SkiRetreat packet 15

Armstrong Chapel UMC
5125 Drake Road
Cincinnati, Ohio 45243-3999
Kyle Hazen-Youth Pastor
[email protected]
November 11, 2014
Dear Parents and Students,
I know it’s crazy to think about but Winter Retreat 2015 is only 3 months away! Last year was my first ever Winter Retreat
and I loved every second of it. I had a great time fellowshipping and worshiping with you last year, and I know God has great
things in store for us again as we return up the Harbor Springs for our annual winter-time get away.
If you are unfamiliar with VI’s Winter Retreat the brochure included with this letter has all the details you need to know. It
includes pricing, a packing list, departure/return dates/times, the forms you need to turn in, and important deadline
information. However, as always there are a few things that need highlighted.
1. Due to an increase in lift ticket prices for the 2015 ski season the regular rate had to be raised a little bit as compared to
last year. However there is good news! We have TWO early bird rates that you can lock into. Just get your registration
form (included in this packet) and $100 deposit in by November 23 and save $100. OR get those items in by December
21 and save $50! Any registration/deposits after 12/21 will be charged the regular rate, which is still a great deal .
2. All remaining forms and balance of funds are due by January 11, 2015.
3. When you bring/mail your deposit it is IMPARATIVE that you bring/mail your registration form in as well. We want to
continue to honor our agreement with Birchwood Inn to get our final numbers in early!
4. A Note to Confirmands: You are our honored guests on this trip; while it’s not required that you join us we certainly
hope that you will. It is one of the best ways to get acquainted with VI and there is nothing better than a weekend
retreat to strengthen and build new friendships! We desire that you join us SO much that we give you priority seating.
That means you get first dibs at our Winter Retreat spots!
5. We are currently working on our Winter Retreat theme and the options we currently have are looking good! We’ll let
you know officially what the theme will be by the beginning of December. So, stay tuned!
Thanks so much for taking the time to read through this! I look forward to and am praying for our time together in January.
If you have any question please let me know!
Blessings,
Pastor Kyle
Phone: (513) 561-4220
Follow us on Facebook
Fax (513) 561-3062
Warm waterproof ski clothes –
jeans and sweatshirts don’t
cut it for skiing!
Hat, Gloves, Scarf
Goggles; Sunglasses
Face mask
Regular inside clothes for
nightly meals & devotions
PJ’s
Toiletries & Towel
$50-75 for food: 2 lunches @
Nubs Nob; 3 meals on the
road; (3 breakfasts provided)
Other spending money
Helmet rental is available at
Nubs Nob for $10. (optional)
Ski Lessons are $45* for a 1½
hr group lesson; 2:00 pm
daily. (*Rates determined by
Nub’s Nob check their website
for current prices.)
Resort Info
www.nubsnob.com
We’ve skied here for
several years now and always have a
great time.
HIT THE SLOPES!
January 16-19,
2015
birchwoodinn.com is the web address for the lodge.
Armstrong Chapel UMC
5125 Drake Rd
561-4220
Verticalimpact.org
Find us
on Facebook
Hey, don’t miss out on a cool getaway
with your Vertical Impact friends to
Harbor Springs, Michigan!
We’re loading up the bus on Friday
afternoon, January 16th and heading
to northern Michigan for two days of
skiing and boarding at Nub’s Knob Ski
Resort. We will be resting our tired
bodies each night at the Birchwood
Inn.
The cost of the trip includes lodging,
transportation, lift tickets, ski rentals,
VI retreat apparel, breakfast, and
Fri/Sat dinner. If skiing is not your
thing, then you can still tag along
and hang out for the snow bunny rate.
We will return on Monday, the 19th,
around 8:00 p.m.
Registration & Rates
Super Early Bird*
Early Bird*
Regular Rate
Deadlines
Nov. 23
Dec. 21
Jan. 11
Rent Equip.
$350
$400
$450
Own Equip.
$285
$335
$385
Snow Bunny
$190
$240
$290
PERTINENT DETAILS
*NEW! Early Bird Deadlines: to lock into an early bird rate turn in your
registration form and $100 deposit** by the indicated deadline.
ALL PAPERWORK (Armstrong and Nub’s Nob liability forms) AND
BALANCE OF FUNDS ARE DUE BY JAN 11
**Deposits are non-refundable. Except in cases of dire illness, family emergency, or
injury that leaves the student unable to participate.
