South SD Spring Break 2017
We can't wait to worship together this Spring Break at InterVarsity's Campus By the Sea on Catalina Island!

Please email Melissa with any questions:
casiano.melissa@gmail.com

>>COST: $306, $70 Cancellation Free
Cost: $306. This pays for your boat ticket there and back, lodging and GREAT food for the entire week, costs of manuscript materials
Payments: You can pay this by cash or check (made out to "InterVarsity"). You can either pay this in one payment or in smaller payments. The total cost of the trip is due by Friday, March 24 to any staff member.
Cancellation Fee: If you register and decide you don't want to go, there is a $70 cancellation fee to cover the cost of your spot to spring break. But who wouldn't want to go?!
>>WHEN: March 26-31
We will be leaving in the morning of March 26 and returning in the afternoon of March 31.
More details after registration will be emailed out.
>>WHAT TO EXPECT
The island terrain is all dirt, and there is a strong ocean breeze with an amazing view of nature. There is not much electricity on the island, so please refrain from bringing electronics unless necessary. Also, there is little to no cell phone reception there. This week is a chance to unplug from electronics and focus on God and on each other.

The weather is usually sunny in the day and cooler at night with the sea breeze. Dressing in layers is best. Also, because there is little electricity, bring a flashlight!

Some possible activities during free time are: kayaking, snorkeling, basketball, ping pong, hiking, and beach volleyball. All equipment is provided by the camp. During one afternoon there will be a long, optional hike you can participate in.

>>PACKING LIST
Word to the wise:
We will be getting off the boat and walking onto dirt and rocks until we get to the cabins.
**Please, only pack what you can carry by yourself.**
Dress in layers.
Remember, there's not much electricity, so don't bring electronics.

Here is what you should definitely bring:
Pillow (Note: CBS is no longer providing pillows!)
Clothes for the week
Warm sweatshirt or jacket
Toiletries - soap, shampoo, deodorant, contact solution, medication, etc.
Towel
Warm sleeping bag - some cabins are open air and can get cold at night
Flashlight
Your Mark manuscript if you have gone before
Pack a meal for the drive, or bring $$ for food

Optional suggestions:

Bible & journal
Alarm clock w/ batteries
Swimsuit, basketball shoes, clothes for hike, etc.
Coffee mug / Reusable water bottle
Extra $$ for the gift shop
Earplugs

