable caring for campers. I understand that my child(ren) may be photographed, and I give consent to the use of these photos to promote future Camp Luminous and/or Six Crows Alliance events. I understand that Camp Luminous reserves the right to dismiss a camper who is a hazard to the safety or rights of others, or who rejects the reasonable expectations of the Camp Luminous leadership and community. I release and agree to indemnity and hold harmless Camp Luminous and its camp counselors, and Six Crows Alliance, and members and volunteers of Six Crows Alliance, regarding any liability concerning my child's participation in Camp Luminous. I understand and agree that use of all Camp Luminous and Six Crows Alliance facilities are at the risk of participants.
 * Full Name                  * Date
DOWNLOAD YOUR CAMPER'S "NEED TO BRING" LIST HERE
(Don't worry, we'll remind you.)
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