Information For
Pastors
Youth Leaders
Camp Coodinators
1Promote
Make sure your students and young adults
have a chance to plan for Camp Marengo.
Display flyers / posters
Announce in service, Sunday school,
and in youth group
Like us on Facebook and follow us on
Twitter for news throughout the year
2Register
Encourage campers and counselors to
register using the appropriate forms.
Distribute Counselor Applications and
information sheets to students and
adults who may be interested in
counseling.
Distribute Registration Forms and
Parent Information sheets to all
families.
Note to Church Leaders
Last year’s camp was great! I want to give a special thanks to those who helped out at camp and
also thank you to those who did the organizing on the church side of things. Camp Marengo served
634 campers last summer. 69 campers gave their lives to Christ for the first time and 78 felt a call to
ministry. Last summer we were blessed with a onetime donation that enabled us to give a Bible,
cabin picture, and picture frame to every student at camp. Praise God!
This year’s theme is “Wanted Dead or Alive”. This theme will be about the endless love that God
has for us and how he wants us to be his. God wants us when we are “Dead” or lost, He wants us
to find Him. God also wants us to keep developing our relationship with him after we know him and
are “Alive” in Christ.
Camp Marengo has been blessed with new opportunities this year. We are now hosting an
American Heritage Girls summer camp. AHG is a girls group that focuses on learning outdoor skills
and deepening their faith. We are also working with Trail Life USA which is similar to Boy Scouts but
very faith based. These two groups love our camp and the opportunities it offers for them to grow in
their relationships with God.
Thank you in advance for another opportunity to invest in your kids and teenagers. Your
support is a must; it is what gives us the opportunity to do the ministries that God has called us to
do. Please keep our staff, counselors, teachers, pastors and most importantly this year’s campers
in your prayers. We know it makes a difference and we appreciate your support!
Melyssa Trussel
P.O. Box 177
Marengo, Ohio 43334
(740) 747-2325
[email protected]
www.campmarengo.com
Paperwork is important to make sure
everything works smoothly.
Remind families to register before the
established deadlines.
Send us a Church Scholarship Form
for each week of camp for which you
are using or giving scholarships prior
to that week of camp.
Scholarships
If your church did not have any campers who
attended Camp Marengo in 2014, your
church is eligible for five 50% scholarships in
2015.
Children of active Church of God pastors and
missionaries are eligible to attend Camp
Marengo for 50%.
If scholarship money is provided by your
church, please use the Church Scholarship
form for each applicable week of camp.
2015 Critical Dates
April 17
First Training Week Registration Due
April 24-25
First Training Week
May 1
Second Training Week Registration Due
May 8-9
Second Training Training Week
John Trussel
Summer Camp Director
Registration
& Information:
3Follow Up
May 11
Camper Registration Due for First Three
Camp Weeks
We Need You!
If you love children or teens, have the gifts of
speaking, teaching or counseling – Camp
Marengo could use you! Contact Director,
John Trussel, (937) 681-4158, and we will find
a place where you can be used.
May 18
Counselor Applications Due
June 1
Couselor Background Checks Due and
Registration Due for Last Two Weeks of
Camp Early Registration Rate
March 2015
Information For
Counselors
1Training
Counselor training is provided in conjunction
with two work weekends at Camp Marengo.
This is an opportunity to gain the necessary
training to become an effective counselor
and it’s a chance to give back to the camp in
preparation for the summer camping season.
April 24-25, 2015 or May 8-9, 2015
Training starts at 7 pm on Friday and is
mixed with work on Saturday until 4 pm. You
may choose either weekend to attend.
Registration is required 7 days in
advance.
First time adult volunteers must attend
counselor training.
Returning adult counselors are strongly
encouraged to attend.
Any student planning to counsel during the
2015 season must attend both the training
weekend and their age-appropriate week of
camp.
2Application
Before anyone will be considered to counsel
at Camp Marengo, they must successfully
attend Counselor Training and participate in
an informal interview with Camp Directors
and Pastors.
Persons 14 years or older may apply for
Junior Counselor assignments.
Persons 16 years or older may apply for
Senior Counselor assignments.
Anyone who is 18 years or older must also
obtain and provide a background check.
A completed Application Form and the
required references must be postmarked
by May 18, 2015.
3Background
Check
All volunteers who are 18 years of age or
older are required to have a background
check before volunteering at Camp
Marengo.
This is an Ohio State Law for all residential
camps.
You must obtain and pay for the BCII check
on your own. This can be arranged through
your local police or sheriff's office.
You must send a copy of the report to
Camp Marengo before June 1, 2015.
Job Description, Expectations, and Guidelines
Counselors are directly responsible to the camp
director first, and also to the camp staff.
More important things to remember:
1. Counselors will attend ALL counselor-staff
meetings/devotions.
1. Campers take a cue from us – if we are rowdy and
disrespectful, they will be too. If we are cooperative,
they will be too. If we enjoy ourselves, so will they.
2. Counselors are responsible for knowing the
whereabouts of their assigned campers at all times.
2. Stay with your assigned campers: women counsel
the young ladies…men the young men.
