The URL can be used to link to this page

Home My WebLink AboutCamp Information, Policies and Procedures �� ,, � � � � � �� ,,..:��: .;' �� CAMP WINGATE * KIRKLAND ARCHERY RANGE RULES 1 .Only a counselor who has completed a Camp-certified archery course during Orientation may lead and supervise an archery period. 2.Only six archers shoot at a time; all other campers stand behind the archers 3.Campers are not allowed in the shed where archery materials are kept. 4.Always pay attention and stay alert 5.Range Commander (R.C.) will use a whistle system to communicate commands to campers. 6.Nock an arrow only when the Range Commander gives the command and a.You are standing over the shooting line b.You are facing the target and C.You are sure in your own mind that the area is clear 7.Aim and fire only at the target. $.Before firing an arrow make sure it is in good condition. If it is not in good condition, give it to a counselor in charge. 9.The arrows should be in the quiver unless knocking or shooting it. 1 �.Place bow on the ground quiver when done firing. 11 .Bows, arrows and quiver should be on the firing line unless taking equipment out or putting it away. 12.When not shooting, sit quietly on the bench (at the waiting line). 13.Always use proper stance and proper knocking grip. 14.Always listen for the grange officer and respond immediately to his/her commands. 15.Retrieve arrows only when instructed to do so. If an arrow falls ahead of the firing line, wait to retrieve it until given the signal. 16.Check your bow to be sure it is in good condition and that the arrows are straight and have all proper feathers. Check your bow tips to be sure the string is securely attached. CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 0�675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� :;: . � ,"'" � r.-Y �,� � �� ili�� M• �� awwt CAMP WINGATE * KIRKLAND BACKGROUND RELEASE I acknowledge that, in order to employ me, Camp Wingate Kirkland is required by law to perform a criminal background check on me in Massachusetts, my state of permanent address, and if applicable, the state in which I currently reside. By signing this letter, I hereby give Camp Wingate Kirkland permission to use a third-party company to perform this search. I also acknowledge that I understand that I have the right to access the results of any such inquiry performed by Camp Wingate Kirkland. Name Date Signature CAMP WINGQTE*KIRKLAND 79 WHITE ROCK ROQD YQRMOUTH PORT, MQ 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� :�` �"w� � �`��is '� � : �� ,r.,b- � �� CAMP WINGATE�KIRKLAND EMERGENCY PROCEDURES Carbon Monoxide Evacuation Plan When we run the Search and Rescue drill within the first 48 hours of each Camp session, the Carbon Monoxide Evacuation procedure is reviewed with the campers and staff. 1 . If a Carbon Monoxide detector activates, campers and staff should evacuate the building immediately. 2. The counselor in charge should immediately call the Camp office (after hours this phone rings in Sandy &Will's house). 3. As soon as Carbon Monoxide is reported to the office or to Sandy &Will, someone there should call the Yarmouth Fire Department and report it. Give directions to Camp if needed and information about the location. 4. At least one person should go to the Camp entrance at Linnell Lane to help guide the fire truck to the building in question. 5. A second person should be assigned to go to the location and do as much as possible to keep the campers away, without risking his/her own safety. 6. No one should enter the building until the Yarmouth Fire Department gives the approval that it is safe to return inside. CAMP WINCATE*KIRKLQND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E—MAIL: HEYCAMPOCAMPWK.COM �� µ�� r ��:"x.� �� t�� CAMP WINGATE �* KIRKLAND CAMPER DISCIPLINE POLICY Basic Princi I{�es ■ Our focus at Camp Wingate Kirkland is on teaching and positive encouragement rather than on punishment. ■ We strive to be a high quality staff providing a high quality experience. ■ Instead of having many detailed rules, we always appeal to the community to respect each other. ■ The Ladder of Discipline is a framework through which camper behavioral challenges are addressed. Counselor Guidelines Responding ■ Ask for help unless you are confident that you are responding in an appropriate way. The single biggest mistake that counselors make is not ask for help with camper issues. The Lodge Leaders and Directors are always available and should be interrupted if they appear busy. ■ In interactions with campers, counselors should strive to respond rather than react to children. Guidelines for Responding to Children ■ You are being entrusted to be a care-taker for children. ■ There is a clear power difference between you and the campers which should inform your actions. ■ You must be sexually appropriate with campers at all times—verbally, non-verbally and physically. ■ Be aware of sexual or sexualized behavior in campers. Be firm and non-shaming when responding to such behavior. CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.�267 E-MAIL: NEYCAMPOCAMPWK.COM ■ Be aware of, and minimize, activities that tend to over stimulate campers such as tickling and pillow fights. ■ Be conscious about your own stress level and take appropriate steps to respond. ■ If you have any question about any behavior or suspected behavior of a camper, please ask for help. ■ Safe places to touch are the hands, shoulders and upper back. Policy ■ Under no circumstances may a counselor hit or strike a child. ■ Counselors must not use abusive or derogatory language with campers. ■ Counselors may never touch a child against his or her will, unless there is a clear and present danger to the child. ■ A counselor may never touch a child if the child appears uncomfortable with the touch, whether that discomfort is expressed verbally or non-verbally. ■ Never touch a child in a place on his or her body that is normally covered by a bathing suit, unless for a clear medical necessity, and then only with supervision by another adult. ■ Hazing of campers by other campers or counselors is not permitted. ■ Campers will not be subjected in initiation rites that are abusive in any manner. ■ A counselor will under no circumstances share a bed or sleeping bag with a camper. A. Nuts and Bolts of Child Abuse Laws Please be aware of and understand the following, which are covered on the page following this one ■ The definition of a mandated reporter. ■ The purpose of the mandated reporting law. ■ A report of abuse is based on suspicion of abuse, rather than proven abuse. ■ Summary of procedure — time frame, reporting agency, providing the information requested. ■ Penalty for not reporting. CQMP WINGATE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� ..�., � �� CAMP WINGATE * KIRKLAND EMERGENCY PROCEDURES Fire Evacuation Plan When we run the Search and Rescue drill within the first 48 hours of each camp session, it is communicated to the campers and staff that the same procedure applies to fires and other emergencies. 1 . If a fire occurs at Camp, we must gather and account for everyone in Camp. 2. As soon as the fire is reported to the office, someone there should call 9-1-1 and report it. Give directions to 20 Linnell Lane and if needed, information about the location and type of fire. 3. The witness will report whether or not he/she knows if any campers or staff might be trapped in the area of the fire. 4. Simultaneously, the nearest person should run to the Office to alert the staff there to begin our emergency procedure. At the Office, he/she should take the red horn hanging on a hook to the right of the door. The person will take the horn and run around Camp and end up at the basketball court (or alternate location depending on the location of the fire). In addition, someone will be instructed to continuously ring the bell at the Office and the Basketball Court, signaling an emergency. 5. Upon hearing the horn, all members of the Camp community will gather at the basketball court, unless the location of the fire makes that impossible. The Frog Pond Field, Tennis Courts and Upper Soccer Fields are alternate locations. 6. As campers and staff arrive, bunk counselors will get their campers seated in a line and will quickly count the number of campers present from their bunk to determine if there are any campers missing. 7. Once everyone is accounted for, everyone should stay there until the fire fighting personnel tell us it is okay to leave. While the emergency procedure is happening, Sandy (or Will if Sandy is not available) will assign roles to the maintenance crew. He/she will use the office staff and Leaders, as needed. At least one person should go to the Camp entrance at Linnell Lane to help guide the fire trucks to the site of the fire. Others should be assigned to go to the fire location and do as much as possible, without risking his/her own safety. Natural Disasters (Flood, Lightning, Wildfire, Tornado, Hurricane, etc.) In the event that we can predict the possibility of a natural disaster, IMII and Sandy will assign a Leader to stay tuned to local media outlets. If the community is advised by local authorities to evacuate the area, the Camp will do so immediately. CAMP WINCATE*KIRKLQND 79 WHITE ROCK ROAD YQRMOUTH PORT, MQ OP675 TEL: 888.714.2267 E-MAII: HEYCAMPOCAMPWK.COM When appropriate, the Camp will follow its standard emergency procedure of blowing the horns and having the entire community gather at the basketball court. Otherwise, Leaders will be sent around Camp to give evacuation or other instructions to the entire community. ' In case of tornado or high winds: • Go to basement of new bunks (Hilltop, Joel's Place, Cottage) or to Linnell Lane, as instructed. • Stay away from glass enclosed places or areas with wide-span roofs, like the Leoj ; • Crouch down against the floor and cover the back of your head & neck with your hands • If no suitable structure is nearby, lie flat in the nearest ditch or depression and use your hands to cover your head � In case of flash flooding: • Evacuate low-lying areas (waterfront, Frog Pond, etc.) and go to higher ground (Hill Bunks, Upper Soccer Field, Office) • Do not try to walk through water that is more than ankle deep • If in a vehicle, do not drive through a flooded area , even if it looks shallow enough to cross � In case of lightning: • Go to safe shelter immediately • If boating or swimming, get out of the water immediately and go to the Leoj • If out of camp in a wooded area, seek shelter under a thick growth of relatively small trees • If you feel your hair stand on end, squat down with your head between your knees • Avoid isolated trees or other tall objects, bodies of water, sheds or fences • Once inside, avoid using a telephone or other electrical appliances—do not take a shower In case of wildfire: • Listen to local radio or television stations for updated emergency information • Follow the instructions of local officials. Wildfires can change direction and speed suddenly. Local officials can advise you of the safest escape route, which may be different than you expected. • If you are trapped, crouch in the pond. You cannot outrun a fire. • Lie flat and cover your body with wet clothing or soil. • If water is not around look for shelter in a cleared area or among a bed of rocks. • Breathe the air close to the ground through a wet cloth to avoid scorching lungs or inhaling smoke. CAMP WINCATE*KIRKLQND 79 WHITE ROCK ROAD YQRMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM ' �� , n,�+ �� `�� .,�., �w� � �w�� , �� CAMP WINGATE � KIRKLAND HAZARDOUS MATERIALS ; All gas and flammable liquids, explosives, and hazardous or poisonous materials may only be handled by Site Staff who have been trained specifically by Christopher Berardi, Camp Wingate*Kirkland Site Manager. Training includes the handling and disposal of fuels used to power maintenance equipment. All dangerous substances are kept under lock in the "Gas Shed" located in the Maintenance Barn area. All dangerous substances must always be kept in a safe and locked cabinet located under the main building, and must be kept separate from food at all times. ; CQMP WINGATE*KIRKLQND 79 WHITE flOCK flOAU YARM�UTH PORT, MA 02675 TEL: 888.714.2267 E—MAIL: HEYCAMPO,CAMPWK.COM �� ,>��;�. �� p ��, � �� +�� CAMP WINGATE �KIRKLAND HEALTH CARE POLICIES � PROCEDURES " SUPERVISION The health care administration of Camp Wingate*Kirkland will be the responsibility of the Camp Nurse. The lead Camp Nurse, Mary Cowell, is a licensed RN in the state of Massachusetts. The Camp Nurse will administer health care to all campers and staff within the camp community. The Assistant Nurse and our part time nurses, will be on duty when Sue Roach is not available. " The Camp Nurse will be available for assistance in planning and assessing the health care needs of campers and � staff according to the Rules and Regulations of the township. � RECORDS All campers and seasonal staff will have completed and submitted a Camp Health Examination Form to the Camp Nurse prior to or on the first day of the camping season. The Camp Nurse(s) will maintain the Daily Health Center records in our Camp database. At the end of each summer, all camper and staff health forms and other related history are stored on a hard drive and moved to the Director's house for long term storage. All medications are sent home with the campers. MEDICAL LOG BOOK There will be two separate logs, one for staff and one for campers. Each log will contain the names of campers and staff with a statement of their chief complaint as stated to the nurse and the action taken by the nurse. There will also be a separate log to record the daily prescription medications for all campers and staff. Documentation on individual camper health issues/visits will be maintained in the database and password protected from all but the Nursing staff and Directors. MEDICAL STORAGE All Health Center supplies and equipment will be stored in the Health Center, which is located next door to the Camp Office. All medications, prescription and non-prescription, will be locked at all times in a clean, dry place. At the time of dispensing, only one of the two RN's will unlock the medications and dispense them Every medication that is dispensed is logged in a bound notebook according to instructions on the child's Health Examination Form. They can be dispensed only at the Health Center, the Dining Hall, or at Planning Session. All equipment and health supplies will be purchased by the Camp Nurse or the camp directors. They will be purchased from a well known mail order dealer or at a local pharmacy using a camp charge account. All CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.�267 E-MAIL: HEYCAMPOCAMPWK.COM prescriptions written by the Mid-Cape Medical Center or a physician at the Cape Cod Hospital will be filled at the same local pharmacy. All health supplies are subject to approval by the physician who provides the Camp with Standing Orders. MEDICATION All medications, prescriptions and nonprescription, will be kept locked in the Health Center. Each medication ' brought to Camp by a camper will be kept locked in the Health Center and its dispensation will be recorded in a ' medication log. The Camp Nurse will administer all medications.. In the event the Nurse is not available (Dr. visit, hospital visit, day off) the Nurse will delegate administration of all medications to either Directors of the Camp. The Camp Nurse will review the proper procedures with the Camp Directors. The Camp Nurse, Camp Directors, � and Camp Leaders will discuss campers' needs for daily medications prior to the opening day of the camp season. In our on-going commitment to meet the needs of our campers who require medication while at Camp, we once again will be working with CampMeds Inc. to provide the convenient service of dispensing, packaging and shipping medications directly to our camp this summer. CampMeds is a service that pre-packages medications for Camp and � saves our nurses from spending unnecessary hours each day sorting campers' medications so that they can focus � on their primary role, tending to the health and wellness of the camp community. Camp Wingate*Kirkland's policy and procedure for dispensing and administering medicine requires camp families to have all of your child's medicine in pill form dispensed, pre-packaged and sent to Camp prior to their arrival. This includes: • All medicine taken daily (prescription and non-prescription) • All medicine taken "as needed" • Vitamins *Our Camp stocks most over the counter items such as Tylenol, Advil, Benadryl, etc. HEALTH CARE PROVIDERS The following Health Care providers will be involved in administering health care to the campers and staff of Camp Wingate Kirkland: • Mid-Cape Medical Center, Hyannis, MA, 508-771-4092, 489 Bearse's Way, Unit A-4, 02601 • Cape Cod Hospital, Hyannis, MA, 508-771-1800 Any instructions received over the telephone from the physician to the nurse, will be written in a bound notebook separate from other Health Center records. All phone orders will be co-signed by the physician and the Camp Nurse. TRANSPORTATION All campers or staff needing to be examined by a physician during the day will be seen at Mid-Cape Medical Center. The Camp Nurse will accompany campers and staff and they will travel in a designated camp vehicle. In the event of a camper or staff needing medical care during the clinic's off-hours, a camp nurse or camp leader will take them to the Cape Cod Hospital. CAMP WINGQTE*KIRKLQND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM The Standing Orders are updated prior to Staff Orientation Week each camp season. These orders are signed by a physician, the Camp Director, and the Camp Nurse each season. EMERGENCIES All emergencies will be called into 911. All emergency transportation will be coordinated through 911 at the time of the emergency. FIRST AID All first aid will be administered by the Camp Nurse and logged immediately in the appropriate health log. First aid . will be administered in accordance with the Standing Orders of the attending physician. In the event the Camp Nurse is not present for non-emergency first aid, a first aid certified person will attend to the needs of the individuaL This person will record his/her actions in the appropriate health log and report these actions to the Nurse upon her/his return to camp. All first aid procedures will be reviewed with certified first aid staff prior to the opening day of the camp season. First aid kits will be provided to the staff for all out-of-camp trips. All camp vehicles will have a first aid kit. Staff will receive an orientation to the use of the first aid kit during staff orientation week. All out of camp activities- day trips and overnight trips- are required to include a First Aid Kit prepared by the Camp Nurse. Each first aid kit will have a copy of the standing orders, emergency procedures, and accident report forms. Each first aid kit contains the following: Band-Aids, sterile pads, q-tips, antiseptic towelettes, ice packs, ace bandage, bacitracin ointment, adhesive tape, antacids, Benadryl, Sudafed, Tylenol, alcohol prep swabs, resusci face shield, after bite, and gloves. A minimum of one staff person is to be trained by the staff nurse in First Aid basic procedures. If a camper is in need of inedication during field trips, the nurse will package the individual's medication in first aid kit and instruct and delegate a staff member to administer it. FOOD SERVICE The Camp Nurse will be available for assistance in planning and assessing the health care needs of the kitchen facility and staff according to the rules and regulations of the township. The Camp Nurse will work closely with the kitchen staff to address special dietary needs of campers. HEALTH CENTER The Health Center is located next door to the Camp Office. The Nurse will be available for routine health procedures, exams, and the dispensing of inedications during established Health Center office hours. These office hours are 8:30a.m. -9:00 a.m., 11:30 a.m. -12:30 p.m., and 4:30 p.m. -5:00 p.m. The Health Center is also open immediately after evening�activity for those campers and staff who need bedtime medication. Parents of campers who are seen by a physician at the Mid-Cape Medical Center or the Cape Cod Hospital Emergency Room will be notified after the doctor visit. All campers admitted to the Health Center for an overnight stay will have their parents notified at staff's earliest convenience. Campers becoming ill during the night will be accompanied to the Health Center by one of their Lodge counselors. CQMP WINCATE*KIRKLAND 79 WHITE ROCK fl0A0 YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCQMPWK.COM �� CAMP WINGATE � KIRKLAND LAUNDRY POLICY Cape Cod Laundry Center of Yarmouth is contracted by Camp Wingate*Kirkland to provide laundry services for our campers. Once a week, laundry is delivered by a Wingate*Kirkland employee to the Laundry Center. Laundry is wash, dried and folded by a Laundry Center Staff. The follow day, a Camp Wingate*Kirkland Staff member will pick up the laundry and return it to Camp. Campers must use their own bedding and towels. CQMP WINCATE*KIRKLQND 79 WHITE ROCK ROAD YQRMOUTH PORT, MA 02675 TEL: 888.714.�267 E-MAIL: HEYCAMPOCAMPWK.COM �� , . � � � � �� ; � ; CAMP WINGATE * KIRKLAND LADDER OF DISCIPLINE � Step One: After a sign of disrespectful or inappropriate behavior, the counselor points it out to the camper and � asks for a change in behavior as needed. It is important to explain the reason to the camper and make sure the ' suggested change is a reasonable one. � Step Two: If the behavior continues, the counselor should remove the camper from the presence of others. Ask �' the camper the reason for their unacceptable behavior and try to work together to create an appropriate alternative. Step Three: If situation has still not resolved in an acceptable manner, the counselor should ask for help from a co- counselor or another counselor. With the camper, the counselor, and the new third counselor, review the situation that occurred. Let the camper know the reason for the meeting. It is important that the camper knows that this meeting is very out of the ordinary. Campers most always know this. Try to come up with alternatives/solutions, without threatening. Step Four: If disrespectful behavior continues in any way, the counselor next goes to a leader. The counselor, leader, and camper will then meet to discuss the situation. Once there is a meeting with a leader, Sandy and Will are informed and the parents are called. Step Five: If the disrespectful behavior continues after meeting with a leader, the next step is for the counselor and camper to meet with Sandy and/or Will. Changes for the behavior will be clearly stated to insure complete understanding by the camper. Parents will be informed of this meeting. Step Six: If the camper's behavior does not change significantly, there will be a second meeting with Sandy and/or Will and the camper will probably be sent home. Parents will be informed of this and a departure time will be established. CAMP WINCQTE*KIflKLAND 79 WHITE ROCK ROAD YQRMOUTH PORT, MQ 02675 TEL: 888.714.�267 E-MAIL: HEYCAMPOCAMPWK.COM , �� s>� �, �� rr ��,. > �� , CAMP WINCATE � KIRKLAND EMERGENCY PROCEDURES Waterfront Search and Rescue— Lost Swimmer Plan 1 , If a buddy tag is left on the buddy board or if it is determined that there are a different number of tags on the ; board than campers in the water, the Waterfront Director or the person in charge at the waterfront will blow four short whistle blasts to signify that the water should be cleared. 