Adult chaperones are needed to go on the trip. Skiing optional– Contact Kyle if
you are interested.
Extra forms are available in the youth lounge or the church office.
Questions? Contact Pastor Kyle [email protected] or call at
561-4220 X305
Vertical Impact Student Ministries'
2015 Winter Retreat Registration Form
January 16-19, 2015 in Harbor Springs, Michigan
Registration & Rates Super Early Bird* Early Bird* Regular Rate Deadlines Nov. 23 Dec. 21 Jan. 11 Rent Equip. $350 $400 $450 Own Equip. $285 $335 $385 Snow Bunny $190 $240 $290 
*NEW! Early Bird Deadlines: to lock into an early bird rate turn in your registration form and $100
deposit** by the indicated deadline. Your registration is NOT complete without the deposit!

All paperwork (Armstrong and Nub’s Nob liability forms) and balance of funds are DUE BY JAN 11

**Deposits are non-refundable except in cases of dire illness, family emergency, or injury
PLEASE MAKE CHECKS PAYABLE TO: Armstrong Chapel and memo line noted “ski retreat”
Mail to 5125 Drake Road, Attn: Ski Trip, Cincinnati, OH 45243
“Armstrong Parental Consent & Liability Release Form” also required!
The enclosed liability form is also required. It is good for two years. If you have been on a recent trip with VI,
you have already filled this out. We have many that are expiring/expired - if you are unsure if yours is up-to-date,
please contact Wendy in the church office (561-4220).
Name:__________________________________________________________ Age: ______ Birthdate:________________
Address:________________________________________________________ Home Phone:_______________________
City/State/ZIP:_______________________________________________________________________________________
E-Mail: ____________________________________________________________________________________________
T-Shirt Size:
 Small
 Medium
 Large
 X-Large Equipment Needs:
Skis: ____
Snowboard: ____
If renting: Shoe Size: _______
Skill level (circle one):
beginner
I have my own gear: _____
Height: _______
Weight: _______
intermediate
advanced Emergency Phone Numbers:
Father's/Mother's Work Phone Numbers: ______________________________ & ____________________________
Father's/Mother's Cell Phone Numbers:________________________________ & ___________________________
Parent Signature:
________________________________________________________________________________
Signature
Print Name
Armstrong Chapel United Methodist Church
Parental Consent and Liability Release Form
Name: ______________________________________________M/F ___ Age: _____ Birthdate: ______________
Address: _________________________________________________________Phone: _____________________
City/State/ZIP: _______________________________________________ SSN: ____________________________
School: ________________________________________________________________________ Grade: _______
Father's/Mother's Work Phone Numbers: __________________________ & __________________________
Father's/Mother's Home Phone Numbers: __________________________ & __________________________
Father's/Mother's Cell Phone Numbers: __________________________ & __________________________
In event of emergency, if parent is not available, name of relative: __________________________________
Phone: _____________________________ Relationship: _________________________________
IF THE PARTICIPANT HAS NOT ATTAINED 18 YEARS OF AGE:
To Whom It May Concern:
• As the parent(s) or legal guardian(s) of this participant, we (I) hereby grant our (my) permission for him/her to participate fully in the
authorized activities (as specified by each individual activity permission form), including transportation related to the activities, of
Vertical Impact Student Ministries of Armstrong Chapel United Methodist Church.
• Further, We (I), hereby consent to and/or authorize another adult (Youth Pastor or person designated by Youth Pastor) in whose care
the participant has been entrusted, to consent to any transportation to a licensed medical doctor or hospital, and to any treatment that
such medical professionals may deem necessary, including but not limited to emergency surgery, x-ray procedure, and/or
anesthesia. We (I) agree to assume responsibility for any and all medical bills.
• Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action, or otherwise, we (I)
hereby agree to assume all transportation costs related to such return.
• Further, we (I), hereby give permission for images of my child, captured during regular and special Vertical Impact Student Ministries
activities through video, photo, and digital camera, to be used solely for the purposes of Vertical Impact Student Ministries
promotional material and publications, and waive any rights of compensation or ownership thereto.
• By signing this form, I understand it is effective for two (2) years from date signed or until the minor has reached 18 years of age.