Cost to attend training:
3. Counselors should report all major discipline
problems to the Camp Director.
3. Do NOT leave camp! Any exceptions need to be
discussed and cleared with the Camp Director.
$30 for students under 17 years of age
4. Counselors need to become familiar with the
personal history (family or health) of their campers.
4. Campers should never be in an area without a
counselor.
5. Counselors need to be aware of their assigned
campers’ personal spiritual needs.
5. Campers should not be in cabin areas other than
where they are assigned.
6. Counselors are expected to lead devotions each
night in their cabin and share their personal
experiences with the Lord.
6. Campers may not change cabins without
permission from the registrar.
Counselor training will not be offered during
Senior High Camp.
$10 for adults and students 18 years of age
and older.
Training fees cover food and lodging for the
training. If necessary, you will be responsible
to obtain and pay for your own background
check.
7. Counselors need to arrive prior to the start of camp
to organize, prepare, and receive instructions. Please
plan to be at camp by 1:00pm on registration days.
8. Counselors will cooperate at all times in a Christian
manner with the staff and other counselors.
Registration
& Information:
Melyssa Trussel
P.O. Box 177
Marengo, Ohio 43334
(740) 747-2325
[email protected]
www.campmarengo.com
9. Counselors need to refer any camper of the
opposite sex seeking personal counseling to the
camper’s own counselor, then to the Camp Pastor or
Camp Director.
10. Counselors are expected to set an example of
Biblical Christianity to all other counselors and to
campers.
11. Counselors may be asked to perform other tasks
deemed necessary by the camp staff and are expected
to do so willingly.
7. Campers are allowed in the dining hall only at
designated times. NEVER USE THE KITCHEN
ENTRANCE.
8. Campers are not permitted to use the restrooms in
the Dining Hall or in Crowder Hall.
9. Campers may not use the telephone except in an
emergency and then only with the Director’s
permission.
10. Campers need counselors to hang out with them.
Counselors should come with an attitude to give
yourself away!
11. Counselors are only permitted to use cell phones
during the designated times.
Perks:
- Free room and meals while volunteering as a
counselor
- Free camp t-shirt
March 2015
Information For
Campers
and Families
Welcome!
Camp Marengo 2015 is coming up fast! God has brought us a fantastic group of summer Staff
applicants and we are working to organize our team of volunteers. This year’s theme “Wanted Dead
or Alive’ will help to teach campers that God desires and seeks a relationship with us when we are
”dead” in our sin, and He wants to continue growing in relationship with us, helping us to change and
mature, once we are “alive” through Christ. Through teaching, drama, worship, activities, and
relationships, campers willl gain friendships, a better understanding of the importance of God’s word,
and a deeper relationhip with Jesus Christ.
Camp Dates
June 7 to June 12
Junior High Camp, 7th thru 9th Graders
June 14 to June 20
Senior High Camp, 9th thru 12th Graders
June 21 to June 26
6th thru 8th Grade Camp
We will maintain our cell phone policy: campers and counselors will be permitted to use cell phones
during designated times, but all cell phones must be turned in at registration. Cell phones will be
distributed for use and then recollected. We hope this will ease your worry about your child and limit
homesickness.
June 26 to June 27
Mom and Me, Dad and Me, Family Camp
We will continue to have a First Aid Coordinator available 24 hours a day for first aid and to administer medication. We want to provide a safe camp experience for everyone at Camp Marengo. Prior to
registration, campers and volunteers will participate in a wellness assessment, which includes a lice
check. This is for the health and safety of all campers, volunteers, and staff.
June 28 to July 3
Paintball Camp, 9th thru 12th Graders
Get ready for a great summer! We can’t wait to meet you!
John and Melyssa Trussel
Frequently Asked Questions
1. What time should I arrive on the first day of camp?
Check-in for all camps except Family Camp will begin at
2:00pm on the first day of camp. Family Camp begins at
4:00pm. Please do not bring campers before 2:00pm –
staff and counselors will not be available for supervision.
2. What time should I pick up my camper on check-out
day?
All camps close at 10:00am on the last day of camp,
except Family Camp which ends at 3:30pm. Please be
sure to note who will be picking up your camper on their
registration form, and plan to pick them up at 10:00am.
3. How much will it cost for camp?
The cost for camp varies, and the cost for each week is
indicated on the registration form.
4. Can I pay using a credit card?
Unfortunately, we do not currently accept credit card
payments for camp. Please send a check or money order
made payable to “Ohio Ministries” as payment.
6. Is there a registration deadline?
Registration cost is based on how early you register. Early
registration deadline for the first 3 weeks is May 11 and
registration for the last 2 weeks is June 1.
Registration & Info:
Melyssa Trussel
P.O. Box 177
Marengo, Ohio 43334
(740) 747-2325
[email protected]
www.campmarengo.com
June 28 to July 3
4th thru 6th Grade Camp
July 5 to July 8
3rd thru 5th Grade Half Week
July 5 and July 10
3rd thru 5th Grade Full Week
July 5 to July 11
Performing Arts Camp, 9th thru 12th Graders
7. Is there a discount if more than one child from the
same family is coming to camp?