2. The Waterfront Director or the person in charge of the waterfront shall tell the lookout person to get one of the two horns out of the boat shed and run the upper loop around camp. While running the upper loop the lookout should be blowing the horn. The upper loop consists of the camp road past Redwood, the Health Center, the Office, Lodge 1, the Dining Hall, Lodge 2, Lodge 3, Lodge 4, Lodge 7, Lodge 5, the mail shed, the frog pond field and back to the basketball court. A CIT/the lookout, or person designated by Waterfront Director goes immediately to the Office and gets the clipboard/Sign-Out book, and runs to the Basketball Court. After the runner finishes the upper loop, report back to.the waterfront. 3, A second person, preferably not an LGT, will be instructed at the same time to get the other horn from the boat shed and run the lower loop around camp. The lower loop consists of Hilltop, Motel, Joel's Place, Cottage, Lodge 6, the art barn, Lodge 8, Lodge 9, the tennis courts, the beach volleyball court, the softball field, the upper soccer field, the lower soccer field, the archery range, the Leoj, and the campfire site. After the lower loop is run, the runner should report back to the waterfront. 4. Upon hearing the horns, all members of the camp community will proceed as quickly as possible to the basketball court. One of the camp nurses will immediately bring the AED to the waterfront and assist as necessary. As they arrive, bunk counselors will get their campers seated in a line and will quickly count the number of campers present from their bunk to determine if all campers are present. Some bunks will have both/all counselors taking part in the search and rescue at the waterfront. A Leader or other available staff member will count the number of campers if all the bunk's counselors are not available. 5. Will or Sandy will supervise the operation at the basketball court. He or she will take the clipboard and the walkie-talkie from the office and be responsible for communicating with the Leader at the waterfront. It is EXTREMELY important that the waterfront personnel are notified IMMEDIATELY once everyone is accounted for, or it is determined which camper is missing. CQMP WINCATE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E—MAIL: HEYCAMPOCAMPWK.COM 6. Janet McGill or a camp Leader will take a walkie-talkie from the office and any cell phone to the waterfront and be responsible for receiving messages from the basketball court and communicating them to the Waterfront Director, or the person in charge of the Search and Rescue procedures. 7. While this is taking place, all staff members who are LGT certified will immediately assemble at the waterfront to begin the Search and Rescue procedures. These procedures are to be led by the Waterfront Director or the person in charge of the waterfront. 8. Once the horn is blown and the waterfront is emptied, the Waterfront Director will assign the first LGT to check underneath the two floating rafts in third crib. The next two LGTs are instructed to check underneath the docks. All remaining LGTs will line up at the first crib rope and wait for further instructions from the WSI in charge. Search and Rescue will start differently if the missing person was checked into 3rd crib. During the entire Search and Rescue the Waterfront Director will have a rescue tube and be standing on the dock between second and third cribs. This is to ensure the maximum safety of the LGTs. 9. At the command of the waterfront director, the LGTs will begin walking through the water, (this will be different if searching for missing person checked into 3rd crib) constantly scanning the bottom. Once the waterfront director feels that they are deep enough, the LGTs will do surface dives to the bottom, swim three strokes, and return to the surface. They should be scanning the bottom the entire time. All lifeguards should come up with their hands above their heads. Once they have reached the surface, they will stroke back to the shallowest person, and then take 2 additional strokes backwards. On the count of the waterfront director, the procedure will continue: a) All campers are accounted for at the basketball court; or b) A victim is discovered—at which point the leader, or the LGT who discovers the victim (if the LGT is not too tired), will attempt an American Red Cross rescue; or c) It is determined that the camper missing at the basketball court is the same one who is missing at the waterfront. If this is the case, the Yarmouth Rescue Squad will be called immediately by the lanet McGill or a camp Leader at the waterfront, or if necessary by the office. 10.In the case of a potential neck and spinal injury, the most qualified lifeguards will initiate the procedures outlined by the American Red Cross. If the lifeguard feels any hesitation about securing the victim to the backboard, he or she should wait for the Yarmouth Rescue Squad to arrive. In this scenario, the victim should remain immobilized in the water. 11 .Once everyone is accounted for at the basketball court, the procedure will end and the waterfront director will debrief campers and counselors at the basketball court. 12,This procedure will be revised, reviewed, and rehearsed at least once during staff orientation week, and twice during the summer. CAMP WINGQTE*KIRKLAND 79 WHITE ROCK flOAD YARMOUTN PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� *,��, a� �. � ��, �� :� �� CAMP WINGATE * KIRKLAND POWER TOOL POLICY � Power tools may only be used by the Camp Wingate*Kirkland Site Staff, who are trained to do so, and by any other ' staff member or camper who has been approved by Christopher Berardi, Site Manager. All power tools used by the � Site Staff for Camp maintenance and renovations are locked up in the Maintenance Barn. Campers and counselors are not permitted to enter the Maintenance Barn without approval and supervision of a Site Staff member. Campers who wish to use power tools in areas such as Woodshop or Arts & Crafts area must always first be instructed and observed by a staff member who has been approved to teach the use of such tools. Safety rules are posted in both program areas. Campers may not enter the Woodshop without supervision from a designated Woodshop staff person. All tools must be kept in good condition at all times, and those in disrepair must either be immediately fixed or discarded. At all times, ANY ONE using a power tool must observe the proper safety methods, including wearing eye protection and any other necessary safety equipment. CAMP WINGATE*KIflKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MQ 02675 TEL: 888.714.2�67 E—MAIL: HEYCAMPOCAMPWK.COM �� „�, �>� +' � � �� '� � CAMP WINGATE * KIRKLAND STAFF SCREENING POLICY Application and Screening Processes for All New Staff Each job candidate fills out a Staff Application. The application includes requests for the following information: • Work experience • Training or certifications pertinent to camp • Three references Attached to the application are the following forms: • CORI Request Form (Commonwealth of Massachusetts criminal record check) • SORI Request Form (Sexual Offender Registry Information) • ACA Voluntary Disclosure Statement (FM 16) Expanded CORIs (adult and juvenile records) are submitted for all prospective employees. For prospective candidates who are not permanent Massachusetts residents,criminal background checks are conducted in their home and school states through a private company called National Background Investigators. Massachusetts SORI checks are conducted on everybody who has ever lived,worked in, or visited the United States. For candidates who live or attend school in states outside Massachusetts,we do whatever is required by the home state to check his/her name against its Sexual Offender Registry Board database. With the exception of a few overseas candidates,each prospective counselor is interviewed face-to-face. If face-to-face interviews are not possible,the candidate will have an extended phone interview with one of the camp directors. In either case, references are always called and notes are taken to be kept in the staff member's file. The international staff placement agency that we work with (CCUSA and BUNAC) conducts background checks on all of the counselors that they place. Policies for Returning Staff All returning,seasonal staff members complete CORI and SORI Request Forms and Voluntary Disclosure Statements. The above background check procedures also apply to returning staff members. Performance evaluations from past summers are also kept in each staff member's file. If counselors spend any summers away from camp,additional references are checked prior to their return. CQMP WINCATE*KIRKLQND 79 WHITE ROCK ROQD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� yt��.�� :'- . � � �� ' �� CAMP WINGATE KIRKLAND TRANSPORTATION POLICY Emergency Equipment/Forms Every vehicle used to transport campers and staff should be equipped with a first aid kit, fire extinguisher and emergency accessories including reflectors, maps, change for a pay phone. For trips outside the neighboring towns of Barnstable, Brewster, Dennis and Yarmouth, the staff member accompanying the group must carry health forms for all passengers and a cell phone for emergency communication. A rental agreement or vehicle j registration, insurance information, vehicle safety maintenance checklist, and this sheet should be in the vehicle at all times. Vehicle Type/Capacity Campers and staff should only be transported in vehicles designed to carry passengers. They are not permitted to ride in the back of trucks except in an extreme emergency and when directed by appropriate staff (i.e. fire evacuation.) Vehicles should carry only the number of passengers specified by the vehicle manufacturer. There should be a seatbelt for each passenger. A staff member (adult) must be present in each vehicle. If traveling by bus, this is in addition to the driver. Extra staff and/or aides must be present for campers with disabilities, based on ratios established for persons requiring additional assistance or supervision. (See established camp ratios.) Vehicle Safety Checks Prior to transporting campers, the following must be checked: _ lights _tires _ horn _windshield and wiper condition _ brakes _mirrors _emergency warning systems If any of these areas do not check out, either remedy the situation or do not take the vehicle. Report all vehicle problems to Greg Gorman. Pre Trip Checks Before Using Camp Vehicles • Check all tires for tread wear and proper pressure. • Check to see that the spare tire is in the vehicle and is in good condition with all necessary equipment to make a tire change. • Check to see that a fully equipped first aid kit is in the vehicle. • Check the gas gauge and determine that all gauges, lights and equipment are functioning properly. • Make sure lights, brakes, mirrors, horn, emergency flashers and windshield wipers all work. CAMP WINCATE*KIRKIAND 79 WHITE flOCK ROAD YARMOUTH PORT, MA 02675 TEL: 888J14.2267 E-MAIL: HEYCAMPOCAMPWK.COM • To get gas, ask the director for a credit card and bring back a receipt. When getting gas, the driver should check lights, tires, windshield wipers, emergency flashers, horn, oil level and coolant level. Problems should be referred to the Site Manager immediately. Passenger Orientation Passengers should be instructed in the following safety procedures prior to transporting: • Passengers should remain seated at all times with hands and arms inside vehicle. • Seatbelts should be fastened—one person per seatbelt. • Noise level should be such as to not distract the driver. There should be no throwing of objects or other disruptive behavior. � • Passengers should enter and leave the vehicle under the direction of a staff member and/or driver. If the vehicle makes an emergency stop, passengers should follow directions of staff member and/or driver and use buddy system if leaving the vehicle. � Supervision Ratios All camp trips with campers out of camp in a camp vehicle will have at least 2 counselors with the group. For example, in a 15 passenger van, there could be up to 13 campers and 2 counselors, one of them driving. In general, there should be a ratio of 1 to 8. Exceptions include short trips within the adjacent towns of Yarmouth, Dennis, Barnstable and Brewster: for these short trips, there may be one driver for 10 campers if circumstances are unusual and no other counselor is available. Otherwise, even for short trips there must be an additional counselor in the van, in addition to the driver. Driver Requirements To transport campers or drive camp vehicles off the site, drivers must be 21 years of age and hold valid vehicle operator's license for the size and type of camp vehicle, and have no moving violations for previous 18 months, verified by a background check through DMV. Travel Procedures Vehicles should be kept a safe distance apart if traveling together. It is not recommended that vehicles travel by convoy. Drivers should pre-establish rest stops to check in with each other. All drivers should have maps, complete directions to destination, and appropriate telephone numbers. One driver should be appointed lead driver. On any trip, stops should be made only at acceptable rest stops. After three continuous hours, the vehicle must stop to rotate or rest drivers and rest the passengers. All traffic laws of the state are to be strictly obeyed when transporting campers and staff. Behind The Wheel Training If you are driving a vehicle that you normally do not drive, the camp director will evaluate and determine when additional behind-the-wheel training is required before transporting persons or equipment. (Includes training in vans, camp trucks, buses, and vehicles pulling trailers.) Camper Behavior CAMP WINCQTE*KIRKLANO 79 WHITE ROCK ROAD YARMOUTH PORT, MQ 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM In larger vehicles, behavior problems should always be the responsibility of adults or staff members other than the driver. If the driver is the only staff member available to handle disruptive behavior and verbal corrections are not successful, he/she should pull off the road in a safe area. Follow established camp discipline procedures. Backing Up Because you cannot see everything behind your vehicle, backing up is always dangerous. Avoid backing up whenever you can. When you park, try to park so you will be able to pull forward when you leave. When you have to back, here are a few simple safety rules: 1. Look at your path. 2. Back slowly using your mirrors. 3. Back and turn toward the driver's side whenever possible. 4. Use a helper whenever possible. Loading and Unloading Passengers Load and unload in areas that are free from vehicular traffic unless an emergency. The vehicle should be in park with the emergency brake on and the motor turned off. Loading and unloading will take place in an orderly fashion following directions from staff member. Campers should be directed where to assemble after unloading and kept under supervision of an adult. Refueling Always refuel before getting down to a quarter of a tank. The engine must be turned off to refuel. If transporting campers, they are to remain in the vehicle. Do not allow unsupervised campers to leave the vehicle for any reason. Dealing with Passenger Illness • Administer first aid as needed. Keep the camper comfortable. • If you need to stop, try to do so in an authorized or designated area. • Contact camp about the camper or return to camp as soon as possible and have the camper check in with the Nurse. Accident Procedures If a counselor or staff member is in an automobile accident, with or without campers in the vehicle, the first priority is to ensure the health and safety of all involved. If there are any injuries to the driver or passengers, call 9-1-1 (of if no phone is available then find a witness and ask him/her to call for help.) If the accident is serious,with any injuries or substantial damage to the vehicles, do not hesitate to call the police. However, if it is a fender-bender with no injuries and limited damage, the driver can simply exchange insurance information with the other driver. In any case, do not admit any liability—try to remain calm and objective, while providing and requesting the required information. Each camp vehicle is equipped with the following: • First Aid Kit • List of Emergency Procedures CAMP WINCQTE*KIRKLQND 79 WNITE ROCK ROQD YQRMOUTH PORT, MA 02675 TEL: 888.714.��67 E-MAIL: HEYCAMPOCAMPWK.COM • Emergency Phone Numbers • Insurance Information • Fire Extinguisher • Reflectors The reflectors should be used if there is any risk of the accident causing a dangerous situation for other drivers or for your passengers. In case of a fire in the vehicle, do not try using the fire extinguisher. Just move yourself and all campers as far from the automobile as possible. Likewise, any injuries should be treated by professional health care and emergency care providers, rather than with the provided first aid kit. The first aid kit is provided for minor injuries sustained out of camp, such as cuts, scrapes, bug bites, etc. As soon as the situation is under control, call the camp at 508-362-3798 or Sandy&Will at 508-362-3799 and let us know exactly what happened, how everybody is, and what future actions are likely to be taken. If possible, we will have a member of the Leadership Team or maintenance crew come to the site of the accident. Dealing with Vehicular Breakdown 1 . Move off the road as far as possible. It's better to drive on a flat tire than park in an unsafe place. 2. Place the transmission in low, reverse or park. Turn off ignition and remove key. 3. Set the emergency brake. 4. Turn on the emergency/hazard blinking lights. 5. If vehicle must stop in nondesignated parking area (ie., the side of the road), carry reflective triangles between yourself and the oncoming traffic when placing reflectors in the following places: a. On the traffic side of the vehicle, within ten feet of the front or rear corners. b. About 100 ft. behind and ahead of the vehicle, upon the shoulder of the lane you are stopped in. C. Back beyond any hill, curve, or other obstruction that prevents other drivers from seeing the vehicle within 500 feet. d. If stopped on or by a oneway or divided highway, place warning devices 20 feet, 100 feet, and 200 feet toward the approaching traffic. 6. If safe to do so, unload passengers and move them well off the roadway away from the vehicle. Make sure campers are supervised at all times by an adult. If evacuation from a bus is necessary, follow established procedures and directions of the staff member. 7. Contact camp with information about nature of the breakdown and your exact location. Additional help may be requested if needed. One staff member must stay with the vehicle and campers. Tips for Driving the Camp Vans 1 . There is an enormous blind spot in the rear view mirror. With children in the van, the rear view mirror becomes even less useful. Use of the side view mirrors is essential to safe driving. Both mirrors need adjustment before each trip—take the time to do this. 2. A van is heavier in the front than in the back. Therefore, when driving in the rain, the rear section may hydroplane or skid. Extreme caution and slow speed minimizes this possibility. CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROAO YARMOUTH PORT, MA 02675 TEL: 888.714.2�67 E-MAIL: HEYCAMPOCAMPWK.COM 3. A van is not as controllable as a car. A van corners poorly, so extra caution should be used on entry and exit ramps. 4. When passengers are entering or leaving the vehicle, it should be in park and the engine should be off. Health Forms and Camp Trips For Challenge trips, copies of health forms will be in the First Aid kit which accompany each trip. Any trip out of ; Camp, whether by car or foot, that is in the town of Yarmouth, or the nearby towns of Barnstable, Brewster or Dennis do not require health forms. All other trips require them. On all trips out of camp, a minimum of 2 staff � members must be present, one of whom may be a CIT. All boating trips, no matter what town, require health forms. � � CAMP WINCATE*KIRKLQND 79 WHITE ROCK ROQD YQRMOUTH PORT, MA 02675 TEL: 888.714.�P67 E-MAIL: HEYCAMPOCAMPWK.COM �� , ;�;�„� � �t��"f �``� � � �� "' ` � � �� CAMP WINGATE * KIRKLAND WATERFRONT DIRECTOR � The Camp Wingate*Kirkland Waterfront during the 2016 summer will be under the direction of Jenny Murran. Jenny is certified in Water Safety Instruction, Lifeguard Guard and CPR. The Waterfront Director is responsible for planning, directing and supervising the Camp's waterfront program. The number one goal of the Waterfront Director, at all times, and regardless of any other demands on his or her time, is the safety of every camper and staff member in relation to waterfront activities. The importance of this primary goal cannot be emphasized enough. Other responsibilities include helping the winter staff with recruitment and training of waterfront staff,teaching waterfront staff their responsibilities for the summer regarding instruction and general swim times;teach staff and campers the rules and regulations of the waterfront including the use of the Buddy Board; teach staff and campers, by lecture and demonstration,the Camp's emergency procedures; teach staff and campers the proper use of waterfront equipment including life preservers and boats; check all waterfront equipment daily for safety, cleanliness and good repair. In addition,the Waterfront Director is has overall responsibility to set up and oversee the instructional swim program at the Camp. This includes the initial placement within 24 hours of campers' arrival, assigning swim groups and instructors, keeping records on progress and recognizing achievements publicly. In addition,the Waterfront Director is responsible for the development and evaluation of the aquatic teaching abilities of the waterfront staff. In addition the Waterfront Director is responsible to be familiar with all ACA Standards that relate to the aquatic activities, both in and out of Camp, and to make sure we are in compliance at all times with each Standard. If the Camp is not in compliance,the Waterfront Director's responsibility is to remedy the situation immediately or to inform the Camp directors right away. The waterfront is especially risky during general swim times and the Waterfront Director is responsible to follow all waterfront regulations to ensure camper and staff safety. If at any time,the Waterfront Director feels that there is inadequate supervision or faulty procedures, he or she should immediately consult with the Camp Directors. The Waterfront Director is responsible for ensuring that the waterfront area is neat and clean at all times. Given the high risk in the waterfront area, it is vital to have a neat waterfront to project an image of order and safety. The waterfront should be clean and organized before closing it each day. This includes the docks, boats, boathouse supplies and anything else found in the waterfront. Any environmental or other hazards should always be eliminated immediately or managed according to agreed upon procedures. The Waterfront Director reports to Sandy&Will Rubenstein, Camp Directors. CAMP WINCATE*KIRKLAND 79 WNITE ROCK ROQD YARMOUTH PORT, MA OP675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� ! �� P.