LIABILITY RELEASE:
In consideration of my child's acceptance for participation in the activities of Vertical Impact Student Ministries of
Armstrong Chapel United Methodist Church, we (I), being 18 years of age or older, for ourselves (myself) and for and on
behalf of our (my) child participant, do hereby release, discharge and agree to hold harmless Vertical Impact Student
Ministries, Armstrong Chapel United Methodist Church, the directors thereof and any other authorized adult chaperone
from any and all liability, claims or demands for personal injury, sickness or death as well as property damage and
expenses of any nature whatsoever, which may be incurred by the undersigned and/or our/my child participant while
participating in that group's activities.
If participant is under 18 years of age both parents must sign unless separated or divorced in which case the custodial
parent must sign.
Witness ____________________
_______________________________________
Witness ____________________
Father Signature
Print Name
Date: ________________________
Witness ____________________
_________________________________________
Witness ____________________
Mother Signature
Print Name
Date: ________________________
Witness ____________________
_________________________________________
Witness ____________________
Legal Guardian Signature
Print Name
Date: ________________________
Reviewed and reconfirmed, with any necessary revisions, on __________________, 20____.
__________________________________ (parent signature)
1
20 November 2009
Armstrong Chapel United Methodist Church
Parental Consent and Liability Release Form
TRIP PARTICIPANT ONLY:
I understand the rules of conduct for participants and will abide by them, as well as the directions of the leadership of the
trip.
Participant: ___________________________________________ Date: __________________
HEALTH INSURANCE: [Please circle]
Yes
No
(If Yes, please attach copy of insurance card)
Insurance Company Name, Claims Mailing Address & Phone Number
Policy and Group Number
Subscriber's Name
SSN
Physician
Physician's Phone Number
HEALTH INFORMATION:
Medication Allergies
Food or Environmental Allergies
Check all items that apply, past or present, to your health history.
Yes
No
ADD or ADHD
Diabetes/Hypoglycemia
Asthma
Heart disease
Cancer/blood disorder
High blood pressure
Convulsion/seizures
Kidney disease
Other
Yes
No
Explain any "yes" answers:
Please list all medications being taken:
List any physical or behavioral conditions that may affect or limit full participation in swimming, hiking, biking,
running or playing strenuous physical games.
IMMUNIZATIONS: (Give date of last inoculation)
Tetanus __________
Rubella __________
Diptheria __________
Polio __________
Pertussis __________
Hepatitis A __________
Measles __________
Hepatitis B __________
Mumps __________
2
20 November 2009
Nub’s Nob Liability Release Form
I realize that there is a possibility of injury in skiing and snowboarding and will not hold
Nub’s Nob Ski Area or the Nub’s Nob Winter Sports School liable if my child is injured.
I will defend and indemnify Nub’s Nob for any loss or damage, including any that results
from claims or lawsuits for personal injury, death and property loss and damage relating
in any way to these activities.
I HAVE READ, UNDERSTAND AND ACCEPT THE RENTAL AGREEMENT AND RELEASE
OF LIABILITY AGREEMENT NOT TO SUE – PRINTED ON THE BACK OF THIS FORM.
User Name:____________________________________ Date:______________
User Signature:____________________________________________________
Parent/Guardian: If equipment user is a minor, I verify that I am the parent or guardian and have the
authority to enter into this agreement on behalf of the user. I agree to be bound by all terms and conditions
of this agreement and to defend and indemnify providers from any claim or suit arising from said minor’s
use of this equipment.
Parent/Guardian Signature:__________________________________________
PARENT/GUARDIAN SIGNATURE: ________________________________________
DATE: ________________ PHONE NUMBER: _______________________________
SKIERS/SNOWBOARDERS RESPONSIBILITY CODE
There are elements of risk in skiing/snowboarding that common sense and personal
awareness can help reduce.
1. Stay in control.
2. People ahead have the right of way.
3. Stop in a safe place for you and others.
4. When starting downhill or merging, look uphill and yield.
5. Use devices to help prevent runaway equipment.
6. Observe signs and warnings and keep off closed trails.
7. Know how to use the lifts safely.
I have carefully read the above responsibility code and understand each rule.
STUDENTS NAME: Please print: _________________________________
STUDENTS SIGNATURE: ____________________________ DATE: _____________
ORGANIZATION NAME: ________________________________________________
THIS COMPLETED FORM REQUIRED FOR EACH
RENTAL CUSTOMER.