Registration Due May 11
for First 3 Weeks of Camp
Yes, there is a $5.00 discount for each additional camper
from the same family.
Registration Due June 1
for Last 2 Weeks of Camp
8. What if my camper takes medication?
Please be sure to indicate any prescription medication on
your child’s registration form. Also, be sure to check which
over-the-counter medicines you approve. On the first day
of camp the First Aid Coordinator will be available to
receive the medication with directions. ALL medications
must be turned in to the First Aid Coordinator, including
Tylenol or Advil.
9. How can I contact my camper during camp?
You may contact the Camp Office throughout the day by
calling (740) 747-2325 if you have a question or concern.
Please talk with your camper about sending letters.
Camper mail can be sent to: Camp Marengo, your
camper’s name, P.O. Box 177, Marengo, Ohio 43334.
10. Do you have a policy about cell phones?
Campers will be permitted to use cell phones while at
camp during designated times. We ask that cell phones be
turned in at registration. They will be distributed daily for
use and then recollected for safe keeping.
11. Are guests permitted at camp?
Other than the first day of camp and the morning of
checkout, only campers, counselors, and staff are
permitted to be in camp. Outside guests will be asked to
visit when campers have gone home. Safety and security
are important to us and NO exceptions will be made.
$50 Deposit Required / $20 Late Fee
Ohio 43334. You can download directions off the internet
or call or email the camp for directions – [email protected], (740) 747-2325.
13. Can my child make a cabin mate or counselor
request?
Yes! There is a place on the registration form to indicate
cabin mate or counselor requests. We make every effort
to honor these requests.
14. Will snacks be available for purchase?
Yes! Camp Marengo has a Snack Stand open throughout
the week! Snack prices range from $0.25 to $2.00 and
include soft drinks, candy, chips, etc. Campers are
encouraged to deposit their money into a “bank account”
for safe keeping throughout the week.
15. Who will be supervising my camper?
Each cabin has one Senior Counselor and one Junior
Counselor (when available). These counselors submit
applications and reference forms, go through an interview
process and training, and have a background check before
being selected to counsel at Camp Marengo. Counselors
will be with your camper all day and night. During the day,
Staff will also be available to assist with supervision.
12. How do I get directions to Camp Marengo?
Our street address is 3480 Township Road 221, Marengo,
March 2015
Information For
Campers
and Families
Camper Checklist & Packing List
Typical Daily Schedule
Registration:
Registration form sent in before
deadline
Attached a copy of insurance card
Selected a T-shirt size
Made sure to initial and sign all
parts of the form
Sent non-refundable deposit
amount of $50.00
Made arrangements with church if
they are paying a portion of the
camp cost
7-8:00am
Get up, take showers, get ready for the day
8-8:30am
Clean cabins, make beds, sweep, take out trash
8:15am
Cruiser Bell rings, Cruiser sets breakfast table
8:30am
Breakfast
9:15am
Morning Praise and Worship in the Chapel
10-12:00pm
Morning Classes/Sessions
12:15pm
Cruiser Bell rings, Cruiser sets lunch table
12:30pm
Lunch
1:30-2:30pm
Crash Time – campers rest in their cabins
2:30-5:30pm
Free Time – pool, climbing wall, sports, crafts
5:15pm
Cruiser Bell rings, Cruiser sets dinner table
5:30pm
Dinner
6:30pm
Area Clean-Up – Campers clean around camp
7:00pm
Chapel
8:00pm
Late Night Activity (Elementary Camps)
9:45pm
Lights Out (Elementary Camps)
10:00pm
Late Night Activity (Junior and Senior High)
11:45pm
Lights Out (Junior and Senior High Camps)
What NOT to bring:
• Clothing inappropriate for a
Christian setting (short shorts, tank
tops, offensive t-shirts)
• Bikini or two-piece swim wear
• Radios, CD players, IPods, MP3
players
• Hand-held video games
• Expensive jewelry or valuables
• Skateboards or in-line skates
*We reserve the right to confiscate
anything inappropriate or disruptive to
the camp experience. It will be
returned at the end of the week.
What to bring:
Bed Linens (twin bed)
Sleeping Bag/Blankets
Pillow
Shower Towels
Beach Towel
Washcloths
Toiletries (soap, shampoo,
toothbrush, toothpaste, deodorant,
brush/comb)
Shoes (more than one pair!)
Hiking Shoes
Pool/Shower Shoes
Swim Suit *one piece ONLY please
Plenty of clothes/play clothes (you
will get dirty!)
Jacket
Sweater or Sweatshirt
Insect Repellant
Sunscreen
Flashlight
BIBLE
Notebook and Pen/Pencil
Poncho/Raincoat
A positive attitude and willingness
to learn!
General Camp Guidelines
Campers and counselors are permitted to use cell
phones only during designated times. Cell phones
must be turned in at registration. They will be
distributed daily for use and then recollected.
Dining Hall
• Dining Hall restrooms and the area beyond the
ravine are off limits.
• No throwing food, rowdiness or horseplay.