��f` �� . j NMF 4MM� . . . . { � CAMP WINGATE KIRKLAND SWIM TESTINC PROCEDURES � PERSONAL FLOTATION DEVICE POLICY A °' All campers and staff must demonstrate their swim skill in a "crib test" during their first 24 hours of � � attendance at Camp. (See crib test on next page). Only campers who have demonstrated the highest ' level of swimming competency will be categorized as a "Crib 3 Swimmer." Any campers or staff who � � refuse to participate in crib placement will automatically be classified as a "non swimmer." � � Camp Wingate*Kirkland requires that all watercraft participants, campers and staff, to wear a personal � � flotation device when participating in any watercraft activity offered at camp including but not limited to: ° boating, sailing, log rolling, kayaking, canoeing and trampolining. Any camper or counselor who refuses ` a personal flotation device may not participate in the activity. Only Crib 3 swimmers may participate in � watercraft activities including the water trampoline. All personal flotation devices(PFDs) are inspected on a daily basis. Boating instructors are trained to ' inspect PFDs on all campers prior to entering the water and embarking on their boat. Instructors must b insure proper fit and all of the clips are secure and work properly. Boating instructors are trained to ' remove any malfunction PFDs from rotation and request a replacement one from the Director ,; Campers and staff participating in to public aquatic activities with public providers are required to wear approved PFDs as determined by the U.S. Coast Guard. If a public provider does not have a U.S. Coast +» Guard approved PFD, Camp Wingate*Kirkland provides our own PFDs for participants to wear. � For aquatics activities run outside of camp, a complete list of participants with their swim skill level must f be included with the group. When the group arrives on-site a counselor on duty must assess location for ; safety and environmental hazards and risks. There must be an LGT present. There must be no more i than 10 campers swimming per counselor on duty. If there are more than 10 campers swimming, use a ° buddy system with checks. If there is an emergency, follow normat out-of-camp emergency procedures. Any campers or staff classified as "non-swimmers" must wear a PFD for aquatics activities outside of ; Camp. ��c�,t�r 6 w��. �tte��ss��v, t��rct�r�� Ci�+� �'�;�d`� + l�iR�.�NQ 3 '9 ��iE �;tC� FQ ; +��RM�UTs� �;;�� A �?a':< I S�1 ��' 3"9� i �Ax 5�� b� ��s Mti�''v� C��t�W� COk 4M�tIl:Jt�4�'��A�t��y. C�jM �� V�'1I� GAT� �� .' KIRK�.AHD � � �� CRIB PLACEMENT PROCEDURES First Crib: � � ■ 10 bobs � � ■ Blow bubbles in the water ■ Fully submerge under water i Second Crib: a ■ 1 length of crawl ■ 1 length of backstroke or elementary backstroke _ ■ 1 length of breast stroke '' ■ 3 minutes of treading water ' ■ 2 minutes of survival float � Third Crib: ■ 2 lengths of crawl `` ■ 1 length of breaststroke ` ■ 1 length of backstroke or elementary backstroke ' ■ 1 length of stroke of choice ` ■ 4 minutes of treading water '' ■ 2 minutes of survival float ; � . �4 Special Notes ' Campers may have 10 seconds rest between each length " Campers can be crib "tested" as many times as they want throughout the summer; however, they '; cannot be tested more than once a day. Only WSIs may crib test campers. S�"Vf11' �, VV4tt Rtt��STElNR ti4tiE"Ct�Qi�� CAwt� �r'sw�.d't � �tf��t�4$ t °� ��{E R�SC+�; f4G t �",�i��QUts� w�R" u� �c+i:': i a�� rf� 3`�"� � �dx 5�# �ih� ��1d VFA'Y� C1At��K CCM a�efYCA,Mf��M+'�1s CC3Mt � �� , .� . Y� �49�.�... ! � � � � �� b"h... ��.. �� . � .,.�.,;,,t!�,.,.:,., , � SPECIAL CONTINGENCY PLANS FOR DAY CAMPS � Children who are reaistered and on the camp roll but fail to arrive for a�iven da�'s activities The Day Camp Director or day camp staff member checking in campers will notify the camp office after a reasonable time ( ten minutes ) that a registered camper has failed to arrive. The camp office will contact the Parent/Guardian via phone using the information available on the Emergency Notification Card for that child. The camp office will keep the Day Camp Director appraised of the information gleaned ( camper delayed, sick ). Children who fail to arrive at the point of pickup following a given day's activities. The Day Camp Staff will notify the camp office and the Procedure for Lost Camper plan will be initiated immediately. (see attached) Children who appear at cam�without having re�istered and without prior notification The Day Camp Staff will notify the camp office and bring there any unregistered child. Office staff will call the Parent/Guardian who dropped off the child and arrangements will be made to register the child over the phone or to have the child picked up. The child will wait at the camp office until registered or picked up. CAMP WINGATE*KIRKLAND 79 WHITE R�CK ROQD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM � The Commonwealth of Massachusetts Executive Office of Health and Human Services - Department of Public Health " Bureau of Environmental Health Cammunity Sanitation Program 250 Washington Street, Boston, MA 02108-4fi19 Phone: 617-624-5757 Fax: 617-624-5777 MARYLOU SUDQER3 CHARLES D.BAKER Secretary Governor TTY: 617-624-5286 MONICA BHAREL,MD,MPH KARYN E.POLITQ Commissloner ' Ueutena�nt(3ovemor Tel:617-824-6000 www.mass.govidph Re�gulation 105 CMR 432.00Q - Guidance Checklist Municiaai and Recreationai Pronram or Camu Name: Address: (3peratoriDirector: Phone Number: Gt�ek f presenl: ❑ Polzcies,proceduces and records pursua�t ta 432.400 are current and readily available. ❑ C?rientation plan for staff and volunteers includes compliance with 105 CMR 432.000. ❑ Training and certification for Certified Swun Instrvctors and Swim Assessors,including swim test observation end participation dates. ❑ Documentation of is►dividuais snecessfully cornpleting PFD fit test training. ❑ Current inventory of PFDs far use by designated non-swunmers and at�risk swimmers. ❑ PFUs readily available and in serviceabte candition. � ❑ If applicable,conf'u�mation of third party provision of PFDs(e,g.—copy of contracti). : ❑ Storage facility(peemanendmobile)protecting PFDs&om the elemencs and providing adequate ven6lation. ❑ Swim ability determinations conducted for all minors and documented appropriately. ❑ Site-specific procedures to confine participants to areas consistent with their swimming abilities. � ❑ If applicable,a pracedure for managing k'FDs provided by a parent or legal guardian. ❑ If applicable,a procedure for cont�eting a parent or legal guardian that provides a P�D that does not fit properly ar is not in serviaeable condition. ❑ Identification system utilized to verify non-swirnmers and at-risk swimmers at swimming venue. Guidance Checklist 5-12-17 �AMp WINGATE �� KiRK�A� o � : , . . � � � �. � � _ CAMP WINGATE*KIRKLAND BUDDY BOARD Camp Wingate*Kirkland utilizes a buddy board system to verify non swimmers and at-risk swimmers a�the waterfront. Every camper and staff will have a buddy tag containing their name, bunk, swimming crib and boatit�g.designation. Before entering the water for any reason, camper must hand their buddy tag to a Certified Waterfront Staff who will place the#ag on the active Buddy Board._ This communicates to the lifeguards exactly how many people are supposed to be in the water at any given time. Staff must pface their tags on the active Buddy Board as well when entering the waterfront. Upon exiting the water, campers will ask a counselor or CIT to remove their buddy tag from ��`� �� the active Buddy Baard. Campers do not remove their own tags. � .a= This procedure applies for all aquatic activities—including swimming,boating, nature and any other activities being done on the waterfront—during both instructional and general swim times. After campers and staff have completed their swim assessment, their designated level and crib are marked on the back of their tag. Specific colored buddy tags are assigned to easily identify non-swmliners and a# risk swimmers. � Yellow: Overnight Campers Blue: Day Campers _ Orange: Staff & CITs Grey: At Risk Swimmers Lavender: Non Swimmers When campers are not in the water, their tags are stored on the inactive Buddy Board. , � , �' `�� SANDY & }NILI RUBENSTEIN, DIRECTORS CAMP WINCATE *KIRKLANO I 79 WHITE flOCK RO I YARMOUTH POflT, MA U2675 ( 508.362.3798 I FAX 508.362.1614 WWW.CAMPWK.COM I HEYCAMPBCAMPWK.CDM I� �AMp =.�- �-�-_.�, WIHGATE �= �: KIRKLANO x �� > CAMP WINGATE*KIRKLAND PRflWDED PERSONAL FLOTATION DEVICE-POLICY (PFD) Parent, guardian or person with custody of a minor may provide a Personal Floatation Device (PFD) to Camp for their camper's use,for the duration of their attendance at Camp if the PFD meets the USCG standards. The Waterfront Director will ensure that the provided PFD is properly sized and fitted for the child, in accordance with guidelines issued by the Department, prior to minor's first bathing or swimming activity. If a parent, guardian or person with custody of a minor elects to provide a PFD for their camper, they must submit in writing instructions that their camper is to only use specifically identified PFD. At no time shall the child be allowed to enter bathing water without wearing this specifically identified PFD except during close(y supervised swim tests, swimming or diving lessons, and beach waterfront activities. The Camp Wingate*Kirkland Waterfront Director will ensure that the_provided PFD designated for a particular child is clearly and permanen.tly marked with the child's first and last name and a parent's or legal guardian's emergency cantact information (name and telephone number). f-�°� �� If, at any time, the provided PFD is determined to not be properly fitting, or is damaged or otherwise not in serviceable condition, Camp shall immediately notify the parent or legal guardian who provided the PFQ. In such case, the minor shall not be allowed to participate in any swimming/bathing activity pending . verbal permission from the parent/legal guardian for the minor to be properly fit tested for a PFD provided by Camp. Any verbal_permission shall be subsequently documented in writing within 24 hours, and, at a minimum, provide the date, time and name of the parent/guardian who provided permission. .�...� � � ``�� SANDY � WILL RUBENSTEIN, DIRECTORS � � � CAMP WINCATE *KIflKLAND I 79 WHITE ROCK flD I YARMOUTH POflT, MA 02675 1 5U8.362.3798 I FAX 508.362.1614 WWW.CAMPWK:COM I HEYCAMP�CAMPWK.COM i i � �AMp ;�..�y WINGATE�T �� KIRKLAHD �, �� _.y.�= __ CAMP WINGATE*KIRKLAND PERSONAL FLOTATION DEVICE-POLICY - Camp Wingate*Kirkland requires that all watercraft participants, campers and staff, to wear a Personal Flotation Device (PFD) when participating in any watercraft activity offered at Camp including but not limited to: boating, sailing, log rolling, kayaking, canoeing and trampolining. Any camper or counselor who refuses a Personal Flotation Device (PFD) may not participate in the activity. Only staff and campers identified as "third crib" swimmers may participate in watercraft activities including the water trampoline. All campers and staff must participate in a Personal Flotation Device (PFD) fit test during their first 24 hours of attendance at Camp. This includes an on-land orientation to the specific rules of the watercraft activities. In small groups the waterfront directors will inform swimmers on rules that are unique to the watercraft activities, and the expectations of campers as well as staff. Before leaving the waterfront orientation all campers must be fitted for a PFD by a certified staff member, and the staff member must record the size for future reference. `�� Cam ers and staff artici atin in ublic a uatic activities with public providers are required to wear p p p 9 p q approved PFDs as determined by the U.S. Coast Guard. If a public provider does not have a U.S. Coast Guard approved PFD, Camp.Wingate*Kirkland provides our own PFDs for participants to wear. All personal flotation devices(PFDs) are inspected on a daily basis. Boating instructors are trained to inspect PFDs on all campers prior to entering the water and embarking on their boat. Instructors must insure proper fit and all of the clips are secure and work properly. Boating instructors are trained to remove any damaged PFDs from rotation and request a replacement one from the Director. The waterfront director will also perform weekly inspections of all PFDs. . .�,_� 4 �� . . . . .. . . l '" -` SANOY �C WI�L flUBENSTEIN, DIRECTORS CAMP WINCATE * KIRKLAND I 79 WHITE ROCK RD l YARMOUTN PORT, MA 02675 I 5�8.362.3798 I FAX 508.362.1614 WWW.CAMPWK.COM ( HEYCAMP9CAMPWK.COM � � IV. Reducing the Risk of Child Abuse In an effort to create the safest possible environment within the camp, several abuse prevention measures will be utilized. These measures include provision for regular training on child abuse issues to staff members and standards for appropriate discipline. A. Staff Training Before camp begins, all staff members will be required to read the camp's abuse policy and indicate that they have read and understand the policy and agree to abide by it. B. Discipline All staff members are trained in appropriate methods of camper discipline. No physical punishment or verbal abuse, e.g.,ridicule, are to be used at any time. VI. Reporting Child Abuse Should there be allegations of child abuse at Camp Wingate Kirkland these procedures will be followed: 1 . Treat any allegation of child abuse seriously. 2. Immediately begin documenting all procedures observed in the handling the allegation. 3. Immediately notify the Camp Directors, who will notify the appropriate authorities. Camp Wingate Kirkland is mandated as an organization to report all allegations to the Massachusetts Department of Social Services, at (800) 792-5200. 4. Do not confront the accused with allegation unless and until advised by the Camp Directors to do so. The accused will be temporarily relieved of their camp duties until the investigation is concluded. 5. Observe confidentiality for both the alleged victim and the accused until advised to the contrary by the Camp Directors. VII. Policy Review The Child Abuse Prevention Policy and Procedures of Camp Wingate Kirkland shall be reviewed annually by the Camp Directors, with assistance from legal counsel. CAMP WINGATE*KIRK�ANU 79 WHITE ROCK ROQD YQRMOUTH PORT, MQ 0�675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM V�� ,� � �� `�� `�� CAMP WINGATE � KIRKLAND CHILD ABUSE PREVENTION POLICY I. Purpose The purpose of this policy is to help Camp Wingate Kirkland provide a caring and secure environment for all of its campers and to help the camp reduce its legal risk and liability exposure. tl. Definition Child abuse refers to an act committed by a parent, caregiver or person in a position of trust which is not accidental and which harms or threatens to harm a child's physical or mental health or welfare. III. Types of Child Abuse A. Physical Abuse A physical injury, threat of injury or creation of a real significant danger of substantial risk of death, disfigurement or impairment of bodily functions. Such injury or threat of injury, regardless of intent, is inflicted or allowed to be inflicted by non-accidental means. Examples: asphyxiation; bone fracture; brain damage, skull fracture, subdural hematoma; burns, scalding; cuts, bruises, welts, abrasions; internal injuries, poisoning; sprains, dislocations; gunshot, stabbing wounds. B. Physical Neglect The failure to provide food, clothing, shelter, or supervision for a child if the child's health or safety is endangered. Physical neglect may include multiple occurrences or a one-time critical or severe event that results in a threat to health or safety, such as toddler left alone. Other types of neglect include abandonment, inadequate supervision, inadequate clothing, inadequate shelter, inadequate personal hygiene, inadequate food and malnutrition. C. Sexual Abuse Sexual abuse includes any act defined in the code of Massachusetts which is committed, or allowed to be committed, upon a child be his/her parent or other persons responsible for the child's care. Examples of such abuse are: sexual exploitation, sexual molestation, intercourse/sodomy and other sexual abuse. D. Medical Neglect Refusal or failure by caretaker to obtain and/or follow through with a complete regimen of inedical or dental care for a condition, which if untreated, could result in illness or development delays. E. Mental Abuse/Neglect A pattern of acts or omissions by the caretaker which result in harms to a child's psychological or emotional health or development. CQMP WINGATE*KIRKLANO 79 WHITE ROCK ROAD YARMOUTH PORT, MQ 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM � ' � ' � 1 ' ' 1 ' i 1 Massachusetts State Regulations require that all staff members provide a complete employment history for the past five years. In the space provided below, please list the name of the organization, address, phone number, and contact person at each place you have been employed during the last five years. If you need more space, please attach an extra sheet. Organization: Position: Dates of Employment: � Address: Phone: Contact Person: Organi�ation: Position: Dates of Employmenf: �� Address: ' Phone: Contact Person: Organization: . Position: Dates of Employment ' Address: Phone: Contact Person: Signature Date caMP wiN�aTe��ir��aN� 79 WHITe rOCI� (08D Y8rM0UTH POIT, Ma 02675 TBI: 888.71�.2267 . �AMP -� yk WINGATE :,�` KlRKLAND �� CAMP WINGATE*KIRKLAND SEXUAL HARASSMENT POLICY In order to encourage the best possible working environment during the summer,Camp Wingate*Kirkland believes that mutual respect between its staff members is absolutely essentiaL We reject sexual harassment in any form. Sexual harassment is "unwelcome sexual advances, requests for sexual favors,slurs,jokes and othe�verbal or physical conduct of a sexual nature." It becomes unlawful when: 1. Submission to such conduct is explicitly or implicitly a condition of an individual's employment; or 2. Submission to or rejection of such conduct affects the employee's job or substantially interferes with an individual's job performance;or 3. Such conduct has the purpose or effect of creating an intimidating,hostile or offensive work environment. Because Camp takes allegations of sexual harassment seriously,we will respond promptly to complaints of sexual harassment and where it is determined that such inappropriate behavior has occurred,we will act promptly to eliminate the conduct and impose such corrective action as is necessary,including disciplinary action or termination of the harasser where appropriate. If sexual harassment is perceived by an employee, he or she should follow the following procedure: 1. Speak to Sandy or Will Rubenstein, Directors of Camp Wingate*Kirkland. : 2. Make it clear to the harasser that you do not approve of his or her behavior or comments, and ask that it stop immediately. Studies have shown that in the majority of cases,the harasser was unaware that his or her conduct was offensive. 3, If the undesirable behavior continues, keep a written record of the behavior,including dates,times, details and witnesses. 4. Sandy and/or Will will promptly conduct an investigation of the charges,exerting their best efforts to maintain the ` complainant's confidentiality. Depending on the evidence,Sandy or Will will discuss#he complaint with the staff member(s). If a pattern of frequent offensive behavior is verified,offenders will be subject to disciplinary actions up to and including immediate termination. 5. There will be no retaliatory action taken against an employee who in all good faith makes a report of sexual harassment. This statement is issued in accordance with the guidelines of the 1981 Equal Employment Opportunity commission. During our staff orientation,we will have a brief discussion of this sexual awareness policy. CAM P WINCATE *KIRKIAND 79 WHITE flOCK ROAD YARM OUTH PORT, M A 02675 TEL• 888 .71 4 .2267 E-M All: HEYCAM PO CAM PWK.COM CQMP wiNGATE �;;?=- KIRKLAND �� SEXUAL HARASSMENT POLICY ACKNOWLEDGMENT I hereby acknowledge that: 1. I have read the Camp policy on sexual harassment, endosed with this contract; 2. I understand the definition of sexual harassment within our Camp setting and the sanctions for that behavior; 3. I am aware of the procedure for filing a complaint if I feel that I have been sexually harassed. Staff Member Signature Date BACKGROUND CHECK I acknowledge that,in order to employ me, Camp Wingate*Kirkland is required by law to perform a criminal background check on me inMassachusetts,my state of permanent address, and if applicable,the state in which I currently reside. By signing this letter, I hereby give Camp Wingate*Kirkland permission to use a third-party company to perform this search. l also acknowledge that I understand that I have the right to access the results of any such inquiry performed by Camp Wingate*Kirkland. Staff Member Signature Date PROMOTIONAL RELEASE I hereby give Camp Wingate*Kirkland permission to use my image photographs and video, for promotional purposes. Staff Member Signature Date MOTOR VEHICLE RECORDS CONSENT - I, , authorize Camp Wingate*Kirkland to obtain my Motor Vehicle Records report for employment purposes. I authorize anyone to disclose this information to Camp Wingate*Kirkland and release all persons from any liability for obtaining or providing this information. I agree that a photocopy or fax copy of this authorization is as valid as the originaL Staff Member Signature Date CAM P WINGATE *KIRKLANO 79 WHITE ROCK ROA� YARM OUTH PORT, M A 02675 TEI: 888 .71 4 .2267 E-M AIL• HEYCAM PO CAM PWK.CdM �",�►�� `,� �� CRIMINAL OFFENDER RECORD INFORMATION (CORI) ACKNOWLEDGEMENT FORM Camp Wingate*Kirkland is registered under the provisions of M.G:L.c. 6, § 172 to receive CORI for the purpose of screening current and otherwise qualified prospective employees, subcontractors,volunteers, license applicants,current licensees, and applicants for the rental or lease of housing. As a prospective or current employee,subcontractor,volunteer, license applicant, current licensee, or applicant for the rental or lease of housing, I understand that a CORI check will be submitted for my personal information to the DC11S. I hereby acknowledge and provide permission to to submit a CORI check for my information to the DCJIS. This authorization is valid for one year from the date of my signature. I may withdraw this authorization at any time by'providing written notice of my intent to withdraw consent to a CORI check. FOR EMPLOYMENT,VOLUNTEER,AND LICENSING PURPOSES ONLY: Camp Wingate*Kirkland may conduct subsequent CORI checks within one year of the date this form was signed by me provided, Camp Wingate*Kirkland first provides me with written notice of this check. By signing below, I provide my consent to a,CORI check and acknowledge that the information provided on Page 2 of this Acknowledgement Form is true and accurate. Signature Date CRIMINAL OFFENDER RECORD INFORMATION (CORI) ACKNOWLEDGEMENT FORM SUBJECT INFORMATION: Last Name First Middle Maiden Name (or other name(s) by which have been known) Date of Birth Place of Birth Social.Security# . Sex: Height: ft. in. Eye Color: Race: Drivers License# State of Issue Current and Former Addresses: Street Number and Name City/Town State Zip Street Number and Name City/Town State Zip The above information was verified by reviewing the following form(s) of government-issued identification: Verified By Name of Verifying Employe (Please Print) Signature of Verifying Employe �� a. — � � �� -� �� _. � � � � � � �� ,��" �,-�,G �� ,� ��r�� P � � � ... ��' 3...ss.� f k-- 5P-L - >.-�s�,��`e§ � h. � � � .�`�°'�'��'u�f,�.� ��:"�-` . z- : =-'�-`�.;,�k,.�r,� .. �. , ,.,,-�._��.��-�.e�#.�;r�''' _ :� xa..�'��.,..�..., __. .z�.s......�. . . . . . . _ . �- . .. .g . . . ___ ._ . Name Date of Birth Last First Home Address Street Address City,State Zip Home Phone Cell Phone Social Security# Drivers License# Issuing State Expiration School or College School or College Address - `` Street Address City,State Zip ,� �� ,�, �~� . � �� ;�� . � �� 511�1� ��,��..