>>LET'S GO!
First Name
Your answer
Last Name
Your answer
Gender
What campus are you from?
What is your ethnicity?
Phone #
Your answer
Address
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Email
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Emergency Contact Name
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Emergency Contact Phone #
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Health Insurance Provider
Name of company (ie. Blue Cross, Kaiser, etc.) If none enter "N/A"
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Healthy Insurance Policy Number
If none enter "N/A"
Your answer
List any allergies (food or medical allergies?)
Your answer
Date of last tetanus shot. (mm/dd/yy)
If you don't know for sure make a guess.
Your answer
Are you able and willing to drive to the San Pedro dock?
If you are able to drive to San Pedro, how many seatbelts do you have?
(seatbelt count = total seatbelts in car including the driver seatbelt)
Your answer
Did someone invite you? If so, what was their name?
First and Last Name
Your answer
What class will you be in?
Individual Release
1. I unconditionally and fully release, hold harmless, indemnify, defend, and discharge (collectively: “Release”) InterVarsity from liability for any direct or indirect loss, expense, liability, claim, suit, proceeding, demand, judgment, assessment, action, costs, fees, or damages of whatever kind or nature, either in law or in equity, arising from or related to my involvement in or presence at the Event, including loss, illness, injury or damage to myself or my property (collectively “Claims”) whether such Claims have accrued or are hereafter acquired. However, I do not Release InterVarsity from liability for Claims to the extent caused by InterVarsity’s negligence, recklessness, or intentional misconduct except, I do expressly Release InterVarsity from liability for any and all Claims based upon InterVarsity’s failure to warn about or protect against the criminal or willful or reckless conduct of a third party, or the intervening act of a third person. Additionally, I covenant not to commence a lawsuit or administrative complaint or any sort of proceeding whatsoever against InterVarsity at any time in the future based on any right or claim that I may have or hereafter acquire with respect to Claims. Additionally, I may be given the opportunity to participate in Riskier Activities (enumerated and described below). I will be under no obligation to participate in Riskier Activities; however, if I elect to participate, I agree that as to those Riskier Activities the definition of Claims will be expanded to include those caused by the negligence of InterVarsity. The Riskier Activities include the following and any substantially similar activities: formal and informal sports (including by way of example activities ranging from capturethe-flag to touch football to Frisbee golf to dodge ball to roughhousing, and every other remotely related physical game or activity), paintball, gymnastics, ice or inline skating, laser tag, hiking, biking, skateboarding, equestrian activities, water activities including use of watercraft, adventure activities, ropes courses, zip lines, rock-climbing walls, downhill skiing, snowboarding, sand boarding, construction, parasailing, cave diving, sky diving (or other similar free-fall or air activities), spelunking, use of firearms or archery, and use of motorized off-road vehicles (including go-karts, ATVs, Segways and snowmobiles). If I have any question regarding whether an activity is a Riskier Activities included within Claims, it is my sole responsibility to inquire. I agree Riskier Activities is intended to be construed broadly and in favor of InterVarsity. 2. Safety and Acceptance of Risks; Behavioral Expectations I personally assume responsibility for my actions. I agree that I am responsible for following all rules communicated to me during the Event and will use safety equipment as applicable. I agree that my participation is a privilege, not a right, and InterVarsity reserves the right to dismiss me from the Event at my expense with no refund, and/or to refuse to allow my participation in future activities. I acknowledge that I have a responsibility to act within the limits of my ability, to heed all warnings and instructions regarding participation in the Event, to maintain control of my person, equipment or devices, and to refrain from acting in any manner that may cause or contribute to death or injury to myself or others or damage to property. I understand that non-medical use of alcohol and other drugs is prohibited on InterVarsity premises and at InterVarsity activities. To the maximum extent possible, I understand, assume, and accept the risks and hazards, either known to me or not readily foreseeable, involved in participation in the Event, including if applicable risks inherent to camping in the wilderness such as uneven terrain, proximity to wildlife, or other known or unknown hazards. I will alert an Event supervisor if I become aware of any condition that would be unsafe or hazardous, and will cease participation. 3. Photograph Release I grant InterVarsity permission to take photographic images or recordings of me, and grant all right, title, and interest in photographic images and recordings made by InterVarsity relating to the Event, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings and allow this material to be used for publicity. 4. Medical Release I understand and agree that InterVarsity does not assume any responsibility for or obligation to provide medical, health, or disability insurance, and I waive any claim to such coverage against InterVarsity. I give permission to InterVarsity to obtain medical assistance in the event of an emergency. This permission will include transportation, the administration of medicines, surgical treatment, X-ray examination or hospitalization as might be ordered by a licensed medical doctor. I release and discharge InterVarsity from any and all liability for any first aid rendered, treatment performed, or transportation provided or arranged pursuant to this consent. Further, I agree that, if I am an adult in my state (see page 3) and am mentally competent to do so at the time, I will make decisions regarding my health care based on the best information available to me, and will not hold InterVarsity responsible for my decisions. If I am not mentally competent to make these decisions, I authorize InterVarsity to make these decisions on my behalf and I release InterVarsity from any liability for damages that I incur as a result of medical decisions made in good faith on my behalf. I understand that it is my responsibility to evaluate my physical and mental health and determine whether I am sufficiently healthy to participate in the Event. 5. Hostage Policy I understand that InterVarsity has a hostage policy that states that InterVarsity should not yield to demands, including the payment of ransom or other extortion, issued through the use of hostage taking or extortion. 6. Alternative Dispute Resolution Any claim or dispute arising from or related to this Agreement shall be settled by mediation and, if necessary, legally binding arbitration in accordance with the rules of a mutually agreed upon alternative dispute resolution service and such proceeding shall take place in Madison, Wisconsin. Judgment upon an arbitration decision may be entered in any court otherwise having jurisdiction. The parties agree that these methods shall be the sole remedy for any controversy or claim arising out of this Agreement and expressly waive their right to file a lawsuit in any civil court against one another for such disputes, except to enforce an arbitration decision. 2 of 3 7. Entire Agreement; Modification: I agree that this Release is intended to be as inclusive as the laws of Wisconsin permit. This Agreement shall be governed by the laws of the State of Wisconsin and the United States without reference to conflict of laws. This release is intended to include all claims made by my family, estate, heirs, personal representatives or assigns. I agree that if a clause or provision of this Release is found by a court to be invalid, that finding shall not invalidate any other clause or provision of this Release, which shall continue to be enforceable.
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Do you need a scholarship?
If you need a scholarship, how much is the maximum you could pay?
Your answer
If you need a scholarship, explain why.
Your answer
If you need a scholarship, explain why you want to go to spring break camp.
Your answer
If you need a scholarship, which day are you available for a scholarship work day?
You are required to do one work day to get a scholarship
March 18
March 25
April 8
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By clicking YES here I acknowledge I will be paying a $70 NON-REFUNDABLE registration fee within a week of completing this form
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