• Only cruisers are allowed out of their seats at
mealtime.
Cabins
• No extra appliances (televisions, radios, hair
dryers, curling irons).
• No cabin raiding of other cabins
• No loud talking or horseplay during crash time.
• No climbing in or on the rafters.
• No markers are to be used on furnishings
(BEDS) or walls and ceilings.
• No guys in girls’ cabin areas/cabins. No girls in
guys’ cabin areas/cabins.
• Handle fire extinguishers only for fire…$20 fee if
used for any other reason.
Shower House
• Be sure to flush the toilets.
• Nothing but toilet paper in the toilets.
• Share in the cleanliness of the shower house by
not littering.
• Do not leave personal items behind in the
shower house.
Chapel
• All campers, counselors, and staff are required
to attend and participate in Chapel time.
• Inappropriate behavior will not be tolerated.
First Aid
• First Aid Station opens at 7:30am and closes 30
minutes after lights out.
• The First Aid Station will open at all times in
emergency situations, otherwise please abide by
the designated times.
• The First Aid station is closed during crash time.
• Campers and Counselors MUST turn in ALL
medication (including Tylenol or Advil) to the
First Aid Coordinator.
• Campers need to make their counselors aware if
they are going to the First Aid Station.
Snack Stand
• The snack stand will be open only during
designated hours, and only drinks will be sold
before meals.
• Items sold include drinks, candy, chips, etc. and
range in price from $0.25 to $2.00.
• Campers are encouraged to deposit their money
into a bank account.
Other Important things to know
• ALL campers who drive must turn in their car
keys for the week.
• Absolutely NO fireworks, lighters, firecrackers
• No weapons, gang colors, racial remarks,
off-color jokes, name-calling, or foul language –
it will not be tolerated.
• No one is permitted to leave camp early without
permission from the Director. Written permission
from a parent/guardian is required.
March 2015
Page 1 of 2
Camper Name:_____________________________________________________________________
Male
Female
Date of Birth: ______________________________________ Age:
_____________________Grade (Fall 2015): ___________
Mother’s Name:_________________________________________
Father’s Name: _______________________________________
Street Address: _________________________________________
City: ________________________________________________
State: _____________________
Home Phone: ________________________________________
Zip: ______________________
Mother’s Work Phone: ____________________________________ Father’s Work Phone: _________________________________
Cell Phone: ____________________________________________
Email: ______________________________________________
Camp Attending
Please check the appropriate box to indicate which week of camp your child will be attending. Campers may choose any camp for the
school grade they will be completing or going into in the Fall of 2015.
June 7-12, 2015 Junior High Camp (grades 7-9) : $193 if registered by May 11, $203 if registered by June 1, $213 at the door
June 14-20, 2015 Senior High Camp (grades 9-12) : $227 if registered by May 11, $237 if registered by June 1, $247 at the door
th
th
June 21-26, 2015 6 thru 8 Grade Camp : $193 if registered by May 11, $203 if registered by June 1, $213 at the door
June 26-27, 2015 Family Camp Weekend : $30 per person if registered by June 1, $35 per person at the door
June 28-July 3, 2015 Paintball Camp (grades 9-12) : $267 if registered by June 1, $277 if registered by June 15, $287 at the door
th
th
June 28-July 3, 2015 4 thru 6 Grade Camp : $193 if registered by June 1, $203 if registered by June 15, $213 at the door
rd
th
July 5-8, 2015 3 thru 5 Grade Half Week : $139 if registered by June 1, $149 if registered by June 15, $159 at the door
rd
th
July 5-10, 2015 3 thru 5 Grade Full Week : $193 if registered by June 1, $203 if registered by June 15, $213 at the door
July 5-11, 2015 Performing Arts Camp (grades 9-12) : $238 if registered by June 1, $248 if registered by June 15, $258 at the door
Cabin Mate Request(s): ________________________________________________________________________________________
T-Shirt Size: Adult
Small
Medium
Large
X-large
XXL Child
Small
Medium
Large
Church Information
Name of Church Camper Attends: ________________________________________________________________________________
Street Address: _________________________________________
City: ________________________________________________
State: __________________ Zip: ________________ Church Phone: ___________________
Pastor’s Name: _______________________________________________________________________________________________
Emergency Information
If out of town during camp, phone number to reach parents: ____________________________________________________________
Please list another contact in the event of an emergency and the parent/guardian cannot be reached:
Name: ________________________________________________
Relationship to Camper: ________________________________
Home Phone: ___________________________________________ Work Phone: _________________________________________
Pick-Up
Please indicate who will be picking up your camper.
*Note - your child will only be released to whomever is
indicated on this form or presents the pick-up card. ___________________________________________________________________
Medical Information
Family Doctor: __________________________________________ Phone Number: _______________________________________
Health Insurance Company: _____________________________________________________________________________________
Primary Holder: _________________________________________ Policy Number: _______________________________________
*Please attach a copy of your child’s insurance card to this registration
2015 Camp Marengo Camper Registration
Page 2 of 2
Medical Information Continued
Medication being taken by camper (must be in original container):
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Please note: Our First Aid Staff cannot administer prescription medications without the written permission of parents, guardians, or a
physician. Please indicate name of medication, dosage, frequency, the time given including any other information necessary.