��2 �� .��:��„�.��»M.�,_ Y�. � s��..,��..�:,�.�..��,�,.�.�,.� �� - �.�,. ��ty State Years ��ty State Years ��ty State Years ��ty State Years ��ty State Years � . K.aa��, �� . � � �s-_�.�.+�-.,�� nz,. . se � .c_ �. -*��*-�,:�-� *�� . ��"��.�r^c�r,�r� ��,�� e��a►��-i��i��i,��lt��k�� _ � � - � � €�� _�,�..t ,� _ ��- � y��„ �: ,��; � � �.�. �;��.�.�� .-�.,� �,. ;� � -'.� � g _ _ - .-:, '- � � .._ . �. . . . .� _� . _ ,��,.v�.., x _ .�,t . r� . >.m, � .�—.�..A . �. ..� . e,,. ..,... .,.. <.��, �v,- .w_ ,_�__ �.,_s_� �._ ,,._.,. _ ___ _. , __ w . . _. _ .. . .. Indecent assault and battery on a child under fourteen YES ❑ NO ❑ Indecent assault aad battery on a mentally challenged person YES ❑ NO ❑ Indecent assault and battery on a person who as obtained the age of 14 YES ❑ NO ❑ Rape YES ❑ NO ❑ Rape of a child under sixteen with for�e YES ❑ NO ❑ Kidnapping of a chiid under sixteen with intent to commit rape YES ❑ NO ❑ Distribution and trafficking of narcotics or other controlled substances YES ❑ NO ❑ Intent to commit any of the above crimes YES ❑ NO ❑ If yes,please explain: (Use separate sheet if necessary.) CAMP WINGATE*KIRKLAND VOLUNTARY DISCLOSURE STATEMENT CONTINUED �s �.�'�iw.��"��" �?`�r . t � . , .. �z - �_ ��-g��'+,-��Z,�.�s s`�� , s. �, �� f. ��at��[pe��tes ar d�n��e��tQ�r��x�af��6�i��iu��,�+�f� � '1� ` ��t�� l� � �i�"��F��e��p��te sh��et�ne�e�sa�� ,�t �� .� � ,..,..a..��. .�:„��'c�.�-.��-,.�..'�''��...r�s�...,-._ , -..a .. , , _. . . . � . ., .F .�. ,..�.+..:�.F .. `�.e.u,_,. _..,x..,..,�.��_.. _. . ..,�":�.,;.� x. .t.. �.. �,.'��'.� '�'�. �"-^y� c��.,�, �,_.�� -. ,.� . �., : �.� .,�'x �`"k -a .,�`�.�,rs`".��.^h,i � .'" -- .��,�� t'�[�-s��o��►�Xsrcc��buse c��rmi'n�t �� '� �t��.��s�� , � �� trn�'f��-� .�"��`��k'�1��c�Q!1�'��e',�y p�eilSE��%(1�In'`��5�'�'��f+'��'��s��'�� '� �� _ . � .�..,:y.��s=a_� .�, �,.;cN. � ' -� -�� - -- - �- .�.�, , � +-�� ,�... , .� ..,� .� v, .��«��. M..�. �.,_ .b, s_,�3.�.'-- _..,_ _ , ... ..,. ,._.� � ..�.� ,..�.,�,....��..�_ �_ _.� -_s_�� _ .... .. ,. -.�,, , � _. _�.,� ...�., �� - '�`�'��' 3'� :. . � �. . �s-y� -'''s�,w,`� ..":�`*� '� -.:a�='.,�-'�: � �� ' ��#��l��'i��,��i;��atma��e��n�oi�nn��+�a��p��+��e�"+��`�� `��,��`�� . � .�'"" � �� .��-e`� �?�� a`�`�'�` 'h' +i�{ M��'Si��i�'�$�M��l��.Ci'r'#'A1�`a� �'�� . �� i� � #�� x� _., . �. x� � , E,� ; ; � � `"= u� � �,� ��...".�"� _ ��a�_ +�`��,x � �,r>m�-:.ti�...0 x � 4.�.,., .,m.. . �e . „�,k.._�, y>.�x.,�-� . . � � a€� ,� �---z ..s-� _ . �.��r,.��_��7 a.,-�� z�w� �-a�'�a�,�`�.�� :",�� ., � :' � , � .' '. �?.c :� , �""�z a -'� . ,{, "'fi�'�s� ��'� � �� i��i'�1��$��`��t��"�r�6�rtdgS�xLLa��u��l��ir��'��ei� �'�� ss� . `_ "�' � � `�'��5�'�"� � � s� �" � � �` `��-,s�'-� :� �'�� ,� ��. ,� � �,Sr � �� G�� '� � '"�" � ��-'�� ' � �':{�� -� � f '�. ,�..�..�:��.,.� �R�'�,:n.<<,�-.. .�-�,�. :�..�,x_-< <_., .,.. , .. �=„ � �.w<, ,� . . . . � „ ._. , �,.� _-..N,. r.: ,.«.��"a €��.�..s�.d.-,...a:..-,-4n. "{ r-�`: .� ,-...�'<�-s,�..='...�.� 1 understand that: a. The camp my deny employment to any persons who answers in the affirmative to any of the questions numbered 2-5 b. In applying for a Camp position the information which I have furnished on this form is subject to verification,which may include a criminal history checky and request from amy Central Registry of child abusers c. The Camp my terminate employment of any person: 1. Found to have a history of complaints of abuse of a minor and/or 2. Found to have resigned,been terminated or been asked to resign from a position whether paid or unpaid,due to complaint(s) of sexual abuse to a minor. d. The disclosed statement must be updated yearly. Signature Date I �eaarye �,°^ , Employment Eligibility Verification USCIS Department of Aomeland Security Form I-9 � `'sP vo- OMB No. 1615-0047 ��.�o sb� U.S. Citizenship and Immigration Services Expires 08/3U2019 ►START HERE: Read instructions carefully before complefing this fortn.The instructions must be available,either in paper or electronically, during completion of this form.Employers are liable for errors in the compietion of this form. ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s)an employee may present to establish employment authorization and identity.The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination. Last Name(Family Name) First Name(Given Name) Middle Initial Other Last Names Used(if any) Address(Street Number and Name) Apt.Number City or Town State ZIP Code Date of Birth(mm/dd/yyyy) U.S.Social Security Number Employee's E-mail Address Employee's Telephone Number � m � I am aware that federal law provides for imprisonment andlor fines for false statements or use of false documents in connection with the completion of this form. I attest, under penalty of perjury,that I am(check one of the following boxes): _--- - ----- i '� 1.A citizen of the United States , ';� 2.A noncitizen national of the United States(See instructions) I ------ --- —--__- ------ i � 3.A lawful permanent resident (Alien Registration NumbedUSCIS Number): ---__-- - -- --- -- — - ---� ',I� 4.An alien authorized to work until (expiration date, if applicable,mm/ddlyyyy): � Some aliens may write"N/A"in the expiration date field. (See instructions) ', Aliens authonzed to work must provide only one of the following document numbers to complete Form I-9: QR code-se�t�on i Do Not Write In This Space ; An Alien Registration NumberNSC/S Number OR Form I-94 Admission Number OR Foreign Passport Number. , 7.Alien Registration NumbeNUSCIS Number: ' OR I 2.Form 1-94 Admission Number. I3.Foreign Passport NOum�ber. i I I Country oflssuance: Signature of Employee Today's Date(mm/dd/yyyy) ��` � �`: �� :' .��.` � � �'� u -,. ,,ti �, � �..;� � � � � . � � � - .,.._ - ` � � �:�" �� _ ` � . � , � ., , � � � '� �� . =;d . , . . ., . . , . � � I attest, under penalty of pery'ury,that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct. Signature of Preparer or Translator Today's Date(mm/dd/yyyy) Last Name(Family NameJ First Name(Given Name) Address(Street Number and Name) Ciry or Town State ZIP Code � �� . � �, � �`�_ z�k} �� ...��.� n�� Form I-9 11/14/2016 N Page 1 of 3 �°�'e��F o Employment Eligibility Verification USCIS T Department of Homeland Security Form I-9 oyB J� OtviB No. 1615-0047 {�NDSE�' U.S. Citizenship and Immigration Services Expires 08l31/2019 . ,� . r, . ' , „ .�.�� <- .:, . . ,:� _ , � ��, . .,� .. . _ , . '� �' � m - � s.. i E . . � � : s , .�. '— �, ,�� _ , �.. ,�-;�" � 'a.' , �� .. . . , � �s'�Y� �'`� �.. . , �, � � � �� .. ' `� =�,, z ' `� . �:�.. � � �, � _ . w �,_.,<k _ ... _. . > _. _ � . . Employee Info from Section 1 Last Name(Family Name) First Name(Given Name) M.I. Citizenship/Immigration Status List A OR List B AND List C Identity and Employment Authorization Identity Employment Authorization Document Title .'� Document Title Document Titie �y: Issuing Authority � Issuing Authority Issuing Authority Document Number �,; Document Number pocument Number Expiration Date(if any)(mm/dd/yyyy) �� Expiration Date(if any)(mm/dd/yyyy) Expiration Date(if any)(mm/dd/yyyy) �: Document Title IssuingAuthority �: Additionallnformation o NotWritein�ThisSpace �:�- .,-_;r Document Number Expiration Date(if any)(mm/dd/yyyy) ' �- �:: ,�;: Document Title � �; Issuing Authority ��` Document Number �° � r•,; Expiration Date(if any)(mm/dd/yyyy) �° k�` ��; Certification: I attest,under penalty of perjury,that(1)I have examined the document(s)presented by the above-named employee, (2)the above-listed document(s)appear to be genuine and to relate to the employee named,and(3)to the best of my knowledge the employee is authorized to work in the United States. The employee's first day of employment(mm/dd/yyyy): (See instructions for exemptions) Signature of Empioyer or Authorized Representative Today's Date(mm/dd/yyyy) Title of Employer or Authorized Representative Assistant Director Last Name of Employer or Authorized Representative First Name of Employer or Authorized Representative Employer's Business or Organization Name Burrell Daria Camp Wingate'`Kirkland Employer's Business or Organization Address(Street Number and Name) City or Town State ZIP Code 79 White Rock Road Yarmouth Port MA 02675 �e >.��':��`��r�t��€��"��-��r�ef��r�� "a ��r�� `�� ``� p_�,�� " 3� �� ,�� . �� A.�[e�r€t�Ca�e(i�applicabte}" t ~B f7ate ofRehire�'r�applieabfe�� Last Name(Family Name) First Name(Given Name) Middle Initial Date(mm/dd/yyyy) �E.ff Ehe empfayee`s previous grant oP emptoyment autF�ori�ation i�as expired,provide the information For the do�ument or receipt that estabtishes Eeontinuing emptvyment authorization in the space providecf below. Document Title Document Number Expiration Date(ifany) (mm/dd/yyyy) I attest,under penalty of perjury,that to the best of my knowledge,this employee is authorized to work in the United States,and if the employee presented document(sj,the document(s)I have examined appear to be genuine and to relate to the individual. Signature of Employer or Authorized Representative Today's Date(mm/dd/yyyy) Name of Employer or Authorized Representative Form I-9 l 1/14/20 l6 N Page 2 of 3 LISTS OF ACCEPTABLE DOCUMENTS All documents must be UNEXPIRED Employees may present one selection from List A or a combination of one selection from List B and one selection from List C. LIST A ^ LIST B LIST C Documents that Establish Documents that Establish Documents that Establish Both Identity and Identity Employment Authorization Employment Authorization AND 1. U.S. Passport or U.S. Passport Card ' 1. Driver's license or ID card issued by a 1. A Social Security Account Number 2. Permanent Resident Card or Alien State or outlying possession of the card, uniess the card includes one of Registration Receipt Card(Form I-551) .� United States provided it contains a the following restrictions: photograph or information such as (1) NOT VALID FOR EMPLOYMENT name,date of birth, gender, height, eye 3. Foreign passport that contains a color, and address (2) VALID FOR WORK ONLY WITH temporary I-551 stamp or temporary INS AUTHORIZATION I-551 printed notation on a machine- �3 2. ID card issued by federal, state or local �3) VALID FOR WORK ONLY WITH readable immigrant visa government agencies or entities, DHS AUTHORIZATION s provided it contains a photograph or 4. Employment Authorization Document =; information such as name, date of birth, 2• Certification of Birth Abroad issued .✓ that contains a photograph(Form gender, height,eye color, and address by the Department of State(Form I-766} FS-545) � 3. School ID card with a photograph 3. Certification of Report of Birth 5. For a nonimmigrant alien authorized to work for a specific employer �_� 4. Voter's registration card issued by the Department of State because of his or her status: (Form DS-1350) f 5. U.S. Militaty card or draft record a. Foreign passport; and 4. Original or certified copy of birth b. Form 1-94 or Form I-94A that has A 6. Military dependenYs ID card certificate issued by a State, the following: 4 Y� 7. U.S.Coast Guard Merchant Mariner county, municipal authority, or � Card territory of the United States (1)The same name as the passport; ��;'- bearing an official seal and `� s� 8. Native American tribal document 5. Native American tribal document (2}An endorsement of the alien's �. nonimmigrant status as long as �� 9. Driver's license issued by a Canadian 6. U.S. Citizen ID Card (Form I-197) that period of endorsement has government authority not yet expired and the 7. Identification Card for Use of proposed employment is not in �;== For persons under age 18 who are Resident Citizen in the United conflict with any restrictions or �:�_ unable to present a doCument States(Form I-179) limitations identified on the form �la listed abOve: �° 8. Employment authorization 6. Passport from the Federated States of �;� 10. School record or report card document issued by the Micronesia(FSM)or the Republic of Department of Homeland Security the Marshall Islands(RMI)with Form '��. 11. Clinic,doctor,or hospital record I-94 or Form I-94A indicating Y� nonimmigrant admission under the r' 12. Day-care or nursery school record Compact of Free Association Between :'y. the United States and the FSM or RMI ��° =�: Examples of many of these documents appear in Part 8 of the Handbook for Employers (M-274). Refer to the instructions for more information about acceptable receipts. Form I-9 11/14/2016 N Page 3 of 3 Fo rm W-4 (2017) The exceptions don't apply to suppiemental wages Nonwage income.if you have a large amount of greater than$7,000,000. nonwage income,such as interest or dividends, Basic instPuctions.If you aren't exempt,complete consider making estimated tax payments using Form Purpose.Complete Form W-4 so that your the Personal Aliowances Worksheet below.The 1040-ES,Estimated Tax for Individuals.Otherwise, employer can withhoid the correct federal income worksheets on page 2 further adjust your you may owe add'Rional tax:If you have pension or tax from your pay.Consider compieting a new Form withholding allowances based on itemized annuity income,see Pub.505 to find out'rf you should W-4 each year and when your personal or financial deductions,certain credits,adjustments to income, adjust your withholding on Form W-4 or W-4P. situation changes. or two-earners/muRiple jobs situations. Two eamers or multiple jobs.If you have a Exemption hom withholding.If you are exempt, Complete all worksheets that apply:However,you Working spouse or more than one job,figure the complete only lines 1,2,3,4,and 7 and sign the may claim fewer(or zero)ailowances.For regular total number of allowances you are entitled to claim form to validate it.Your exemption for 2017 expires wages,withholding must be based on ailowances on all jobs using worksheets from oniy one Form February 15,2018.See Pub.505,Tax Withholding you claimed and may not be a flat amount or W-4.Your withhoiding usually will be most accurate and Estimated Ta�c. percentage of wages. when all allowances are claimed on the Form W-4 for the highest paying job and zero allowances are Note:If another person can claim you as a dependent Head of household.Generally,you can claim head claimed on the others.See Pub.505 for details. on his or her tau return,you can't claim exemption of household filing status on your tax ret orn only if Nonresident alien.If you are a nonresident alien,see from withhoiding if your total income exceeds$1,050 you are unmarried and pay more than 50/o of the Notice 1392,Suppiemental Form W-4 Instructio�s for and includes more than$350 of uneamed income(for costs of keeping up a home for yoursetf and your Nonresident Aliens,before completing this form. example,interest and dividends). dependent(s)or other qual'rfying individuals.See Exceptions.M employee may be able to claim Pub.501,Exemptions,Standard Deduction,and Check your withhoiding.After your Form W-4 takes exemption from withhoiding even'rf the employee is Filing I�formation,for information. effect,use Pub.505 to see how the amount you are a dependent,if the employee: Tax credits.You can take projected tax credits into having withheld compares to your projected total tax � account in figuring your allowable number of for 2017.See Pub.505,especially'rf your earnings Is age 65 or older, exceed$130,000(Singie)or$180,000(Married). withholding allowances.Credfts for child or dependent •Is blind,or care expenses and the child tax credft may be claimed Future developments.Information about any future using the Personal Allowances Worksheet below. developments affecting Form W-4(such as •Will claim adjustments to income;tax credits;or See Pub.505 for information on converting your other legislation enacted after we release it)will be posted item¢ed deductions,on his or her tax retum. credits into withhoiding allowances. at www.vs.gov/w4. Personal Allowances Worksheet(Keep for your records.) A Enter"1"for yourself if no one else can claim you as a dependent . . . . . . . . . . . . . . . . . . A � •You're single and have only one job;or � , B Enter"1"if: •You're married,have only one job,and your spouse doesn't work;or . . B •Your wages from a second job or your spouse's wages(or the total of both)are$1,500 or less. C Enter"1"for your spouse.But,you may choose to enter"-0-"if you are married and have either a working spouse or more than one job.(Entering"-0-"may help you avoid having too little tax withheld.) . . . . . . . . . . . . . C D Enter number of dependents(other than your spouse or yoursel fl you will claim on your tax retum . . . . . . . . D E Enter"1"if you will file as head of household on your tax return(see conditions under Head of household above) . . E F Enter"1"if you have at least$2,000 of child or dependent care expenses for which you plan to ciaim a credit . . . F (Note:Do not include child support payments.See Pub.503,Child and Dependent Care Expenses,for details.) G Child Tax Credit(including additional child tax credit).See Pub.972,Child Tax Credit,for more information. •If your total income will be less than$70,000($100,000 it married),enter"2"for each eligible child;then less"1"if you have two to four eligible children or less"2"if you have five or more eligible chiidren. •If your total income will be between$70,000 and$84,000($100,000 and$119,000 if marcied),enter"1"for each eligible child. G H Add lines A through G and enter total here.(Note:This may be different from the number of exemptions you claim on your tax retum.) ► H •If you plan to itemize or ciaim adjustments to income and want to reduce your withhoiding,see the Deductions For accuracy, and Adjustments Worksheet on page 2. complete all •If you are single and have more than one job or are married and you and your spouse both work and the combined worksheets earnings from all jobs exceed$50,000($20,000 if married),see the Two-Earners/Multiple Jobs Worksheet on page 2 that apply. to avoid having too little tax withheld. •If neither of the above situations applies,stop here and enter the number from line H on line 5 of Form W-4 below. ---------------------------------- Separate here and give Form W-4 to your empioyer.Keep the top part for your records.---------------------------------- _ Employee's Withholding Allowance Certificate oM6 No.1545-0074 Form � � ^O� � Department of che Treasury �Whether you are entitled to claim a certain number of allowances or exemption from withholding is S internai Revenue service subject to review by the IRS.Your employer may be required to se�d a copy of this form to the IRS. 1 Your first name and middle initiai Last name 2 Your social security number Home address(number and street or rural route) 3 ❑ Single ❑ Married ❑ Marcied,but withhold at higher Single rate. Note: If married,but legally separated,or spouse is a nonresident alien,check the"Single"box. City or town,state,and ZIP code 4 If your last name differs from that shown on your social security card, check here.You must call 1-800-772-1213 for a replacement card. ►� 5 Total number of allowances you are claiming(from line H above or from the applicable worksheet on page 2) 5 6 Additional amount,if any,you want withheld from each paycheck . . . . . . . . . . . . . . 6 $ 7 I claim exemption from withholding for 2017,and I certify that I meet both of the following conditions for exemption. ' � • Last year I had a right to a refund of all federal income tax withheld because I had no tax liability,and •This year I expect a refund of all federal income tax withheld because I expect to have no tax liability. If you meet both conditions,write"F�cempY'here. . . . . . . . . . . . . ► 7 Under penafties of perjury,I declare that I have examined this certificate and,to the best of my knowledge and belief,it is true,correct,and complete. Employee's signature (This form is not valid unless you sign it.) ► Date► 8 Employer's name and address(Employer:Complete lines 8 and 10 only if sending to the IRS.) 9 Office code(optional) 10 Employer identification number(EIN) For Privacy Act and Paperwork Reduction Act Notice,see page 2. Cat.No.1022oc] Form W-4(20�7} Form W-4(2017) Page 2 Deductions and Ad'ustments Worksheet Note:Use this worksheet only if you plan to itemize deductions or claim certain credits or adjustments to income. 1 Enter an estimate of your 2017 itemized deductions.These include qualifying home mortgage interest,charitable contributions,state and local taxes,medical expenses in excess of 10%of your income,and miscellaneous deductions.For 2017,you may have to reduce your itemized deductions if your income is over$313,800 and you're married filing jointly or you're a qualifying widow(er);$287,650 if you're head of household;$261,500 if you're single,not head of household and not a qualifying widow(er);or$156,900 if you're married filing separately.See Pub.505 for details . . . . . . . . . . . . . . . . . . . . . � $ ( $12,700 if married filing jointly or qualifying widow(er) � 2 Enter: � $9,350 if head of household . . . . . . . . . . . 2 $ � $6,350 if single or married filing separately 3 Subtract line 2 from line 1.If zero or less,enter"-0-" . . . . . . . . . . . . . . . . 3 $ 4 Enter an estimate of your 2017 adjustments to income and any additional standard deduction(see Pub.505) 4 $ 5 Add lines 3 and 4 and enter the total. (Include any amount for credits from the Converting Credits to Withholding Allowances for 2017 Form W-4 worksheet in Pub.505.). . . . . . . . . . . . 5 $ 6 Enter an estimate of your 2017 nonwage income(such as dividends or interest) . . . . . . . . 6 $ 7 Subtract line 6 from line 5.If zero or less,enter"-0-" . . . . . . . . . . . . . . . . 7 $ 8 Divide the amount on line 7 by$4,050 and enter the result here.Drop any fraction . . . . . . . 8 9 Enter the number from the Personal Allowances Worksheet,line H,page 1 . . . . . . . . . 9 10 Add lines 8 and 9 and enter the total here.If you plan to use the Two-Earners/Multiple Jobs Worksheet, aiso enter this total on line 1 below.Otherwise,stop here and enter this total on Form W-4, line 5,page 1 10 Two-Earners/Multi le Jobs Worksheet See Two earners or mu/ti le 'obs on a e 1. Note:Use this worksheet only if the instructions under line H on page 1 direct you here. 1 Enter the number from line H,page 1 (or from line 10 above if you used the Deductions and Adjustments Worksheet) 1 2 Find the number in Table 1 below that applies to the LOWEST paying job and enter it here. However, if you are married filing jointly and wages from the highest paying job are$65,000 or less,do not enter more than«3„ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 If line 1 is more than or equal to line 2, subtract line 2 from line 1. Enter the result here (if zero, enter "-0-")and on Form W-4,line 5,page 1.Do not use the rest of this worksheet . . . . . . . . . g Note:If line 1 is less than line 2,enter"-0-"on Form W-4, line 5,page 1.Complete lines 4 through 9 below to figure the additional withholding amount necessary to avoid a year-end tax biil. 4 Enter the number from line 2 of this worksheet . . . . . . . . . . 4 5 Enter the number from line 1 of this worksheet . . . . . . . . . . 5 6 Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . 6 7 Find the amount in Table 2 below that applies to the HIGHEST paying job and enter it here . . . . 7 $ 8 Multiply line 7 by line 6 and enter the result here.This is the additional annual withholding needed . . 