EQUIPMENT/HELMET RENTAL AGREEMENT
WARNING - RELEASE OF LIABILITY, ASSUMPTION OF RISK AND AGREEMENT NOT TO
SUE
I, (the undersigned) am aware that by signing this agreement I am waiving certain legal rights and agree
unconditionally to all terms as outlined below:
I accept for use AS IS the equipment listed on this form and accept full financial responsibility for the care of the
equipment listed on this form while it is in my possession. I will be responsible for the replacement at full value of any
equipment rented under this form, but not returned to the shop. I agree to return all rented equipment by the agreed
date and to pay for any repairs for damage beyond normal wear and tear during my rental period.
I understand how this equipment works and have received instructions and satisfactory answers to any questions. I
agree to check this equipment before each use (including the binding anti-friction device – Alpine only); and if at any
time this equipment does not seem to be working properly, I will stop using it immediately and return it for inspection
and possible repair or adjustment.
I understand that proper bindings settings or stance depend upon the accuracy of my statements about weight, height,
age, skier type and stance on this form. I have confirmed that the binding release/retention settings or stance on this
equipment correspond to those stated on this form.
If this equipment is to be used by someone other than me, I certify that I am acting as agent for the user and that I will
provide this form and all pertinent warnings and information to the user.
I understand and agree that the sports of skiing, skiboarding (SnowBlade), snowboarding and other winter activities
(“snow sports”) are HAZARDOUS activities, that INJURIES from various causes are an INHERENT RISK of
participating in these activities, and that injuries to any and all parts of my body are a COMMON AND ORDINARY
OCCURRENCE during these activities. I freely accept and voluntarily agree to expressly ASSUME ALL RISKS OF
INJURY OR DEATH that may occur while engaged in snow sports or which relate in any way to the use of this
equipment.
ALPINE SYSTEMS:
I understand that the Alpine ski/boot/binding system CANNOT RELEASE OR RETAIN in all situations where release
or retention may prevent injury or death and therefore CANNOT GUARANTEE MY SAFETY.
SNOWBOARDS, SNOWBLADE, AND NORDIC EQUIPMENT:
I understand that the binding systems on snowboards, ski boards (SnowBlades) and cross country skis are NOT
INTENDED TO RELEASE in a fall or upon impact.
HELMETS:
I understand that a helmet designed for snow sports use will help reduce the risk of some types of injuries to the user at
slower speeds. I recognize that serious injury or death can result from both low and high energy impacts even when a
helmet is worn and that no helmet can protect the user against every foreseeable impact and that snow sports present
situations which surpass the limits of protection offered by a helmet. I understand that a helmet does not protect
against trauma to any other part of my body, including my face, neck and spine. A helmet does not protect what it does
not cover.
I WILL NOT SUE (RELEASE OF LIABILITY, HOLD HARMLESS AND INDEMNITY)
To the fullest extent allowed by law, I agree to release from liability and to indemnify and hold harmless Nub’s Nob,
the ski/snowboard shop, their employees, owners, affiliates, agents, officers, directors, and all other manufacturers and
distributors of any equipment (collectively “providers”) from all liability for injury, death, property loss and damage of
any nature which results from the equipment users participation in snow sports or in any way relating to use of this
equipment, including all liability which results from the NEGLIGENCE of PROVIDERS, breach of warranty, product
defect or any other theory. I will defend and indemnify providers for any loss or damage, including any that results
from claims or lawsuits for personal injury, death and property loss and damage relating in any way to the use of this
equipment.
THIS DOCUMENT IS A LEGALLY BINDING CONTRACT which supercedes any other agreements or
representations by or between the parties. It shall be interpreted to provide as broad and inclusive release of liability as
is legally possible as governed by the applicable law of this State. If any provision of this agreement is deemed to be
unenforceable, all other provisions shall be given full force and effect, as this agreement is not intended to assert any
claims or defenses which are prohibited by law. I will not transfer the equipment for use to any other person. If I do
transfer the equipment in violation of this agreement, I will indemnify providers against any claim, demand, losses or
damages arising out of the injury or property damage through use of this equipment. This agreement shall be binding
and may be pled as a complete bar and defense against any claim, demand, action or causes of action by or on behalf of
the undersigned or any user.

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