Allergies (please check all that apply):
Bee Stings
Food ___________________
Medication __________________
Other _______________________
Is your child subject to any of the following (please check all that apply)?
Fainting
Sleepwalking
Epileptic Seizures
Convulsive Seizures
What was the date of your child’s last Tetanus shot?__________________________________________________________________
Any other important medical information:
___________________________________________________________________________________________________________
Please check and initial if you give consent for our First Aid Staff to administer any of the following over-the-counter medications to your
child while he/she is at camp.
For Headaches
Tylenol (Acetaminophen)
Advil (Ibuprofen)
For Cough
Cough Drops
For Stomachache
Tums
Mylanta
Other
Benadryl (for itching, allergic reaction)
Pepto Bismol
___________ Parent/Guardian Initials
Robitussin
Antibiotic Ointment (for scrape, cut, splinter)
Consent and Liability Release
Special activities are offered each week of camp. Please check the activities in which you give consent for your child to participate.
Climbing Wall (all ages)
rd
th
Archery (not offered 3 to 5 grade weeks)
High Ropes (first 3 weeks of camp)
Paintball* (first 3 weeks of camp) *Please fill out the additional release form for your child to participate in Paintball.
___________ Parent/Guardian Initials
I give consent for the above named camper to engage in the activities of Camp Marengo. Included in those activities are (not limited
to): swimming, climbing wall, ropes course, play areas, and obstacle course events. During the camping season, pictures and video
are taken of campers and activities. These photos and/or video may be used for future promotional use. I will not hold Camp Marengo
Ohio Retreat Center, Ohio Ministries of the Church of God, Camp Staff or any other individual responsible for injuries incurred while
participating in Camp Marengo’s camping Program.
In case of medical and/or surgical emergency, I hereby give permission to the selected physician by the Camp Director to
hospitalize, secure proper treatment for, and order injection, anesthesia, X-rays, or surgery for my child as named above. I also give
permission for the First Aid Staff to administer the medications indicated on this form. My signature below is evidence of my
understanding of all above information.
_______________________________________________________________________
Parent/Guardian Signature
____________________________
Date
Payment and Registration Fee
A minimum of $50.00, non-refundable deposit, is required to register your camper. Please send a check or money order along with this
form made payable to “Ohio Ministries”. The balance is due the first day of camp.
Send registration to:
Melyssa Trussel
Camp Marengo
P.O. Box 177
Marengo, Ohio 43334
2015 Camp Marengo Camper Registration
Registration for the first 3 weeks of camp must be postmarked by May 11 to received
early rate, and registration for the last 2 weeks of camps must be postmarked by
June 1 to receive early rate.
For office use only:
Deposit received (Date)
Paid in full (Date)
Page 1 of 2
Applications and references must be received by May 18, 2015
Background checks must be postmarked by June 1, 2015*
Applicant Name:_____________________________________________________________________
Male
Female
Street Address: _________________________________________
City: ________________________________________________
State: _____________________
Zip: ______________________
Home Phone: _________________________________________
Cell Phone: ____________________________________________
Email: ______________________________________________
Date of Birth: ___________________________________________
T-Shirt Size
Adult Counselor*
Small
Senior Counselor (must be 16 years or older)
Medium
Large
X-large
XXL
Junior Counselor (must be 14 years or older)
Camp Weeks Please check the appropriate box(es) to indicate each week of camp for which you are applying.
th
June 7-12, 2015 Junior High Camp (grades 7-9)
rd
June 14-20, 2015 Senior High Camp (grades 9-12)
th
th
June 28-July 3, 2015 4 thru 6 Grade Camp
th
July 5-8, 2015 3 thru 5 Grade Half Week
th
rd
th
June 21-26, 2015 6 thru 8 Grade Camp
July 5-10, 2015 3 thru 5 Grade Full Week
June 28-July 3, 2015 Paintball Camp (grades 9-12)
July 5-11, 2015 Performing Arts Camp (grades 9-12)
Background Information Have you at ANY time EVER:
1. Been arrested for any reason?
✔
✔
Y or
N If yes, please explain
2. Been convicted of or pleaded no contest to any crime?
Y or
____________________________________________________
N If yes, please explain ________________________________
3. Engaged in or been accused of any child molestation, exploitation, or abuse?
Y or
N If yes, please explain ______________
___________________________________________________________________________________________________________
4. Are you willing to submit to a background check?
Y or
N
High School Attended/City:___________________________________________________________Graduation Date:
___________
College: _______________________________________________ Employer: ___________________________________________
List the church(es) you have attended in the past five years.
Church:
Church:
Church:
Church:
Church:
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
City/State: ___________________________________________
City/State: ___________________________________________
City/State: ___________________________________________
City/State: ___________________________________________
City/State: ___________________________________________
In what ways are you involved in your church? ______________________________________________________________________
___________________________________________________________________________________________________________
Do you have any other counseling-related work experience?