8 $ � 9 Divide line 8 by the number of pay periods remaining in 2017.For example,divide by 25 if you are paid every two weeks and you complete this form on a date in January when there are 25 pay periods remaining in 2017.Enter the result here and on Form W-4,line 6,page 1.This is the additional amount to be withheld from each paycheck 9 $ Table 1 Table 2 Married Filing Jointly All Others Married Filing Jointly All Others If wages from LOWEST Enter on If wages from IOWEST Enter on If wages from HIGHEST Enter on If wages from HIGHEST Enter on paying job are- line 2 above paying job are- line 2 above paying job are- line 7 above paying job are- line 7 above $0 - $7,000 0 $0 - $8,000 0 $0 - $75,000 $610 $0 - $38,000 $610 7,001 - 14,000 1 8,001 - 16,000 1 75,001 - 135,000 1,010 38,001 - 85,000 1,010 14,001 - 22,000 2 16,001 - 26,000 2 135,001 - 205,000 1,130 85,001 - 185,000 1,130 22,001 - 27,000 3 26,001 - 34,000 3 205,001 - 360,000 1,340 185,001 - 400,000 1,340 27,001 - 35,000 4 34,001 - 44,000 4 360,001 - 405,000 1,420 400,001 and over 1,600 35,001 - 44,000 5 44,001 - 70,000 5 405,001 and over 1,600 44,001 - 55,000 6 70,001 - 85,000 6 55,001 - 65,000 7 85,001 - 110,000 7 65,001 - 75,000 8 110,001 - 125,000 8 75,001 - 80,�00 9 125,001 - 140,000 9 80,001 - 95,000 10 140,001 and over 10 95,001 - 115,000 11 115,001 - 130,000 12 130,001 - 140,000 13 140,001 - 150,000 14 150,001 and over 15 Privacy Act and Paperwork Reduction Act Notice.We ask for the information on this form You are not required to provide the information requested on a form that is to carry out the Internal Revenue laws of the United States.Intemal Revenue Code sections subject to the Paperwork Reduction Act unless the form displays a valid OMB 3402(�(2)and 6109 and their regulations require you to provide this information;your employer control number.Books or records relating to a form or its instructions must be uses it to determine your federal income tau withholding.Failure to provide a properly retained as long as their contents may become material in the administration of completed form will result in your being treated as a single person who claims no withholding any Internal Revenue law.Generally,tax returns and return information are allowances;providing fraudulent information may subject you to penalties.Routine uses of confidential,as required by Code section 6103. this information include giving it to the Department of Justice for civil and criminal litigation;to The average time and expenses required to complete and file this form will vary cities,states,the District of Columbia,and U.S.commonwealths and possessions for use in depending on individual circumstances.For estimated averages,see the administering their tax laws;and to the Department of Health and Human Services for use in instructions for your income tax return. the National Directory of New Hires.We may also disclose this information to other countries under a tax treaty,to federal and state agencies to enforce federal nontax criminal laws,or to If you have suggestions for making this form simpler,we would be happy to hear federal law enforcement and intelligence agencies to combat terrorism. from you.See the instructions for your income tax return. COMPLETE PAYROLLSOLUTIONS DIRECT DEPOSIT AUTHORIZATION Form I authorize my employer or a payroll processor on my employer's behalf to deposit any amounts owed me by initiating credit entries to my account at the financial institution (the "BANK") indicated below. Further, I - authorize BANK to accept and credit entries indicated by COMPANY to my []Checking []Savings account (select one).I acknowledge the deposit of any amount is an advance of funds on behalf of my employer and the responsibility of my employer and not that of a payroll processor,if any,and is subject to the successful collection of the funds by the processor from my employer's account. If my employer does not make available to the processor the funds that were advanced to make the deposit into my account I authorize the processor to debit my account to recover said advance. I agree to hold the processor harmless from loss and to indemnify it, limited to the amount of the deposit. I also authorize my employer or the processor, if any, to debit my account in the event of a credit which should not have been made for an amount not to exceed the original amount of the erroneous credit. I authorize you and the financial institution listed below to deposit my pay automatically to my: Checking account ❑ Deposit Net Savings account ❑ Deposit Net ❑ Deposit $ ❑ Deposit $ ♦ • • s s s t s s � • a a s • • s • • • • s • s • � � s • s • • s • • s s � s • • • a s • • • • s t s • • • • • s s • s � s CLIENT INFORMATION CLIENT IVO. CLIENT NAME a • s • • ss • • e • • • • s • s • sa • sss • s • • • • • • • � s � s • � • • * • ss • s • • • ass • s • • � � ssa EMPLOYEE INFORMATION NAME ADDRESS CITY STATE ZIP EMPLOYEE EMAIL DEPAR'TIVIENT N0. EMPLOYEE N0. NAME SOC SEC. N0. DAT`E OF BIRTH_J / EMP. SIGNA'�'[IRE DATE BANK NAME . CHECKING TRANSIT NUMBER(9 DIGTTS) ACCOUNT Nt7MBER SAVINGS __�� TRANSIT NUMBER(9 DIGTfS) ACCOiTNT NUMBER i ' i ! Received __{ / Entered / / By , ca��► �� ..#� Vli� �! GA�'� � v. � KI R K�.Al� � �.� � ! CAMP WINGATE � KIRKLAND BACKGROUND RELEASE i I acknowledge that, in order to employ me, Camp Wingate Kirkland is required by law to perform a criminal background check on me in Massachusetts, my state of permanent address, and if applicable, the state in which I currently reside. By signing this letter, I hereby give Camp Wingate Kirkland permission to use a third-party company to perform this search. I also acknowledge that I understand that I have the right to access the results ' of any such inquiry performed by Camp Wingate Kirkland. Name Date Signature CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROQD YARMOUTH PORT, MQ OP675 TEL: 888.714.2P67 E-MQIL: HEYCAMPOCAMPWK.COM C(�r�-s+�� L� c�� `�,��;5 �'`l�� .t�� ' r r�,� S�' , -f� �// .� S � ��;1�/e �� ,s�- ,�'�-�� • o �-rr�+.-� . qc�t c-r�h-�' �,��s �y �� f� S��r��f�.S ` �. � .- s��s� �..,�, � c`c�`'�'�,'' � � T- �', Sl� S�L'� vr C� 1�� '�'c��`S � c n �S r f �tc l�Gl<� /�'��Y%� r�l � ��S�e�� ot f� A � �f G/! r"`''�' f ,/.7 p�.i( ia��-1 s�.�r - d�� -" G'-r 1't/'�'' � .�� s 6�,.� ksl-�' a � .� � , /,� -�, �,,�� s�'� CAMp w � N ��TF �� K � R K �A N o �� CAMP WINGATE �KIRKLAND HEALTH CARE POLICIES � PROCEDURES SUPERVISION The health care administration of Camp Wingate*Kirkland will be the responsibility of the Camp Nurse. The lead Camp Nurse, Mary Cowell, is a licensed RN in the state of Massachusetts. The Camp Nurse will administer health care to all campers and staff within the camp community. The Assistant Nurse and our part time nurses, will be on duty when Sue Roach is not available. The Camp Nurse will be available for assistance in planning and assessing the health care needs of campers and staff according to the Rules and Regulations of the township. RECORDS All campers and seasonal staff will have completed and submitted a Camp Health Examination Form to the Camp Nurse prior to or on the first day of the camping season. The Camp Nurse(s) will maintain the Daily Health Center records in our Camp database. At the end of each summer, all camper and staff health forms and other related history are stored on a hard drive and moved to the Director's house for long term storage. All medications are sent home with the campers. MEDICAL LOG BOOK There will be two separate logs, one for staff and one for campers. Each log will contain the names of campers and staff with a statement of their chief complaint as stated to the nurse and the action taken by the nurse. There will also be a separate log to record the daily prescription medications for all campers and staff. Documentation on individual camper health issues/visits will be maintained in the database and password protected from all but the Nursing staff and Directors. MEDICAL STORAGE All Health Center supplies and equipment will be stored in the Health Center, which is located next door to the Camp Office. All medications, prescription and non-prescription,will be locked at all times in a clean, dry place. At the time of dispensing, only one of the two RN's will unlock the medications and dispense them Every medication that is dispensed is logged in a bound notebook according to instructions on the child's Health Examination Form. They can be dispensed only at the Health Center, the Dining Hall, or at Planning Session. All equipment and health supplies will be purchased by the Camp Nurse or the camp directors. They will be purchased from a well known mail order dealer or at a local pharmacy using a camp charge account. All CQMP WINGATE*KIRKLAND 79 WHITE ROCK ROAD YQRMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMP�CAMPWK.COM prescriptions written by the Mid-Cape Medical Center or a physician at the Cape Cod Hospital will be filled at the same local pharmacy. All health supplies are subject to approval by the physician who provides the Camp with Standing Orders. MEDICATION All medications, prescriptions and nonprescription, will be kept locked in the Health Center. Each medication brought to Camp by a camper will be kept locked in the Health Center and its dispensation will be recorded in a medication log. The Camp Nurse will administer all medications.. In the event the Nurse is not available (Dr. visit, hospital visit, day off) the Nurse will delegate administration of all medications to either Directors of the Camp. The Camp Nurse will review the proper procedures with the Camp Directors. The Camp Nurse, Camp Directors, and Camp Leaders will discuss campers' needs for daily medications prior to the opening day of the camp season. In our on-going commitment to meet the needs of our campers who require medication while at Camp,we once again will be working with CampMeds Inc. to provide the convenient service of dispensing, packaging and shipping medications directly to our camp this summer. CampMeds is a service that pre-packages medications for Camp and saves our nurses from spending unnecessary hours each day sorting campers' medications so that they can focus on their primary role, tending to the health and wellness of the camp community. Camp Wingate*Kirkland's policy and procedure for dispensing and administering medicine requires camp families to have all of your child's medicine in pill form dispensed, pre-packaged and sent to Camp prior to their arrival. This includes: • All medicine taken daily (prescription and non-prescription) • All medicine taken "as needed" • Vitamins *Our Camp stocks most over the counter items such as Tylenol, Advil, Benadryl, etc. HEALTH CARE PROVIDERS The following Health Care providers will be involved in administering health care to the campers and staff of Camp Wingate Kirkland: • Mid-Cape Medical Center, Hyannis, MA, 508-771-4092, 489 Bearse's Way, Unit A-4, 02601 • Cape Cod Hospital, Hyannis, MA, 508-771-1800 Any instructions received over the telephone from the physician to the nurse, will be written in a bound notebook separate from other Health Center records. All phone orders will be co-signed by the physician and the Camp Nurse. ' TRANSPORTATION All campers or staff needing to be examined by a physician during the day will be seen at Mid-Cape Medical Center. The Camp Nurse will accompany campers and staff and they will travel in a designated camp vehicle. In the event of a camper or staff needing medical care during the clinic's off-hours, a camp nurse or camp leader will take them to the Cape Cod Hospital. CAMP WINGQTE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 0�675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM The Standing Orders are updated prior to Staff Orientation Week each camp season. These orders are signed by a physician, the Camp Director, and the Camp Nurse each season. EMERGENCIES All emergencies will be called into 911. All emergency transportation will be coordinated through 911 at the time of the emergency. FIRST AID All first aid will be administered by the Camp Nurse and logged immediately in the appropriate health log. First aid will be administered in accordance with the Standing Orders of the attending physician. In the event the Camp Nurse is not present for non-emergency first aid, a first aid certified person will attend to the needs of the individual. This person will record his/her actions in the appropriate health log and report these actions to the Nurse upon her/his return to camp. All first aid procedures will be reviewed with certified first aid staff prior to the opening day of the camp season. First aid kits will be provided to the staff for all out-of-camp trips. All camp vehicles will have a first aid kit. Staff will receive an orientation to the use of the first aid kit during staff orientation week. All out of camp activities- day trips and overnight trips- are required to include a First Aid Kit prepared by the Camp Nurse. Each first aid kit will have a copy of the standing orders, emergency procedures, and accident report forms. Each first aid kit contains the following: Band-Aids, sterile pads, q-tips, antiseptic towelettes, ice packs, ace bandage, bacitracin ointment, adhesive tape, antacids, Benadryl, Sudafed, Tylenol, alcohol prep swabs, resusci face shield, after bite, and gloves. A minimum of one staff person is to be trained by the staff nurse in First Aid basic procedures. If a camper is in need of inedication during field trips, the nurse will package the individual's medication in first aid kit and instruct and delegate a staff member to administer it. FOOD SERVICE The Camp Nurse will be available for assistance in planning and assessing the health care needs of the kitchen facility and staff according to the rules and regulations of the township. The Camp Nurse will work closely with the kitchen staff to address special dietary needs of campers. HEALTH CENTER The Health Center is located next door to the Camp Office. The Nurse will be available for routine health procedures, exams, and the dispensing of inedications during established Health Center office hours. These office hours are 8:30a.m. -9:00 a.m., 11:30 a.m. -12:30 p.m., and 4:30 p.m. -5:00 p.m. The Health Center is also open immediately after evening activity for those campers and staff who need bedtime medication. Parents of campers who are seen by a physician at the Mid-Cape Medical Center or the Cape Cod Hospital Emergency Room will be notified after the doctor visit. All campers admitted to the Health Center for an overnight stay will have their parents notified at staff's earliest convenience. Campers becoming ill during the night will be accompanied to the Health Center by one of their Lodge counselors. CAMP WINCQTE*KIflKLQND 79 WHITE ROCK flOAD YQRMOUTH PORT, MQ 02675 TEL: 888.714.2�67 E-MQIL: HEYCAMPOCAMPWK.COM f I �,A Mp �:.: � �"� � �r�� :. �� .� � � � � .�;�. �� CAMP WINGATE � KIRKLAND HAZARDOUS MATERIALS All gas and flammable liquids, explosives, and hazardous or poisonous materials may only be handled by Site Staff who have been trained specifically by Christopher Berardi, Camp Wingate*Kirkland Site Manager. Training includes the handling and disposal of fuels used to power maintenance equipment. All dangerous substances are kept under lock in the "Gas Shed" located in the Maintenance Barn area. All dangerous substances must always be kept in a safe and locked cabinet located under the main building, and must be kept separate from food at all times. CAMP WINCATE*KIflKLAND 79 WHITE ROCK ROQD YARMOUTH PORT, MA 02675 TE�: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM CAMp WI N GATE � KI R K�A N O �� CAMP WINGATE � KIRKLAND SMOKE DETECTOR POLICY All of the residential buildings at Camp Wingate*Kirkland are equipped with hard-wired smoke detectors and carbon monoxide detectors. They are inspected by Chris Berardi Camp Site Manager, or a trained member of the site staff, to ensure that they are in working order once in March and again in 1une. CAMP WINCQTE*KIRKLAND 79 WHITE ROCK ROQD YARMOUTH POflT, MQ 02675 TEL: 888.714.2267 E-MQIL: HEYCQMPOCQMPWK.COM i � � �� + ` �� CAMP WINGATE � KIRKLAND POWER TOOL POLICY Power tools may only be used by the Camp Wingate*Kirkland Site Staff, who are trained to do so, and by any other staff member or camper who has been approved by Christopher Berardi, Site Manager. All power tools used by the Site Staff for Camp maintenance and renovations are locked up in the Maintenance Barn. Campers and counselors are not permitted to enter the Maintenance Barn without approval and supervision of a Site Staff member. Campers who wish to use power tools in areas such as Woodshop or Arts & Crafts area must always first be instructed and observed by a staff member who has been approved to teach the use of such tools. Safety rules are posted in both program areas. Campers may not enter the Woodshop without supervision from a designated Woodshop staff person. All tools must be kept in good condition at all times, and those in disrepair must either be immediately fixed or discarded. At all times, ANY ONE using a power tool must observe the proper safety methods, including wearing eye protection and any other necessary safety equipment. CAMP WINCATE*KIRKLAND 79 WHITE ROCK ROQD YQRMOUTH PORT, MA U2675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM , � � i j �� '�;:« �� ' .:< HI. �� CAMP WINGATE � KIRKLAND LAUNDRY POLICY Cape Cod Laundry Center of Yarmouth is contracted by Camp Wingate*Kirkland to provide laundry services for our campers. Once a week, laundry is delivered by a Wingate*Kirkland employee to the Laundry Center. Laundry is wash, dried and folded by a Laundry Center Staff. The follow day, a Camp Wingate*Kirkland Staff member will pick up the laundry and return it to Camp. Campers must use their own bedding and towels. CAMP WINGATE*KIRKLQND 79 WHITE ROCK ROAD YARMOUTH PORT, MQ 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCQMPWK.COM r �� ,:� .� �,� �� i ; CAMP WINGATE * KIRKLAND ARCHERY RANGE RULES 1 .Only a counselor who has com leted a Cam -certified archer course durin Orientation ma P P Y 9 Y lead and supervise an archery period. 2.Only six archers shoot at a time; all other campers stand behind the archers 3.Campers are not allowed in the shed where archery materials are kept. 4.Always pay attention and stay alert 5.Range Commander (R.C.) will use a whistle system to communicate commands to campers. 6.Nock an arrow only when the Range Commander gives the command and a.You are standing over the shooting line b.You are facing the target and C. You are sure in your own mind that the area is clear 7.Aim and fire only at the target. $.Before firing an arrow make sure it is in good condition. If it is not in good condition, give it to a counselor in charge. 9.The arrows should be in the quiver unless knocking or shooting it. 1 �.Place bow on the ground quiver when done firing. 11 .Bows, arrows and quiver should be on the firing line unless taking equipment out or putting it away. 12.When not shooting, sit quietly on the bench (at the waiting line). 13.Always use proper stance and proper knocking grip. 14.Always listen for the grange officer and respond immediately to his/her commands. 15.Retrieve arrows only when instructed to do so. If an arrow falls ahead of the firing line, wait to retrieve it until given the signal. 16.Check your bow to be sure it is in good condition and that the arrows are straight and have all proper feathers. Check your bow tips to be sure the string is securely attached. CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH POflT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCQMPOCAMPWK.COM �� M � �� # � �.� �.. �� CAMP WINGATE*KIRKLAND EMERCENCY PROCEDURES Carbon Monoxide Evacuation Plan When we run the Search and Rescue drill within the first 48 hours of each Camp session, the Carbon Monoxide Evacuation procedure is reviewed with the campers and staff. 1 . If a Carbon Monoxide detector activates, campers and staff should evacuate the building immediately. 2. The counselor in charge should immediately call the Camp office (after hours this phone rings in Sandy &Will's house). 3. As soon as Carbon Monoxide is reported to the office or to Sandy &Will, someone there should call the Yarmouth Fire Department and report it. Give directions to Camp if needed and information about the location. 4. At least one person should go to the Camp entrance at Linnell Lane to help guide the fire truck to the building in question. 5, A second person should be assigned to go to the location and do as much as possible to keep the campers away, without risking his/her own safety. 6. No one should enter the building until the Yarmouth Fire Department gives the approval that it is safe to return inside. CAMP WINCATE*KIRKLAND 79 WHITE flOCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM V�� . �� 1 CAMP WINGATE*KIRKLAND EMERGENCY COMMUNICATION PLAN COMMUNICATION IN CASE OF EMERGENCY In the case of an in-Camp emergency, the staff at the site of the accident will send the oldest camper to notify the Camp nurse. The nurse is�then responsible for contacting the rescue squad or designating someone to contact them, and for notifying the Camp director or person in charge at the time. In the case of an out-of-Camp emergency, the staff at the site of the accident will notify the comm.unity rescue service (meaning dial 9-1-1), if necessary, and then contact the Camp Director at 888.714.2267 or person in charge who will make the necessary arrangements for providing health record and release statement for medical treatment and the safe return to Camp for all others at the site. The Camp Director is responsible for contacting the parents or guardian. The Camp director is also responsible for contacting law enforcement officials if necessary. Only the Camp Director will deal with the Media, after consultation and A.M. Skier Insurance representatives. These steps are also clearly outlined in the Camps Crisis Response Plan. Specific sections have been included in the attached pages. Injury or Other Emergency on Out-of-tamp Trip All groups that leave camp will be equipped with a cell phone. In any emergency, call 9-1-1 and tell them where you are and what happened. If the Camp has not already been notified, then call the office as soon as possible. At camp, the applicable parts of the following procedure should be put in effect. 1. The Director or Assistant Director should carefully document all information on the Emergency Response Checklist (see Appendix A). Accuracy is crucial here. Always have the checklist available at The Office, The Directors Home, Redwood and the Health Center. 2. Sibling and Family Support at Camp (if applicable) A director or the assistant director should designate a member of the Leadership Team to tell the sibling and/or other relatives, in a private setting what happened and stay with the child as lon�as necessarv The sibling may speak to his/her parents after the directors have had contacted them. CAMP WINCATE*KIRKLQND 79 WHITE ROCK ROQD YQRMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM 3, Contact Parents/Guardians The Camp directors should call the parents of the involved child. This phone call should take place from the � directors home. If the database is not operational on the directors home computer, then a member of the Leadership Team should obtain the name and phone number from the emergency number section of the camper's Health Examination Form in the Health Center. Call the parents and tell them what happened. Offer to help with arrangements for parents to travel to the hospital or Camp. Also make arrangements for someone from Camp to meet the parents at the hospital. Consider making reservations for comfortable accommodations in advance of the parents' arrival in the area. ** If the incident occurs off-Cape, one of the directors will to go to the scene and can meet the parents there. 