Y or N If yes, please explain ______________________________
___________________________________________________________________________________________________________
Camp Experience
Have you ever attended a camp?
Y or N Where? ____________________________________ How many years?__________
Have you ever been a counselor?
Y or N Where? ___________________________________ How many years?__________
Have you ever been on a camp staff?
Y or N Where? ________________________________ How many years?__________
If yes, what position(s) did you hold? __________________________________________________________________________
References A minimum or 2 references are required: 1 from your current pastor, 1 from another adult leader of your choice.
1. Name: ________________________________________________________ Relationship: _______________________________
Address: ______________________________________________________ Phone: ____________________________________
City/State/Zip: ______________________________________________________________________________________________
2. Name: ________________________________________________________ Relationship: _______________________________
Address: ______________________________________________________ Phone: ____________________________________
City/State/Zip: ______________________________________________________________________________________________
2015 Camp Marengo Counselor Application
Page 2 of 2
Please respond to the following to the best of your ability. Attach an additional page if necessary to fully answer the questions.
1. My testimony of my relationship with Christ:
2. Describe how you would help lead someone else to Christ.
Recognizing there is a great need for Christians to share in the Church of God State Youth Camping Program at Camp Marengo, I am
filling out this application to state my qualifications and express my desire to serve in this ministry. I will, to the best of my ability,
prepare by knowing my responsibilities, complete any assignments given to me, and commit to pray for the purposes and needs of
Camp Marengo. I will support the overall program by cooperating with camp staff and conforming to the recommendations and policies
of the camp. I will also be a Christian example and witness through my daily life. My relationship with Christ is described and my
signature signifies that every word on this application is true.
Signature: _________________________________________________________________
Send application to:
Melyssa Trussel
Camp Marengo
P.O. Box 177
Marengo, Ohio 43334
2015 Camp Marengo Counselor Application
Date:____________________________
Counselor Applications AND all References must be received by May 18, 2015 to be
considered for this summer.
For office use only:
App received (Date)
References received (Date)
Page 1 of 1
References must be received by Camp Marengo by May 18, 2015
Applicant Name:______________________________________________________________________________________________
Your name has been submitted as a reference for the above named applicant. This person is being considered for a volunteer position
as a summer camp counselor. Please complete the following form to assist us in selecting the best counselors for Camp Marengo.
Your honesty is greatly appreciated. We believe that a great staff and great volunteers help make Camp Marengo influential to the
young people we serve. Please also be praying for this ministry as we begin the camp season.
1. What is your relationship to the applicant? How long have you known him/her?
___________________________________________________________________________________________________________
2. What do you think about this person working in a youth camp?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
3. To the best of your knowledge, has this applicant ever been dismissed or asked to resign from a position because of an inability to
carry out work responsibilities?
Y or
N If yes, please explain.
___________________________________________________________________________________________________________
4. To the best of your knowledge, has this applicant ever been convicted of child abuse or any other violent crimes, or has this person
ever had a child removed from their home by the courts?
Y or
N If yes, please explain
___________________________________________________________________________________________________________
5. Has this person made a commitment to Christ?
Y or
N
In what ways are they demonstrating that commitment?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
6. In what areas of the church ministry is this applicant involved?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
7. How is this person’s church/youth attendance?
very regular
often
sporadic
8. Overall, would you recommend this applicant?
without reservation
with reservation
not at all
Please comment further: ________________________________________________________________________________________
___________________________________________________________________________________________________________
Reference Name (printed): _________________________________________________
Date: _____________________________
Signature: ___________________________________________________________________________________________________
Send this form to:
Melyssa Trussel
Camp Marengo
P.O. Box 177
Marengo, Ohio 43334
2015 Camp Marengo Counselor Reference Form
References must be received by May 18, 2015 in order for the applicant to be
considered for this summer.
For office use only:
Date received (Date)
App received (Date)
Page 1 of 1
Counselor Name:
____________________________________________________________________________________________
Mother’s Name: _________________________________________
Father’s Name:_______________________________________
Street Address: _________________________________________
City: ________________________________________________
State:____________________ Zip: ______________________ Home Phone:_____________________________________________
Mother’s Work Phone: ____________________________________ Father’s Work Phone:__________________________________
Cell Phone: ____________________________________________
Email: ______________________________________________
Training Week Attending
Please check the appropriate box to indicate which training week you will be attending.
April 24-25, 2015 (registration required by April 20)
May 8-9, 2015 (registration required by May 4)
Emergency Information
If out of town during training weekend, phone number to reach parents:___________________________________________________
Please list another contact in the event of an emergency and the parent/guardian cannot be reached:
Name:________________________________________________
Relationship:__________________________________________
Home Phone: ___________________________________________ Work Phone: _________________________________________
Medical Information
Family Doctor: __________________________________________ Phone Number: _______________________________________
Health Insurance Company: _____________________________________________________________________________________
Primary Holder: _________________________________________ Policy Number: _______________________________________
Allergies (please list): _________________________________________________________________________________________
Consent and Liability Release
I give consent for the above named student to engage in the activities of Counselor Training/Work Weekend. I acknowledge that the
activity will take place in Marengo, Ohio at Camp Marengo Ohio Retreat Center. In the event of an injury to my child, I also give my
permission for any emergency treatment deemed necessary to be performed by a qualified physician (every attempt to contact a parent
or guardian will be made before treatment is administered). I will not hold Camp Marengo Ohio Retreat Center, Camp Staff, or any
other individual responsible for any injuries incurred to my student while participating in the Counselor Training/Work Weekend.