4. Call AM Skier Camp ALERT Network 1-800-226-1666 5. Establish Emergency Headquarters Designate either the office or the directors home as the Emergency Headquarters, and keep all other activities away from this location. Select which member(s) of the office staff and/or Leadership Team will handle all incoming phone calls. They must use the phone log book (see Appendix L) to document all phone calls After the Leadership Team meets, the office staff or Leadership Team may be asked to call designated families. If so, use the prepared Phone CaII Scripts (Appendix C). The camp's designated spokesperson for all other outside sources will be (in this order of preference): the directors or assistant director 6. Mobilize the Leadership Team and Staff Convene the Leadership Team, tell them what happened and assign responsibilities. Review plan for speaking with staff and campers. Identify high-risk campers. Meet with the entire staff. The meeting will focus on providing accurate information, dealing with their own reactions and preparing them for their work as they support campers and other staff members. Hand out "Counselor's Support of Campers" (Appendix L) and "Trauma Reactions / Behaviors" (Appendix M). 7. Assess Range of Care Needs for the Following Groups . individuals directiv involved in the event (injured parties, family members, and those were present at the incident) —determine whether or not to bring the rest of the Challenge group(s) back to camp . individuals indi_re� involved in the event (bunkmates and close friends) . the rest of the camp community . Determine the level of intervention needed. A.M. Skier's Camp ALERT Network will help. Assistance is available both from within and outside the camp community. CAMP WINGQTE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MQIL: HEYCAMPOCQMPWK.COM 8. Contact Parents/Guardians of Other Campers The directors will decide if and haw we want to communicate with parents. All decisions and materials will be reviewed by our insurance company and attorney. Dealina With the Media 1. Review the following materials and them fax them to the media . Press Release . General Information about Wingate Kirkland . Driving Directions 2. Before a director meets with media, remember ... . The media may not come onto our property (private land) without our permission . Everyone needs to be reminded that all inquiries should be directed to the directors only . Meet with the Leadership Team to identify and discuss the important information we want to convey to the public 3. Preparation for press conference . Rope off the visitor parking lot. . Daria should post four older staff members at the camp entrances to greet the media if they arrive unexpectedly. If the press conference has not yet occurred, direct them to it. If it has occurred, have them wait in the parking lot and see if a director is available to speak with them. . Greeters should be friendly; and if asked questions, say only one of the directors are allowed to speak with the press. . Tell all campers and staff ahead of time why it is best for only the directors to talk to the media. We do not want to send mixed messages and offend any involved parties. . [Include bullet points for meeting with staff so that the directors has these reasons handy.] . The assistant director, along with members of the leadership team, should roam the bunk areas to calmly and tactfully remind campers and staff not to talk to the media. 4. During the media meeting, remember ... . Respect their need to report events in a way that (we hope) will be fair and accurate. . Avoid speculation about the event (avoid names and hometowns). . Correct or clarify inaccurate statements made by the media during the interview. CAMP WINCQTE*KIRKLAND 79 WHITE ROCK ROQD YQRMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCQMPOCAMPWK.COM f S�eaking with the Media Some emergencies will generate media coverage. You can't always prevent coverage, but you can lessen the negative impact by responding quickly and honestly. In general: . Respect deadlines. If you can't speak to a reporter, ask what the deadline is and make sure you call him/her back. . Don't be confrontational. Stay calm and in control at all times. . Don't arouse media suspicion by saying "no comment" or refusing to return calls. . Communicate what you know and tell reporters what you don't know. When interviewed: . Stick with the key points. . Never lie; be truthful and cooperative. . Don't speculate; stay with the facts. . Be careful of leading questions. ' . Never go "off the record". There really is no such thing; anything you say can be quoted. . If you can't discuss certain details, explain why. When dealing with television crews: . If your camp is on private property and you're in the middle of an emergency, you can ask them to leave. Remember to calmly explain why and be polite. Plan a time to call them later. . If you feel forced into an on-camera interview, ask if you can talk to the reporter off camera first. Use this time to explain the situation calmly and try to set parameters for the interview. . Remember that television works with 10-20 second sound bytes, so prepare your key points in short statements that fit this format. CAMP WINGQTE*KIRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �AMp Wi N GATE � KI R KLA N Q �� CHILD DISCIPLINE POLICY Basic Principles • Our focus at Camp Wingate Kirkland is on teaching and positive encouragement rather than on punishment. • We strive to be a high quality staff providing a high quality experience. • Instead of having many detailed rules, we always appeal to the community to respect each other. . The Ladder of Discipline is a framework through which camper behavioral challenges are addressed. Counselor Guidelines Responding • Ask for help unless you are confident that you are responding in an appropriate way. The single biggest mistake that counselors make is not ask for help with camper issues. The Lodge Leaders and Directors are always available and should be interrupted if they appear busy. • In interactions with campers, counselors should strive to respond rather than react to children. Guidelines for Responding to Children • You are being entrusted to be a care-taker for children. . There is a clear power difference between you and the campers which should inform your actions. • You must be sexually appropriate with campers at all times verbally, non-verbally and physically. • Be aware of sexual or sexualized behavior in campers. Be firm and non-shaming when responding to such behavior. • Be aware of, and minimize, activities that tend to over stimulate campers such as tickling and pillow fights. • Be conscious about your own stress level and take appropriate steps to respond. • If you have any question about any behavior or suspected behavior of a camper, please ask for help. • Safe places to touch are the hands, shoulders and upper back. Policy • Under no circumstances may a counselor hit or strike a child. • Counselors must not use abusive or derogatory language with campers. • Counselors may never touch a child against his or her will, unless there is a clear and present danger to the child. • A counselor may never touch a child if the child appears uncomfortable with the touch, whether that discomfort is expressed verbally or non-verbally. • Never touch a child in a place on his or her body that is normally covered by a bathing suit, unless for a clear medical necessity, and then only with supervision by another adult. • Hazing of campers by other campers or counselors is not permitted. • Campers will not be subjected in initiation rites that are abusive in any manner. Per the Prohibitions Stated in CMR 430.191 b, Camp Wingate*Kirkland strongly enforces staff shall not: • No corporal punishment, no hitting of any kind. • No cruel punishment, verbal abuse or humiliation • No denial of food or shelter. • No punishment for wetting the bed f �A�Kp ..� � `�� r�TF :�� ,'� �� .►� � � �� CAMP WINGATE * KIRKLAND LADDER OF DISCIPLINE Step One: After a sign of disrespectful or inappropriate behavior, the counselor points it out to the camper and asks for a change in behavior as needed. It is important to explain the reason to the camper and make sure the suggested change is a reasonable one. Step Two: If the behavior continues, the counselor should remove the camper from the presence of others. Ask the camper the reason for their unacceptable behavior and try to work together to create an appropriate alternative. Step Three: If situation has still not resolved in an acceptable manner, the counselor should ask for help from a co- counselor or another counselor. With the camper, the counselor, and the new third counselor, review the situation that occurred. Let the camper know the reason for the meeting. It is important that the camper knows that this meeting is very out of the ordinary. Campers most always know this. Try to come up with alternatives/solutions, without threatening. Step Four: If disrespectful behavior continues in any way, the counselor next goes to a leader. The counselor, leader, and camper will then meet to discuss the situation. Once there is a meeting with a leader, Sandy and Will are informed and the parents are called. Step Five: If the disrespectful behavior continues after meeting with a leader, the next step is for the counselor and camper to meet with Sandy and/or Will. Changes for the behavior will be clearly stated to insure complete understanding by the camper. Parents will be informed of this meeting. Step Six: If the camper's behavior does not change significantly, there will be a second meeting with Sandy and/or Will and the camper will probably be sent home. Parents will be informed of this and a departure time will be established. CAMP WINCATE*KIRKLAND 79 WHITE ROCK ROAO YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �AMp WI N GATE � Ki R KI.A N D �� CAMP WINGATE *KIRKLAND WATERFRONT PROCEDURES 1 . The waterfront is completely off-limits unless a person or persons with WSI, LGT, CPR and first aid certifications is/are present and the waterfront gate is open. 2. Campers must only enter the waterfront area through the main gate. 3. No camper can enter the water for any purpose unless a lookout is present and attentive in the lookout tower. 4. All campers will be tested on the first day of programming to determine his/her swimming ability. This placement is only to be done by certified WSIs. 5. Every camper will, after crib placement, have a buddy tag with his/her name, bunk, crib placement and boating designations on it. Before entering the water for any reason, a camper must hand his/her buddy tag to a staff member who will place the tag on the active buddy board. This is to let the lifeguards determine how many people are supposed to be in the water at any given time. Upon exiting the water, campers will ask a counselor to remove his/her buddy tag from the active buddy board. Campers do not remove their own tags. This procedure applies for all aquatic activities — including swimming, boating, nature and any other `activities being done on the waterfront — during both instructional and general swim times. 6. The waterfront should close immediately at the first sign of thunder or lightning. CAMP WINGQTE*KIRKLQND 79 WHITE ROCK ROAD YQRMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� s a�' CAMP WINGATE * KIRKLAND EMERCENCY PROCEDURES Waterfront Search and Rescue—Lost Swimmer Plan 1 . If a buddy tag is left on the buddy board or if it is determined that there are a different number of tags on the board than campers in the water, the Waterfront Director or the person in charge at the waterfront will blow four short whistle blasts to signify that the water should be cleared. 2. The Waterfront Director or the person in charge of the waterfront shall tell the lookout person to get one of the two horns out of the boat shed and run the upper loop around camp. While running the upper loop the lookout should be blowing the horn. The upper loop consists of the camp road past Redwood, the Health Center, the Office, Lodge 1,the Dining Hall, Lodge 2, Lodge 3, Lodge 4, Lodge 7, Lodge 5, the mail shed, the frog pond field and back to the basketball court. A CIT/the lookout, or person designated by Waterfront Director goes immediately to the Office and gets the clipboard/Sign-Out book, and runs to the Basketball Court. After the runner finishes the upper loop, report back to the waterfront. 3. A second person, preferably not an LGT, will be instructed at the same time to get the other horn from the boat shed and run the lower loop around camp. The lower loop consists of Hilltop, Motel, Joel's Place, Cottage, Lodge 6, the art barn, Lodge 8, Lodge 9, the tennis courts, the beach volleyball court, the softball field, the upper soccer field, the lower soccer field, the archery range, the Leoj, and the campfire site. After the lower loop is run, the runner should report back to the waterfront. 4. Upon hearing the horns, all members of the camp community will proceed as quickly as possible to the basketball court. One of the camp nurses will immediately bring the AED to the waterfront and assist as necessary. As they arrive, bunk counselors will get their campers seated in a line and will quickly count the number of campers present from their bunk to determine if all campers are present. Some bunks will have both/all counselors taking part in the search and rescue at the waterfront. A Leader or other available staff member will count the number of campers if all the bunk's counselors are not available. 5. Will or Sandy will supervise the operation at the basketball court. He or she will take the clipboard and the walkie-talkie from the office and be responsible for communicating with the Leader at the waterfront. It is EXTREMELY important that the waterfront personnel are notified IMMEDIATELY once everyone is accounted for, or it is determined which camper is missing. CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROQO YAHMOUTH PORT, MQ 02675 TEL• 888.714.2267 E-MAIL: HEYCAMP�CQMPWK.COM 6. Janet McGill or a camp Leader will take a walkie-talkie from the office and any cell phone to the waterfront and be responsible for receiving messages from the basketball court and communicating them to the Waterfront Director, or the person in charge of the Search and Rescue procedures. 7, While this is taking place, all staff members who are LGT certified will immediately assemble at the waterfront to begin the Search and Rescue procedures. These procedures are to be led by the Waterfront Director or the person in charge of the waterfront. 8. Once the horn is blown and the waterfront is emptied, the Waterfront Director will assign the first LGT to check underneath the two floating rafts in third crib. The next two LGTs are instructed to check underneath the docks. All remaining LGTs will line up at the first crib rope and wait for further instructions from the WSI in charge. Search and Rescue will start differently if the missing person was checked into 3�d crib. During the entire Search and Rescue the Waterfront Director will have a rescue tube and be standing on the dock between second and third cribs. This is to ensure the maximum safety of the LGTs. � 9. At the command of the waterfront director, the LGTs will begin walking through the water, (this will be different if searching for missing person checked into 3rd crib) constantly scanning the bottom. Once the waterfront director feels that they are deep enough, the LGTs will do surface dives to the bottom, swim three strokes, and return to the surface. They should be scanning the bottom.the entire time. All lifeguards should come up with their hands above their heads. Once they have reached the surface, they will stroke back to the shallowest person, and then take 2 additional strokes backwards. On the count of the waterfront director, the procedure will continue: a) All campers are accounted for at the basketball court; or b) A victim is discovered —at which point the leader, or the LGT who discovers the victim (if the LGT is not too tired), will attempt an American Red Cross rescue; or C) It is determined that the camper missing at the basketball court is the same one who is missing at the waterfront. If this is the case, the Yarmouth Rescue Squad will be called immediately by the Janet McGill or a camp Leader at the waterfront, or if necessary by the office, � 10.In the case of a potential neck and spinal injury, the most qualified lifeguards will initiate the procedures outlined by the American Red Cross. If the lifeguard feels any hesitation about securing the victim to the backboard, he or she should wait for the Yarmouth Rescue Squad to arrive. In this scenario, the victim should remain immobilized in the water. 11 .Once everyone is accounted for at the basketball court, the procedure will end and the waterfront director will debrief campers and counselors at the basketball court. 12.This procedure will be revised, reviewed, and rehearsed at least once during staff orientation week, and twice during the summer. CAMP WINCQTE*KIRKLAND 79 WHITE ROCK ROQD YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MAIL: HEYCQMPOCAMPWK.COM ; CAMp ; �, . ; � _ � wi N �aTE # : � �� K � R K �a N o � � �� CAMP WINGATE * KIRKLAND WATERFRONT DIRECTOR 0 ; � � ; The Camp Wingate*Kirkland Waterfront during the 2015 summer will be under the direction of Jason Bertrand. Jason is certified in Water Safety Instruction, Life Guard Instructor, Lifeguard Guard and CPR. The Waterfront Director is responsible for planning, directing and supervising the Camp's waterfront program. The number one goal of the Waterfront Director, at all times, and regardless of any other demands on his or her time, is the safety of ever cam er and staff member in relation to waterfront activities. The im ortance of this rimar oal cannot be Y P p P Y9 emphasized enough. Other responsibilities include helping the winter staff with recruitment and training of waterfront staff,teaching waterfront staff their responsibilities for the summer regarding instruction and general swim times; teach staff and campers the rules and regulations of the waterfront including the use of the Buddy Board; teach staff and campers, by lecture and demonstration,the Camp's emergency procedures; teach staff and campers the proper use of waterfront equipment including life preservers and boats; check all waterfront equipment daily for safety, cleanliness and good repair. In addition,the Waterfront Director is has overall responsibility to set up and oversee the instructional swim program at the Camp. This includes the initial placement within 24 hours of campers' arrival, assigning swim groups and instructors, keeping records on progress and recognizing achievements publicly. In addition, the Waterfront Director is responsible for the development and evaluation of the aquatic teaching abilities of the waterfront staff. In addition the Waterfront Director is responsible to be familiar with all ACA Standards that relate to the aquatic activities, both in and out of Camp, and to make sure we are in compliance at all times with each Standard. If the Camp is not in compliance, the Waterfront Director's responsibility is to remedy the situation immediately or to inform the Camp directors right away. The waterfront is especially risky during general swim times and the Waterfront Director is responsible to follow all waterfront regulations to ensure camper and staff safety. If at any time,the Waterfront Director feels that there is inadequate supervision or faulty procedures, he or she should immediately consult with the Camp Directors. The Waterfront Director is responsible for ensuring that the waterfront area is neat and clean at all times. Given the high risk in the waterfront area, it is vital to have a neat waterfront to project an image of order and safety. The waterfront should be clean and organized before closing it each day. This includes the docks, boats, boathouse supplies and anything else found in the waterfront. Any environmental or other hazards should always be eliminated immediately or managed according to agreed upon procedures. The Waterfront Director reports to Sandy&Will Rubenstein, Camp Directors. CAMP WINGATE*KIRKIQND 79 WHITE ROCK ROAD YARMOUTH PORT, MA 0�675 TEL: 888.714.2267 E-MAIL: HEYCAMPOCAMPWK.COM �� CAMP WINGATE * KIRKLAND EMERGENCY PROCEDURES Fire Evacuation Plan When we run the Search and Rescue drill within the first 48 hours of each camp session, it is communicated to the campers and staff that the same procedure applies to fires and other emergencies. 1 . If a fire occurs at Camp, we must gather and account for everyone in Camp. 2. As soon as the fire is reported to the office, someone there should call 9-1-1 and report it. Give directions to 20 Linnell Lane and if needed, information about the location and type of fire. ' 3. The witness will report whether or not he/she knows if any campers or staff might be trapped in the area of ; ' the fire. 4. Simultaneously, the nearest person should run to the Office to alert the staff there to begin our emergency ; procedure. At the Office, he/she should take the red horn hanging on a hook to the right of the door. The person will take the horn and run around Camp and end up at the basketball court (or alternate location de endin on the location of th ' p g e fire). In addition, someone will be instructed to continuousl rin the bell at Y 9 the Office and the Basketball Court, signaling an emergency. 5. Upon hearing the horn, all members of the Camp community will gather at the basketball court, unless the location of the fire makes that impossible. The Frog Pond Field, Tennis Courts and Upper Soccer Fields are alternate locations. 6. As campers and staff arrive, bunk counselors will get their campers seated in a line and will quickly count the number of campers present from their bunk to determine if there are any campers missing. 7. Once everyone is accounted for, everyone should stay there until the fire fighting personnel tell us it is okay to leave. While the emergency procedure is happening, Sandy (or Will if Sandy is not available) will assign roles to the maintenance crew. He/she will use the office staff and Leaders, as needed. At least one person should go to the Camp entrance at Linnell Lane to help guide the fire trucks to the site of the fire. Others should be assigned to go to the fire location and do as much as possible, without risking his/her own safety. Natural Disasters (Flood, Lightning, Wildfire, Tornado, Hurricane, etc.) ln the event that we can predict the possibility of a natural disaster, Will and Sandy will assign a Leader to stay tuned to local media outlets. If the community is advised by local authorities to evacuate the area, the Camp will do so immediately. CAMP WINCQTE*KfRKLAND 79 WHITE ROCK ROAD YARMOUTH PORT, MQ 02675 TEL: 888.714,�267 E-MAIL: HEYCAMPOCAMPWK.COM r When appropriate, the Camp will follow its standard emergency procedure of blowing the horns and having the entire community gather at the basketball court. Otherwise, Leaders witl be sent around Camp to give evacuation or other instructions to the entire community. In case of tornado or high winds: • Go to basement of new bunks (Hilltop, Joel's Place, Cottage) or to Linnell Lane, as instructed. • Stay away from glass enclosed places or areas with wide-span roofs, like the Leoj • Crouch down against the floor and cover the back of your head & neck with your hands • If no suitable structure is nearby, lie flat in the nearest ditch or depression and use your hands to cover your head In case of flash flooding: • Evacuate low-lying areas (waterfront, Frog Pond, etc.) and go to higher ground (Hill Bunks, Upper Soccer Field, Office) • Do not try to walk through water that is more than ankle deep • If in a vehicle, do not drive through a flooded area , even if it looks shallow enough to cross In case of lightning: • Go to safe shelter immediately • If boating or swimming, get out of the water immediately and go to the Leoj • If out of camp in a wooded area, seek shelter under a thick growth of relatively small trees • If you feel your hair stand on end, squat down with your head between your knees • Avoid isolated trees or other tall objects, bodies of water, sheds or fences • Once inside, avoid using a telephone or other electrical appliances—do not take a shower In case of wildfire: • Listen to local radio or television stations for updated emergency information • Follow the instructions of local officials. Wildfires can change direction and speed suddenly. Local officials can advise you of the safest escape route, which may be different than you expected. • If you are trapped, crouch in the pond. You cannot outrun a fire. • Lie flat and cover your body with wet clothing or soil. • If water is not around look for shelter in a cleared area or among a bed of rocks. • Breathe the air close to the ground through a wet cloth to avoid scorching lungs or inhaling smoke. CAMP WINGATE*KIRKLAND 79 WHITE ROCK ROAO YARMOUTH PORT, MA 02675 TEL: 888.714.2267 E-MQIL: HEYCAMPOCQMPWK.COM r ;,. � . . . . . �AMp WINGATE �� KIFiKLAN � �� Camp Wingate"Kirkland 79 White Rock Road Yarmouth Port, MA 02675 Tet: 508.362.3798 e-mail; heycam C�p campwk.com STANDING ORDERS 2017 ABDOMINAL TRAUMA Assess for any targe hematomas or bruises overlying major organs (liver or spleen). If patient has persistent pain in the abdomen, he/she must be evaluated by the camp physician prior to returning to contact sports. For any persistent pain in the dght or left upper quadrant, the camp physician must be notified and the camper must be on rest from atl sports until an evaluation can be done. ABRASIONS, SCRATCHES, CUTS Cleanse with disinfectant soap and water or wash with antiseptic pad, dress with triple antibiotic ointment and bandage or light dressing to prevent infection. Review signs and symptoms of infection. Deeper cuts may require sutures and need to be seen by the camp Physician. Any laceration involving tendons or large facial wounds that may require a plastic surgeon must be seen at Cape Cod Hospital Emergency Room. (See bleeding). ALLERGIC REACTION Symptoms may include itchy eyes, stuffy/runny nose, or hives. Assess for anaphylaxis. For ENT symptoms administer diphenhydramine 1.25mg/kg every 6 hours to max of 4 doses per day. May use fixed dosing: 6-11 year otds 12.5-25mg per dose (maximum daily dose 150mg); 12 years and older 25-50mg per dose (maximum of 300mg/day). For skin reactions, may include 1% hydrocortisone ointment topical. If rash involves face or genital area or covers large amount of body, evaluation by the camp Physician is necessary. ANAPHYLAXIS An immediate and overwhelming allergic reaction seen in people who are extremety sensitive to insect stings, drugs or foods. Signs and symptoms include, severe itching or hives, sneezing, coughing or wheezing, shortness of breath, tightness/ swetling of the throat and or chest, dramatic swetling of face, tongue or mouth; vomiting, cramps, diarrhea, convulsions, low blood pressure, and loss of responsiveness. Monitor ABC's; administer EpiPen immediately according to directions on kit. EpiPen dosing is 0.15mg for children under 25kg (<55 pounds) and 0.3mg for children over 25 kg (>55 pounds). If no 0.15mg dose is readily availabte, may use 0.3mg dosing for smaller children. Call 911 immediately after administering EpiPen (even if child is improving). Give diphenhydramine 1.25mg/kg PO every 6 hours to max of 4 doses per day if patient is conscious and able to swallow. May use fixed dosing: 6-11 year olds 12.5-25mg per dose (maximum daily dose 150m�); 12 years and older 25-50mg per dose (maximum of 300m�/day). Unless contraindicated, keep conscious victim flat with legs elevated while awaiting ambutance. � e r Camp Wingate*Kirkland 79 White Rock Road Yarmouth Port, MA 02675 Tel: 508.362.3798 e-mait: heycampC�cam�wk.com ASTHMA if child has been previously dia�nosed, follow prescribed medication regimen. For acute asthma exacerbation or wheezing episodes, use Albuterol/Ventolin inhalers; 2 puffs every 4 hours prn. If patient does not significantly respond in 20 minutes, seek emergency care. If this is the first episode of wheezing, camp physician shoutd evaluate camper. TINEA (ATHLETE'S FOOT/JOCK ITCH/RINGWORM) Cleanse skin with soap and water and dry thoroughly. Apply Lotrimin anti-fungal powder twice a day to relieve itching and burning for athlete's foot or "jock itch". The consulting physician must evaluate any open or draining tesions. For ringworm on the body, appty antifungal ointment (rubbed in wetl) twice daily x 4 weeks. If there is no improvement in 3 days or conditions worsen, evaluate by camp physician. BLEEDING Locate source of bleeding. Appty direct pressure over wound. Cover with sterile dressing. If first dressing is blood soaked, do not remove it; add others over it. If bteeding persists and wound is on the arm or leg, elevate wound above heart and continue to apply pressure. If bleeding still continues, locate proximal pressure point and appty pressure. Once bleeding has stopped, cleanse wound with soap and water, apply antibiotic ointment and cover with bandage. Change bandage daily to keep ctean and free of infection. ** If bleeding continues with no relief, or if there is an impaled object, do not remove and refer to camp physician or Cape Cod Hospitat Emergency Room. If you suspect internal bteeding dial 911``" BLISTERS Prevent further injury by applying a dressing that limits friction: 2nd Skin or a moleskin doughnut over the intact blister. If blister has broken, drain fluid, leave btister's roof on, apply a sterile dressing, and monitor for signs of infection (redness, hot to touch, purulent drainage). If the intact blister is unbearably painful, wash affected area with soap and water, make a smatl hole at blister's base with a sterite needle and treat as broken blister. Prevention: Treat "hot spots" with moleskin, 2nd Skin, tape or triple antibiotic ointment, before they become blisters; wear liner sock inside thicker sock; break in shoes and boots before lon� walking trips. BRUISES AND BUMPS Apply ice pack to reduce swellin�, rest, and elevate. Administer analgesic for pain: Ibuprofen 10mg/kg every 6 hours (maximum one-time dose 600m�) or Tylenol 15mg/kg every 6 hours (maximum one-time dose 650mg). If significant point tenderness persists for more than 5 days, see consultingphysician.Reference: 1 kg = 2.2 pounds. CONJUNCTIVITIS Conjunctivitis can be viral, bacterial or allergic. if aller�ic conjunctivitis, may use Visine eye drops as wetl as an antihistamine per packa�e insert. If symptoms persist for more than 2 days, contact camp physician for evaluation and possible use of over-the-counter nasal spray with an oral antihistamine. If viral conjunctivitis suspected, apply warm moist compresses until symptoms resolve and keep at Health Center to avoid spread, review good hygiene, and dispose of any contact lenses/eye makeup. If bacterial refer to camp physician for evaluation and child must remain at Health Center until they have been on antibiotic therapy for 24 hours, review good hygiene, and dispose of any contact lenses/eye makeup p r c Camp Wingate*Kirkland 79 White Roek Road Yarmouth Port, MA 02675 Tet: 508.362.3798 e-mail: heycam c�p _campwk.com CONSTIPATION Encourage fluids (especiatly water and juices) and intake of high fiber foods (especialty fruits, green vegetables and grains). Limit intake of processed foods and dairy products. May try Miralax 1 capful (17 grams) mixed in juice daity x3 days. if diet modification and Miralax fails, see camp physician. lf constipation is accompanied by vomiting, contact camp physician immediatety. CONVULSIONS/SEIZURES Assist patient safely to the ground and protect head. Remove nearby obstacles and furniture to prevent further harm. Loosen belt and tight clothing around neck. Turn child on side to maintain drainage of fluids and prevent aspiration and monitor for airway obstruction. Do not force any object into mouth. Do not restrain during convulsion. Time length of seizure. Calt 911 for seizures lasting longer than 5 minutes or any recurrent seizures. Call 911 for any first-time seizures, regardless of duration. When seizure activity stops check for injuries that could have resulted as a result of the seizure and allow child to rest on side. Contact camp physician and parent/guardian if this is first seizure. COUGH/COLD/ALLERGY SYMPTOMS Encourage fluids (especiatly water). Use cough drops and/or warm salt water gargle for symptom relief. if cough keeps child or other campers awake at night, put child to bed in the Health Center. If cough persists for >1 week, if wheezing is present, or no symptom retief, child needs to be examined by the camp physician. For nasal congestion, encourage fluids and administer nasal saline per package insert. For itchy red eyes (without drainage or pain) and congestion secondary to allergies, ora[ antihistamine may be administered for persistent allergy symptoms without fever or signs/ symptoms of infection. If symptoms do not resolve or become worse, seek care with camp physician. DENTAL PROBLEMS/TOOTHACHE Rinse mouth with warm water to remove debris. Remove any trapped food with dental floss. Apply cold pack to outside of cheek to reduce any swelting. Administer analgesia for pain: Ibuprofen 10mg/kg every 6 hours (maximum one-time dose 600mg)or Tylenol 15mg/kg every 6 hours (maximum one-time dose 650mg). Reference: 1 kg = 2.2 pounds. If pain persists, refer to dentist. Broken Tooth: Rinse mouth with warm water. Apply cold pack to outside of cheek to reduce swelling. Refer to dentist. ' Secondary Tooth Knocked Out: Rinse tooth with warm water to remove any dirt. Place tooth back in socket if possible. If not, place tooth under tongue to bath it in patient's sativa. if this is not possible place the tooth in a cup of milk. Immediately refer to dentist or Cape Cod Hospital ER. Broken Braces: Remove broken wire if possible or cover with dentat wax. Notify parent. Refer to orthodontist if necessary. Canker Sores: Small ulcers with a white or gray base and red border inside the mouth. Instruct pt. to avoid hot, spicy or acidic foods that can irritate the sore. If severe discomfort is present, appty Benzoin tincture compound (available in ampoules) or "Magic Mouthwash" 1-2 teaspoons swish and spit every 6 hours (one part diphenhydramine, 12.5mg in 5mL and one part Maalox paste - do not substitute Kaopectate - for pain.) { Camp Wingate*Kirkland 79 White Rock Road Yarmouth Port, MA 02675 Tel: 508.362.3798 e-mail: heycamp�campwk.com DIARRHEA (>6 loose, watery s�ools / 24 hours) Record child's weight upon presentation. Put child to bed in Health Center. If there is a fever, vomitin�, or significant abdominat pain, seek evaluation by camp physician. If not, monitor for signs of dehydration. Implement ctear liquid diet (Jell-0, Pedialyte, Pedialyte popsicles) for 12-24 hours. Gradually increase diet as tolerated; tell camper to avoid dairy products for 1-2 days. Stress hand washing to camper. If not resolved in 24-48 hours evatuate by camp physician. EARACHE If the skin of the external ear canal is painful, red, and swollen and/or the external ear is painful to touch or suspected AOE, refer to camp physician. Ears that are painful in conjunction with other upper respiratory symptoms or that have discharge need to be examined by camp physician. EPISTAXIS (NOSEBLEEDS) Nosebleeds are unlikely a sign of serious iltness and often a resutt of trauma/injury or a result of chronic allergic rhinitis. Keep camper seated and leaning forward with head straight, firmly pinch the top of the campers' nose using a nasal clamp or cold compress if available and keep pressure for 10 minutes. If bleeding continues after 10 minutes repeat pressure for another 10 minutes. If bleeding stitt persists, contact camp physician or refer to Urgent Care. EYE TRAUMA Loose Object in Eye:Attempt the fotlowing procedures in order until the loose object is found and removed: when object is seen, flush gently with water or saline. Putl upper eyelid up. Putt lower lid down and look at inner surface as child looks up. Invert upper eyelid over Q-tip. Contact consulting physician if object unable to be flushed, pain persists, vision is impaired, or eye is discolored or swollen. Embedded Object in Eye: Call 911 immediately. Do not remove embedded object. Cut several gauze and place over eye around embedded object being careful to not disturb embedded object. Place disposable drinking cup over embedded object to prevent further injury, rest on the gauze, and tape in ptace. Cover uninjured eye with dressin� and tape in place to avoid movement of injured eye. Keep child itat on back. Child needs to be treated at the Emergency Room. Cut on Eye: Cover eye with gauze pads. Keep child in a semi-reclining position. Do not apply pressure. Chitd must be treated at the Emergency Room. FAINTING Lay child on back with legs elevated above level of heart. Loosen clothing around neck. Wipe forehead and face with cool, wet cloth. If vomitin� occurs or is anticipated, turn chitd on side to prevent aspiration. Evatuation from camp physician to assess whether or not further work up is warranted. ' FEVER/COLD AND FLU Put the child to bed in the Health Center if temperature is >_100.4F. Encourage fluids. Administer Ibuprofen 10mg/kg every 6 hours (maximum one-time dose 600m�) or Tylenot 15mg/kg every 6 hours (maximum one- time dose 650mg). Reference: 1 kg = 2.2 pounds. If fever persists for more than 2 days, have camper evaluated by camp physician or Urgent Care. , Camp Win�ate''Kirkland 79 White Rock Road Yarmouth Port, MA 02675 TeL• 508.362.3798 e-maiL• heycam C�jZcampwk.com HEADACHE Administer Ibuprofen 10mg/kg every 6 hours{maximum one-time dose 600mg) or Tylenol 15mg/kg every 6 hours (maximum one-time dose 650mg) for minor headaches. Reference: 1kg = 2.2 pounds. If headache is persistent or associated with nausea, vomiting, interrupted sleep, or any other unusual symptoms, the child needs to be examined by camp physician or seen in Cape Cod fR if severe. HEAD INJURY _ Check ABC's and treat accordin�ly. Assess for concussion and if concussion is suspected, the child needs to be seen by the camp physician or at the Cape Cod Hospital ER. If bleeding occurs and a fracture is suspected, apply pressure only to outer edges of intact bone. Otherwise, appty direct pressure over wound. If laceration present which may require sutures, camper should be evaluated by camp physician or Cape Cod ER within 12 hours. Do not remove impaled objects and refer to camp physician or Cape Cod Hospital ER. If concussion is diagnosed, child requires "brain rest" and should be discharged home untit headaches resolve and must be cleared by pediatrician or specialist before returning to camp. If this is not achieyable, must be cteared by camp physician before returning to any activities. If no concussion or spinat injury is suspected, raise the head and shoulders slowty. Allow child to sleep in the Health Center, but wake the chitd every hour far total of four hours in order to check the state of consciousness and orientation as symptoms of concussion may not be immediately recognized. Have camper evaluated by camp physician as soon as possible following injury. Refer to Cape Cod Nospital ER if any of the foltowing occur: severe headache, headache persisting for more than 2 days or increases in severity, nausea persists for more than 2 hours, vomiting begins again hours after 1 or 2 episodes have ceased, child complains of impaired vision, eyes become cross-eyed or asymmetrical, pupil sizes are unequal, childhas slurred speech or cannof talk, child is unsteady in walking or is unable to use arms or legs as well as previously, child has involuntary muscle contractions of voluntary muscles, or if child is disoriented. HEAT ILLNESS Heat exhaustion:An etevated body temperature > 105. If not treated quickly may advance to heat stroke. Symptoms include excessive thirst, weakness, fainting, muscte aches, N/V, increase sweating, irritabi{ity. Bring child into shaded area or indoors, undress and if alert place in a cool shower/mist and rehydrate with cool fluids (water or Gatorade) and have chitd rest in shade with feet elevated. Heatstroke:An elevated body temperature at or above 105 with any of the following symptoms: severe headache, confusion, weakness, tachycardia/tachypnea, LOC, skin may be hot and dry without sweating, seizures. Requires immediate attention, call 911 and begin rapid cooling measures by pouring on cool water and fanning and giving ftuids by mouth if alert. HYPOTHERMIA Get the patient out of wet clothes and into something dry, out of outdoor elements. Cover the campers, especially head and neck where heat is lost. Give warm fluids. If temperature drops below 96°F, quickly assess chitd, warm rapidly with blankets and warm ctoths to forehead and behind neck. Calt 911. IMPETIGO Wash infected area with disinfectant soap and water 4 times daily. Apply Mupirocin 2% antibiotic ointment three times daily x5 days. Encourage strict hand washing to prevent further spreading. If involvement is extensive or does not improve after 1-2 days, contact the consulting physician. � � f Camp Wingate*Kirkland 79 White Rock Road Yarmouth Port, MA 02675 Tel: 508.362.3798 e-mait: heycampC�campwk.com INSECT STINGS(If anaphylactic defer to ANAPHYLAXIS protocol) If stinger is present, remove with flat, hard object (credit card) being careful not to squeeze the stinger as this may cause more venom to be injected. Keep affected area lower than the heart. Monitor ABC's and treat accordingly. If no allergic reaction occurs, wash the site with disinfectant soap and water, appty a cold pack for 15 - 20 minutes, and apply baking soda paste to relieve pain. PEDICULOSIS(LICE) Wash hair with shampoo, rinse well, and towel dry. Contact Camp Directors and contracted Lice Professionat. If contracted professionat is not available apply one treatment of Nix (especially behind the ears and at the nape of the neck). Rinse hair after 10 minutes and remove all nits with the nit comb. Place comb in alcohol bath. Machine wash all headgear, scarves, coats, and bed linen in hot water and machine dry for at least 20 minutes by hot air. Articles that cannot be machine-washed must be sealed in a plastic bag for 4 weeks. Disinfect personal combs and brushes by soaking in hot water (>130°F) for 10 minutes. Thoroughly clean sleeping area. Monitor other campers for pediculosis. POISONING if suspected poisoning, whether verbatized by camper/staff or evidenced by empty container of toxic substance notify the POSION HELP LINE at 1-800-222-1222. Possible si�ns of poisoning may include: burnin� of lips/mouth, droolin�, nausea and/vomiting, odd odor, abdominal cramping in the absence of fever, difficulty breathing, sudden behavioral changes (i.e. sleepiness, irritable, jittery), and in serious cases LOC/ convutsions which require immediate attention, dial 911. POISON IVY If contact has just occurred, wash with soap and water only and wipe with rubbing atcohol, launder clothing. Formitd signs of itching, appty cotd wet pack and calamine totion, topical hydrocortisone or Rhuli Gel. Give diphenhydramine 1.25mg/kg PO every 6 hours to max of 4 doses per day. May use fixed dosing: 6-11 year olds 12.5-25mg per dose (maximum daily dose 150mg); 12 years and older 25-50mg per dose (maximum of 300mg/day). If severe blistering or swelling occurs or rash on face or genitals, evaluate by camp physician. Showing the campers what the poison ivy plant looks like and teaching them to avoid contact if at alt possible may prevent poison ivy. SCABIES May have a bumpy/blistery red rash that erupt with scratching and/or evidence of burrowing mites with severe itching which intensifies at night. Red bumps may form a line on skin Common areas include between digits, inner wrist, folds of arms, genitals, buttocks, around navel. Camper must be isotated in Health Center and evaluated by camp physician. SKIN INFECTION Cteanse with soap and water, and apply warm compresses, triple antibiotic ointment. If significant area of redness, pain and swelling is present, outline limits of area with waterproof marker. All infected wounds, sutured sites, those unresponsive to 1-2 days of treatment, or those that are worsening need to be examined by camp physician. , r Camp Wingate'"Kirkland 79 White Rock Road Yarmouth Port, MA 02675 Tel: 508.362.3798 e-maiL• hevcamp�campwk.com SORE THROAT Encourage ice-cold drinks and gargling with warm salt water. Administer a throat drop or Chloraseptic spray. If no relief, administer acetaminophen or ibuprofen. If symptoms persist for more than 3 days, or the child has associated symptoms of fever, headache, stomachache, swolten glands, extremely red throat, swolten uwla, or difficulty swallowing, evaluate by camp physician. SPLINTERS Remove superficiat foreign body with sterile tweezers. Treatwound as an abrasion (see#1). Deep foreign bodies need to be removed under tocal anesthesia by the camp physician or at Cape Cod Hospitat Emer�ency Room. _ SPRAINS, STRAINS, FRACTURES Treat mild to moderate sprains and strains immediately with RICE: Rest injured part, Ice pack for 20 minutes, Compression with stretch gauze or ace wrap, and Elevate affected area. Ibuprofen may be �iven for pain. After 48 - 72 hours, apply heat. Suspected or obvious fractures or distocations need to be splinted for immobitization and then seen by the consu[ting physician or, if after hours, at the Cape Cod Hospital Emergency Room. STOMACH AOHE : For indigestion, rest and administer Calcium Carbonate (antacid) or Mytanta. For cramps related to menstruation, please give camper ibuprofen 10mg/kg (max one-time doseb00mg). 