_______________________________________________________________________
Parent/Guardian Signature
____________________________
Date
Training Fee
A training fee is required to register. This fee is $30 for students under 17 years of age and $10 for adults and students 18 years of age
and older. Training fees cover food and lodging for the training. Please send a check or money order along with this form made payable
to “Ohio Ministries”.
Send to:
Melyssa Trussel
Camp Marengo
P.O. Box 177
Marengo, Ohio 43334
2015 Camp Marengo Counselor Training Release
Registration is required in advance of your training weekend.
You must have this signed form on file in order to participate. You may bring it with you
to the training weekend.
For office use only:
Release received (Date)
Paid in full (Date)
PAINTBALL
ADULT RELEASE FORM
Camp Marengo | The Ohio Retreat Center
3480 Township Rd. 221, Marengo, OH 43334
In consideration of being permitted to participate in any way in the
sport and activity of paintball under the auspices of Ohio
Ministries, Camp Marengo | The Ohio Retreat Center, I
acknowledge,
appreciate,
and
agree
that:
The risk of injury from the activity and weaponry involved in
paintball is significant, including the potential for permanent
disability and death, and while particular protective equipment and
personal discipline will minimize the risk, the risk of serious injury
does exist.
I fully understand and acknowledge that: (a) risks and damages
exist in my participation in paintball activities and my use of
paintball equipment; (b) my child’s participation in such activities
and/or use of such equipment may result in injury or damage to
personal property including the potential for permanent disability
and death; (c) these risks and dangers may be caused by the
paintball activity operator, camp staff members or other
participants, or by accidents, or by the forces of nature or other
causes. Risks and dangers may arise from foreseeable or
unforeseeable causes including, but not limited to, selection of trail
or uneven terrain on the playing field, weather conditions, injuries
and/or welts or bruises caused by the paintballs, and such other
risks, hazards and dangers that are integral to recreational
activities that take place in a wilderness, outdoor or recreational
environment.
I knowingly and freely assume all such risks, both known and
unknown, even if arising from the negligence of those persons
released from liability below, and assume full responsibility for my
participation. I understand that the activities of paintball are
physically and mentally intense. I understand that the rules of play
will be reviewed during the safety orientation class. I understand
and appreciate the importance of knowing and abiding by the
rules, regulation and procedures established for the safety of the
paintball participants and agree to do so.
I further understand that I should bring to the attention of the
nearest paintball instructor any unusual or unnecessary hazard
observed during my participation in the activity.
I, myself and on behalf of my heirs, assigns, personal
representatives and next of kin, hereby release, discharge, and
agree to hold harmless from liability Ohio Ministries, Camp
Marengo | The Ohio Retreat Center, its owners, directors, officers,
employees and agents “Releasees”, with respect to any and all
injury, disability, death, or loss or damage to person or property,
whether caused by the negligence of the releasees or otherwise,
except that which is the result of gross negligence and/or wanton
misconduct.
I understand and agree that this agreement covers each and every
paintball activity and event in which I participate hereafter.
I hereby acknowledge that this Waiver and Release of Liability,
Assumption of Risk and Indemnity Agreement extends to all acts
of negligence by Releasees, and is intended to be as broad and
inclusive as permitted by the laws of Ohio and that if any portion
thereof is held valid, it is agreed that the balance shall,
notwithstanding, continue in full legal and effect.
I am in good health. I understand that strenuous physical exertion
may be required and I have no known physical disabilities or
health problems which will present any risk to my participation in
activities.
I also understand and agree that Camp Marengo will not be held
responsible for damages to clothing or personal belongings.
(Paintballs are water soluble, biodegradable, and nontoxic.)
General Rules of Play
1.
2.
3.
4.
5.
6.
Participants are not permitted to enter the field without proper protective gear to include goggles,
masks, and helmets. All protective equipment must be worn at ALL time in designated playing
and chronograph areas.
Barrel covers and safety controls must be on paintball markers at all times when outside of areas
designated for paintball activities. There is to be ABSOLUTELY NO shooting outside of the
playing area.
All paintball markers must be checked by chronograph prior to the start of the game to ensure that
they are shooting fewer than 280 fps.
Field paint must be used for all games played at Camp Marengo.
Shooting within close proximity (less than 20 feet) is strictly prohibited.
Referees have the final say in all matters and must be obeyed immediately.
Release of Liability
I, ___________________________________, do hereby acknowledge and certify that I am at least
18 years of age and agree both on behalf of myself and my heirs, assigns and legal representatives,
to all of the terms and conditions set forth in the above Release of Liability and Assumption of Risk
Agreement, thus declaring that I have read and understood the same. Furthermore, I understand the
risks involved in allowing participation and that by making this agreement I surrender valuable
rights. I do so freely and voluntarily without inducement.