1 kg = 2.2 lbs. If any camper presents with severe pain in the right lower quadrant accompanied by no interest in eating +/- vomiting or fever, please refer to camp physician or Cape Cod ED for evaluation for possible appendicitis. SUNBURN Apply cool atuminum acetate/Domeboro compresses and aloe. Keep all blisters intact. Analgesics may be given for pain. Ibuprofen. Cold compresses. Do not use petroleum. Applying waterproof sunsereen prior to outdoor activity and periodically throughout the day witl help to prevent sunburn. SWIMMING ACCIDENTS Any significant immersion needs immediate emergency care. Dial 911, and monitor ABC's and treat accordingly. Monitor for hypothermia. Other injuries may be treated as above. Enforcing safety rules at the waterfront will help to prevent accidents. TICK EMBEDDED IN SKIN With tweezers grasp tick as close to skin surface as possible. Pull upward with steady even pressure. Save tick in clear sandwich bag for potential infectious disease testing. Cleanse site with disinfectant soap and water. Apply rubbing atcohoL Apply cold pack. Apply calamine lotion or 1% hydrocortisone cream for itching. If tick is engorged and/or has been on a camper over the age of 8-years-old for more than 36 hours, ptease refer to camp physician for possible antibiotic prophylaxis. Monitor for signs of infection or unexplained symptoms, inctuding rash, fever and body aches, for 3 - 10 days. Evaluate by camp physician for concerns of infection or transmission or tick-borne illnesses. If any camper presents with a "bults-eye" rash, please refer to camp physician. VOMITING Record chitd's weight and assess for infective process. Place chitd in Health Center bed and encourage fluids, evatuate by camp physician. For persistent nausea/vomiting, may give ondansetron 4mg once. WHEEZING See Asthma. , • r Camp Wingate*Kirkland 79 White Rock Road Yarmouth Port, MA 02675 TeL• 508.362.3798 e-mail: heycam c�p _campwk.com MENTAL HEALTH ANXIETY Excessive worrying about many things. May present with vague physical symptoms such as headaches, muscle aches or tension, stomachaches or fatigue. Physical symptoms may include shortness of breath, racing heart, sweaty palms, nausea, trembling. Their anxiety may prevent them from participation of camp activities or avoidance behaviors. Talk with parent or guardian about coping strategies that work at home, promote retaxation techniques (i.e. meditation, focused deep breathing), provide reassurance and positive thinking. DEPRESSION Sadness, discoura�ement, despair, or hopelessness that lasts for weeks that limits a persons' ability to function normally. May present with feelings of worthlessness, �uilt, sadness and unable to feel happiness which wilt interfere with day to day function. Physical symptoms may be weight change, change in steep patterns (excessive sleep/trouble falling asteep), toss of interest or inability to enjoy things that bring happiness, isolation, feeting sad for no reason. Contact parent/guardian to discuss any recent stressors or changes to child's life or if this has been an issue in the past and offer support. EXCESSIVE PICKING at bug bites or sores can lead to skin infection. Can be a form of compulsive behavior and/or possible form of self harm. SELF HARM Injuring setf purposety by making cuts or scratches on body with sharp object or burns (wrists, arms, abdomen and legs are common sites for cutting). Self harm is done in an effort to cope with emotional pain and often accompanies other mentat health problems. Address wounds and treat per protocols. Discuss safety plans and encourage alternative coping skills. Contact parent/guardian to discuss any previous history of self harm, recent stressors or changes to child's life and offer support. SUICIDAL IDEATION A recent stressful event (divorce, breakups, fight with friends, death of loved one, family conftict) might cause thoughts or attempts of suicide. May present with overwhelming sense of hopetessness, may talk of death or suicide, may insinuate that they may not be around soon, giving away valued items, risk taking behaviors, change in sleep patterns. Previous history of suicide attempt increases risk and/or history of mentat health problems. Take concerns seriously and do not ignore child's or other persons concern for suicidal thoughts. Ask questions about thou�hts of suicide or setf harm and plan for suicide. Child will stay at health center, one on one, until parent/guardian is notified and will be discharged from camp and will need to be evaluated by pediatrician/psychiatrist/psychologist/therapist before return to camp. If unable to be discharged in the safety of parent/guardian refer to Cape Cod Hospital ER for psychiatric consultation. 1-800-SUICIDE is another resource to utilize. � I , • • , Camp Wingate*Kirkland 79 White Rock Road Yarmouth Port, MA 02675 Tel: 508.362.3798 e-maiL• heycam C��pwk.com Camp Wingate*Kirkland 2017 Standing Orders have been reviewed and approved by the following: Bonnie Arzuaga, MD: Date: � 2Z t�- Nataniel Vasquez, MD: Date: Z' Keith Chappell, MD: Date: Mary Colwell, RN: Date: /�. �a. �- Head Nurse Sandy Rubenstein: Date: C� • 22 • t� mp Director Camp Wingate'Kirkland 79 White Rock Road Yarmouth Port, MA 02675 Tel: 508.362.3798 e-mail: hevcampCcampwk.cam �AMp WINGATE ��,� KIRKLANO � . r: F � � � TRAINING AND CERTIFICATION FOR CERTIFIED SWIM INSTRUCTORS AND SWIM ASSESSORS During staff training the waterfront director will review all of the policies and requirements for swim assessment. Only certified Swim Instructors (WSI) can swim assess campers and staff. In addition,WSIs obtain this training in their "Observation For Assessment and Photographic Eye" section of their training which also refers to the stroke evaluation chart. PFD FIT TEST 'fRAINING Qualified "Marina Staff"will all participate in PFD Fit Test training. In addition to watching the videos listed below they will partficipate in a hands on training session with the Waterfront airector. How to Choose& Fit a Life7acket https://youtu.be/Q7CMNby_BI .-��T�� Christians Law Videa https://www.youtube.com/watch?v=oXQqgYRPUvk&feature=youtu.be , ; z �e°T �-� � `"" SANDY � WII.L RUBENSTEIN, DIRECTORS CAMP WINCATE * KIRKLANO 1 79 WHITE ROCK RD I YARMOUTH POflT, MA 0�675 l 508.362.3798 I FAX 5�8.362.1614 WWW.CAMPWK.COM ( HEYCAMP9CAMPWK.COM � � CAMA �.��, WINGATE �;�,� : KIRKLAHO ' a,..�.d �� - _ CAMP W*K SWIM TEST POLICY � PROCEDURES All campers and staff must demonstrate their swim skill in a "crib test" during their first 24 hours of attendance at Camp. (See crib test on next page). All swim tests must be conducted by Red Cross certified Water Safety Instructors (WSI); all WSI's at Camp W*K are also trained and certified Red Cross lifeguards. Any campers or staff who refuse to participate in crib placement will automatically be classified as a "non swimmer," and may not participate in waterfront activities with or without a PFD. Swim tests at Camp W*K are comprised of three distinct components. The first, crib placement,tests � swimmers endurance. Swimmers must demonstrate their ability to swim long distances and perform essential life saving techniques, including treading water and the survival float. Swimmers are then classified based on their abilities into either first, second, or third crib. Crib placements are recorded by the staff member performing the assessment, and written on the campers "buddy tag" for easy identification. Only third crib swimmers may participate in boating activities. ,-,�, , �.��> ' The second component of the assessment tests swimmers competency level in various different strokes. Swimmers are assessed and then classified by level pursuant to Red Cross standards outlined in the Red Cross water safety instructor's manual. All crib plaeements, Red Cross-swimming levels, and PFD sizes will be recorded by the WSI's performing the assessment, which will then be compiled into a master list by the waterfront director. Copies of this list will be kept on file, with the waterfront staff, and in the boat shed at the waterfront, to be used as needed by staff. For aquatics activities run outside of camp, a complete list of participants with their swim skill level must be included with the group. When the group arrives on-site a counselor on duty must assess location for safety and environmental hazards and risks. There must be a certified life guard present. There must be no more than 10 campers swimming per counselor on duty. If there are more than 10 campers swimming, use a buddy system with checks. If there is an emergency, follow normal out-of-camp emergency procedures. Any campers or staff classified as "at risk swimmers" must wear a PFD for aquatics activities outside of Camp. Any campers or staff classified as "non swimmers" may not _� participate in aquatics activities outside of Camp. �. ; ``"'�� SANDY & WILL RUBENSTEIN, DIflECTORS CAMP WINCATE *KIRKLAND I 79 WHITE NOCK RD 1 YARMOUTH PORT, MA 02675 l 508.362.3798 I FAX 5U8.362.1614 WWW.CAMPWK.COM I NEYCAMP9CAMPWK.COM I i � � �AMp ..nfr WINGATE �,r KIRKLANO , .�� r i �_�: - -. CRIB PLACEMENT PROCEDURES First Crib • 10 bobs • Blow bubbles in the water • Fully submerge under water Second Crib • 1 length of crawl • 1 length of backstroke or elementary backstroke • 1 length of breast stroke • 3 minutes of treading water • 2 minutes of survival float Third Crib �� ,,> • 2 lengths of crawl • 1 length of breaststroke • 1 length of backstroke or elementary backstroke • 1 length of stroke of choice • 4 minutes of treading water • 2 minutes�of survival float Special Notes Campers may have 10 seconds rest between each length Campers can be crib "tested" as many times as they want throughout the summer; however, they cannot be tested more than once a day. Only WSIs may crib test campers. �.... , � , � `Y SANDY & WILL RUBENSTEIN, DIflECTORS CAMP WINGATE * KIRKLANO I 79 WHITE HOCK RD I YAflMOUTH PORT, MA 0^c675 I 508.362.3798 I FAX 5U8.362.1614 WWW.CAMPWK.COM ( HEYCAMP�CAMPWK.COM � j ' Camp Wingate*Kirkland Waterfront Swim Assessment Balsam Full Season Burrell Full Season � .:,- ;: _ _ __ . __...... __. » �. z. � � Deligio First Session _ _ __ ___ __ _ __ °� � Flowers-Turner Full Season Gao First Session � Kenyon Full Season �'� � Leftwich First Session , ��n . :w. � : Pena Full Season � .;; ,.t . . __ � Rappaport Full Season ' Reilly First Session Remondi ' Fuil Season ` 3 Senz-Azcunaga First Session �r� Sinclair `Full Season .. „ Toto Full Season ;_ �= Weber First Session � 1 Swim and Fit Test Model Documentation Form 105 CMR 432.400 Municipal and Recreationa! Program or Carnp: Address: OperatorlDirector: Phone Number: E i SWIM TEST FIT TEST ` Name and A e of Ghiid: Date: PFD Provided by Parent? (circ�e) Yes / No Swim Level: PFD Required Per Swim Test? �circie� Yes / No Swim Test Location: T e of PFD: Size of PFD: CSI or Swim Assessor - Print NAME: lndividual conductir� Fit Test - Print NAME: SWIM TEST FIT TEST Name and A e of Child: Date: PFD Provided b Parent? (circfe) Yes / No Swim Levef. PFD Required Per Swim Test? �cir�ie) Yes / No r Swim Test Location: T e of PFD: Size of PFD: � � CSf or Swim Assessor - Print NAME: lndividual conducting Fit Test - Print NAME: t � ;: SW1M TEST FIT TEST Name and A e of Child: Date: PFD Provided b Parent? (circie} Yes / No E � Swim Level: PFD Required Per Swim Test? (circle) Yes / No � � Swim Test Location: T e of PFD: Size af PFD: � CSt or Swim Assessor - Print NAME: Individual conductin Fit Test - Print NAME: � , � Tes#ing Form 5-12-17 �tH oF M 2� \ V� * � � � � � av � �� OF P�o4� N�assac�iusetts Department of Public Health Gui�dance for.Implementittg Regulation 1 QS CMR 432.000 May 12, 2Q 17 � Based on Massachusetts Generat Law(M.G.L.)c. 1 I 1, §127A%x,commonly referred to as"Christian°s I.aw", and the Massachusetts Departmen�E af Public Health's(Department}previaejsly issued guidance un Christian's La.w,the Department has promuigated regulation 105 CMR 432.000:"Minimum Requimements for Personal Flotatian Devices for Minor Children at Municipal and Recreational Programs and Camps",effective May 5, 2017. The law and regutations only apply to swirnming or diving areas at marine or freshwater beaches and explicitly exclude swi.mming pools,wading poals,and other artificial bodies of water. In addition,the Department is issuing this guidance document to support complianee with the regulation,ta provide associated best practiees and to help assist municipal and recreational programs and carnps implementing provisions of the regulation. According to M.G.L. c. 111, §127A%,all municipal and recreational programs and Iicensed cat�nps must: 1) Determine each minor's swimming ability prriar to allowing participatioz�in swimming aot�vities; 2) Make ava,ilable properly sized and snug fittuig Type I,II,or III personal flotation dev�ces(PFD) to a11 minor cbiildren who have been determined to be a non-swimmer or at-risk swimmer; and 3) Accept a PFD provided by a parent or guardian of a rainor for the rtunor tu use while in attendance at the program or camp. Swim Abilitv Determin�tion: Ghristian's Law, in part,rec�uiz�es that municipal and recreational programs and licensed caznps determine each participating minor's swinuning ability,privr to or at the first swimming session, in order to identi�'y and classify non-swirtuners aud at-risk swimmers. If municipal and z�creation.al programs and licensed camps determine that , all participants are assumed to be non-swimmers, and ensure properly fitting PFDs are available to a11 zxunors engaged in swimming activities wi.thin areas classified for non-sw�xr�mers,then swi.m tests are not required. • Based on input from water safety professionals,individuals whQ do not meet criteria for a R�d Czoss Level 3 swim rating or a YMCA Minnow shall be classified as a"non-swimmez"and individuals w�.o may or may not Yzave met the critexaa foz a Red Cross Level 3 swixn rating or the YMCA Minnow,but have been determined to have a physical,psychalogical,medical,or cognitive disability that cautd negatively irr��act his or her swimming ability, shall be classified as an"at-risk swimmex". • All minors, including progra�m or camp participants, staff,voluuteers, and Counselors in Train�ing(CI'I�, need to be swim tested, at a minimum once per sunamer,to deterniine swimming ability. • In accordance with the regulations,swim tests shall be conducted ar overseen by a trained Certified Swim Instructor(CSI�that holds approgriate certifieat�ans from a nationally recognized svv�m instructor program, such as the Aznerican Red Czoss(ARC}or the YMCA, o�r a�a eqtuvalent certificate,as determined by the � Departcnent. A lxfeguazd rnaintaining current requirements as outlined in the regulations may also conduct ' swim tests as a Swim Assessor if they have previously observed one and participated in one annual swim test trainin�conducted hy a CSI. • Swim testing needs ta be conducted at the same vr a camparable location to w}aere the swimmin.g activities will occur unless the municipal and recreational pragram or licensed camp p�rovzdes ded'zcated Xx�egua�rds at the marine of freshwater beach where swimming wi��occur, in whieh case swim testing may be conducted at a swimnrii�n.g paol priar to the s��rimming activities. • Swim tests must be conducted under close supervision and without the use af a PFD. If a parent or guardian provides a PFD for their child,the muzxicipal and recreation program ar licensed camp should confirm witk�the parent or guardian,priar to any swim testing,that this testing will be conducted without the use af the P�D. • The Deparhnent has crea.ted the"Srvim and Fit Test Model Documentadon Form"as an optian for the operators to document and track swim testing an.d PFD fit tests.Th�form provides for indi.vidua.�ized documenfiation for each minor being�wijn and fit tested?ar who has been provided a PFD from a parent or guardian,and xs available an the Department's website. Xdenti�vinE Non-Swimmers and At-Risk Swimmers Non-swimmers and at-risk swi.mm�rs n�ed ta be identifzed wk�enever they are at a swimming or diving area,in accordance with 105 CNIR.432.400(A)(8}. Below are several e�amples of how municipal and recreational prograrns or licensed camps may choase to accornplish this: • Providing colored wrist bands that are not easily transferred between each child to identify their swimming ability;or • Pzaviding non-toxic,waterproof,temporary tattoos with U.S. Food 8i Drug Administration(FDA) certification for dyes/colorants and compliance witk�Consumer Product and Safety Commission(CPSC} and America.� Society of Testing Materials(ASTM)requirements; o Temporary tattoos that are digitally printed(with computer inks) on temporary tattoo trausfer papex and Henna-based temporary tattoas should not be used; oz • Any other methad including swi.m markers designed with FDA compliarit,toxic-fre�cosmetic ingredients which allows for an easy identification ta differez�txate between non-swimmers,at-risk swimmers and other classifted swiznmers; o Alcohol-based skin ink hand stamps should not be used. The identification process should be clearly o�tlined a�nd documented in the municipal and recreational program ar licensed camp's pvlieies and pracedures. Conf nement to Dedicated Swimmin�Areas Christian's Law requires municipal and recreational progza�nns and licensed camps to ensure all participants, including non-swi.nnmers and at-risk swimmers that are either determined through a swirn test or designated as �uch lay the program or cazzlp operator, as we��as minors whose parents or guardians have provided a PFD for their ch�ld,be confined to swimming areas consistent with the limits of their s«rirr�ming skills or to svuimnLing areas requiring lesser skills than those for which they have b�n classified. All swimming areas sha111ae permitted and meet the requirernents of regulation ].OS CMR 445A00: Mi.nimum Standards far Bathin�Beaches (State Sazaitax'y Code,Chapter Vii). • In order to praperly identify confinement areas at the swimming site,the Department suggests that the municipal and recreational program or licensed camp operator create a waterfront site plan for identification and training purposes. This site plan should include all natural and artificial baxriers and boundaries of the swimming or diving area,including Uut not limited to rocks,trees,drop-offs,buoys, ropes,docks,diving board platforms,and slides,which should cleazly outline the areas in which specified swimmers, non�swimmers and at-risk swirnmers have access.This site plan may be po5ted at the swimming or diving area,utilized as part af sta.ff arientatians,and maintained.with other recards in accordance with 105 CMR 432.004. • Additionally,the Department suggests eaeh municipal and recreational program and licensed carnp consider implem.enting a"buddy system"far a11 minors who are�aarticipata.n.g in swimming or diving activities. o A buddy system is desi�ned to pair or teaan-up two pec�ple,refe�d to as"buddies",to stay together and be responsible for keeping track of each ather, as well as let someone know if either needs assistance or can't be located while at the waterfro�i.The buddies act as a single unit in order to monitor and help each other during swunming or diving activities. o Buddies shau�d be tea�med up based on similar swimming ability; it is not advisable to team up a swimmer with a non-swimmer or at-risk swimmer. o A"buddy eheck"should be performed approximately every l5 minutes.After a designated signal like blowing a whistle, all swimming or diving should stop and each minor then instructed to go ' ta their established buddy, stand in the water, and hold their buddies hand high in the air while the lifeguard and ather counselors ensure everyone is accounted for. Once the count is confirmed swimming ox diving may resume. • The Department recommends contacting marine b�aeh aperatars to inquire about existiz�,g loca�b3��aws, ordinances,or regulations prohibiting the use of PFDs due to water current,and undertow concerns, prior to scheduiing any swimming activities. �nsurin�PFDs are Made Available: Christian's Law requires that municipal and recreational programs and licensed camps have a system in place to make PFDs available to nan-swimmers and at-risk swimmers,and requires programs and camps to accept a PFD fram a parent or legal guardian for th�eir child to use when these programs or Izcensed camps conduct swimming or waterfront activities at fresh or saltwater beaches. • Uperators of municipal a�nd reczeatianal programs and licensed caxnps xn.ay mainta.in their own inventory of PFDs or have them provided by a beach operatox,in which case the program operatQr must secure a written agreement for the amount and the condition of the PFDs. • The PFDs should be accessibl�foc staff to distribute to participax�ts at�r en-route to the swimming or diving area and oniy after a determination has be�n made on swimming ability. • All PFDs, ineluding those provided by a garent or guazdian,need to be U.S. Coast Guard(USCG)certified according to type(�,II,III),size,and buoyancy,in servzceable condition and properly fitted to each i�dividuat prior to b�ing used for the first time. o A FFU sh�ll not have rips,tears,holes,visible mold ar mildew odor,signs of wa:terloggix�g, damagad seams,straps or hardware,or any shrinkage or leaks ian buQyant material. o All PFDs maintaitned on-site during the season should be stored in an area with adcquate natural or ra�chanical ventilation,in order to ensure a proper drying process between use. Once the season is over,the PFDs should be thoroughly dried and then stared in an area where they are maintained dry until the fallowing season. o The serviceable eondition of each PFD must be inspected annually,preferahly at the beginnix�g or end of the season prior to off-season storage,however it is recommended tha.t more frequent inspeetions are conducted with a procedute in pla.ce�or properly disposing any that are not determined to be in serviceable condition. o Information on the types of PFDs,size selection, and tips for determining&maiz�taitung a PFD in serviceable condition are available directly from the USCG website at; http.//w+ww.uscg6aating.org/safe,ty/life,,,jacket wear wesring yonr lifejacket.aspx [All spaces represent an underscore character"_"in the website address.] • When a FFD is used by a minor, either when one is provided by a program or camp or when one is dropped off by a parent or legal guardian,trained staff at municipal and recreational pragrams and licensed camps shall ensure the PFD is properly sized according to manufacturer's guidelines for height and wei�ht, securely fastened and assessed for a proper fit prior ta each swimming activity. � The Department recoznmends that all staff be trained for PFD fit testing by reviewing the short guidantic.e video provided by the Department with assistance from the U.S. Coast Guard Auxiliary and Massachusetts P�urks/Depart�naent of Conservation&Recreations.A link to the video can be found at the website below: �t_.,pt •//www mass�ovJeohhslgovldepartmentsld�h(rsro�arnsJenviranmental-healthlcom�n-sanitatioNchristians-law html • Non-swimmers,at-risk swimmers,and participants whose parents or legal guardians have provided a PFD for their chi.�d and are aware of the conditions,do not need to wear a PFD during closely supervised swim tests, swimming lessons,and other ciosely supervaised r�on-swimming beach waterfront activities,including wading in shallow water where the water depth is less than iwo feet;however a PFD shuuld be worn for all other swimming activities,and whenever minors are on a dock. "Closely supervised,"non-swimmin� activities should be supervised by adults at a ratio of one adult far every five minors below a�e 7 and at a ratio of one to 10 for all minors age 7 and abave. • A PFD should never be worn during any diving activities. � A�participant should not be allowed to swim if a parent or guardian provides a PFD that does not fit properly or is not in serviceable condition and permission should be provided by the parent or guardian before an alternative PfiD is issuai. • The Department has also created the"Regulatian 105 CMR�32.000—Guidance ChecklisY'which is availabte on the Department's website,to assist all stakeholders with meeting the overall requirements af the rcgulations. For more information please visit the MDPH—Community Sanita#ion Program website www.mass.gov/dqh/dcx�or contact the Massachusetts Department oF Public Health,Bureau of Enviranmental Health at 617-824-5757. Letterhead of Local Board of Health Department I, �name/ritle� , cerrify that�name of recrearional cam�l I i is authorized to receive a license to operate a recrearional camp for children in the city/town of for the summer of_f�ear� without i � prior inspection,in accordance with 105 CNIR 430.650. i � The local board of health for (name of town/cit�L hereby exercises its discrerion to j authorize�name of recrearional cam��to operate a recrearional camp without a prior inspecrion based on the following (all must be checked to waive the pre-inspecrion): i ' The recreational camp submitted a timely application for renewal of its license. f — _The recreational camp is undex the same ownership and directorship as the prior camping season. _The recreational camp is located at the same site as the prior camping season. _The recreational camp had a satisfactory inspection report during the prior camping season. _Based on a review of the recreational camp record, there is no evident risk to health and safety. _The local board of health will inspect the recrearional camp during the 2017 camping season. � i Signature of Designated Authority at Local Board of Health Date ; , Print Name of Designated Authority and Tide �