Signature: ________________________________ Date: _____________________________
Paintball Adult Release Form
Drafted: 9/10/2009
Brett T. Henry, Chief Information Officer, Ohio Ministries of the Church of God
PAINTBALL
MINOR RELEASE FORM
Camp Marengo | The Ohio Retreat Center
3480 Township Rd. 221, Marengo, OH 43334
In consideration of being permitted to participate in any way in the
sport and activity of paintball under the auspices of Ohio
Ministries, Camp Marengo | The Ohio Retreat Center, I
acknowledge,
appreciate,
and
agree
that:
The risk of injury from the activity and weaponry involved in
paintball is significant, including the potential for permanent
disability and death, and while particular protective equipment and
personal discipline will minimize the risk, the risk of serious injury
does exist.
I fully understand and acknowledge that: (a) risks and damages
exist in my child’s participation in paintball activities and my child’s
use of paintball equipment; (b) my child’s participation in such
activities and/or use of such equipment may result in injury or
damage to personal property including the potential for permanent
disability and death; (c) these risks and dangers may be caused
by the paintball activity operator, camp staff members or other
participants, or by accidents, or by the forces of nature or other
causes. Risks and dangers may arise from foreseeable or
unforeseeable causes including, but not limited to, selection of trail
or uneven terrain on the playing field, weather conditions, injuries
and/or welts or bruises caused by the paintballs, and such other
risks, hazards and dangers that are integral to recreational
activities that take place in a wilderness, outdoor or recreational
environment.
I knowingly and freely assume all such risks, both known and
unknown, even if arising from the negligence of those persons
released from liability below, and assume full responsibility for my
child’s participation. I understand that the activities of paintball are
physically and mentally intense. I understand that the rules of play
will be reviewed with my child during the safety orientation class. I
have instructed my child in the importance of knowing and abiding
by the rules, regulation and procedures established for the safety
of the paintball participants and my child has agreed to do so. I
have further instructed my child to bring to the attention of the
nearest paintball instructor any unusual or unnecessary hazard
observed during his/her participation in the activity.
I, myself and on behalf of my heirs, assigns, personal
representatives and next of kin on behalf of my child, hereby
release, discharge, and agree to hold harmless from liability Ohio
Ministries, Camp Marengo | The Ohio Retreat Center, its owners,
directors, officers, employees and agents “Releasees”, with
respect to any and all injury, disability, death, or loss or damage to
person or property, whether caused by the negligence of the
releasees or otherwise, except that which is the result of gross
negligence and/or wanton misconduct.
I hereby certify that I, as parent/guardian with legal responsibility
for this participant, do consent and agree to his/her release of
Camp Marengo, and all other Relesees from any and all liabilities
incident to his/her involvement in these programs for myself, my
heirs, assigns, and next of kin.
I understand and agree that this agreement covers each and every
paintball activity and event in which my child participates hereafter.
I hereby acknowledge that this Waiver and Release of Liability,
Assumption of Risk and Indemnity Agreement extends to all acts
of negligence by Releasees, and is intended to be as broad and
inclusive as permitted by the laws of Ohio and that if any portion
thereof is held valid, it is agreed that the balance shall,
notwithstanding, continue in full legal and effect.
My child is in good health. I understand that strenuous physical
exertion may be required and my child has no known physical
disabilities or health problems which will present any risk to
his/her participation in activities.
I also understand and agree that Camp Marengo will not be held
responsible for damages to clothing or personal belongings.
(Paintballs are water soluble, biodegradable, and nontoxic.)
General Rules of Play
1.
2.
3.
4.
5.
6.
Participants are not permitted to enter the field without proper protective gear to include goggles,
masks, and helmets. All protective equipment must be worn at ALL time in designated playing
and chronograph areas.
Barrel covers and safety controls must be on paintball markers at all times when outside of areas
designated for paintball activities. There is to be ABSOLUTELY NO shooting outside of the
playing area.
All paintball markers must be checked by chronograph prior to the start of the game to ensure that
they are shooting fewer than 280 fps.
Field paint must be used for all games played at Camp Marengo.
Shooting within close proximity (less than 20 feet) is strictly prohibited.
Referees have the final say in all matters and must be obeyed immediately.
Consent of Parent or Guardian
Name of Player: ______________________________________________________________
I, ___________________________________, parent and/or guardian of the above named Player,
(minor) do hereby agree both on behalf of myself and said Player and his/her and my heirs, assigns
and legal representatives, to all of the terms and conditions set forth in the above Release of
Liability and Assumption of Risk Agreement, thus declaring that I have read and understood the
same. Furthermore, I understand the risks involved in allowing participation and that by making
this agreement I surrender valuable rights. I do so freely and voluntarily without inducement.
Signature: ________________________________ Date: _____________________________
Paintball Minor Release Form
Drafted: 9/10/2009
Brett T. Henry, Chief Information Officer, Ohio Ministries of the Church of God