Indiana Runner

7:00 am                                 Wake up

7:15 am                                 Morning workout

8:15 am                                 Breakfast

9:00 – 11:15                         Instruction

11:30 am-12:30 pm           Lunch

1:00 pm – 3:30 pm             Instruction/training/fun activity

4:00 pm – 5:30 pm             Afternoon workout

6:00 pm                                 Dinner

7:00 pm – 9:30 pm             Group activity

10:30 pm                              Lights out

Check-in & registration @ Culver Academies

Sunday, June 20 from 10:00 am – 11:30 am at the McMillen Recreation Center lobby

Check out

7:00 pm on Wednesday, June 23

Fees include

lodging in dorms, meals (11) – Sunday lunch through dinner on Wednesday, camp t-shirt, instruction

Personal items needed

bring clothing & foot gear for at least 8 workout sessions, spikes, swimming suit, toiletries, pillow, linens, blanket, towels, washcloths, soap – no laundry will be done while @ camp

Camp information/location/directions:

The Culver Academies is located in north-central Indiana – about 35 miles south of South Bend & 100 miles north of Indianapolis.  The Academies’ campus is about 9 miles west of U.S. 31 on Indiana 10.

Call Dana Neer @ 765-252-7030 or email  @ neerd@culver.org

Access www.culver.org for general Academies information & go to the Cross Country web page for camp info

Camp site – direct:  http://www.culver.org/images/CSSC-other-camps/culver%2520academies%2520distance%2520camp-web%2520brochure%252010.pdf

Camp Fees

June camp:  registration & fee due by June 8, 2010

      Resident:         $350 (for team rates:  contact Dana Neer)

      Commuter:      $300

Send this page & fee to: (check or money order payable to: “Culver Educational Foundation”)

Culver Academies Distance Camp

Culver, IN  46511-1291

Sunday - Wednesday (June 20 – June 23)

Name       _______________________________________

School     _______________________________________

Home address___________________________________

                      ___________________________________

Home phone ___________________________________

Email address: __________________________________

Age:  ______   Grade in school for 2010-11:  __________

Best performances:       Event                           time 

___________          ____________

___________          ____________

___________          ____________

___________      ___________

THE CULVER EDUCATIONAL FOUNDATION

CONSENT AND RELEASE AGREEMENT

Distance Running Camp

In consideration of permission to participate in, or continue participating in, the activities and programs of The Culver Educational Foundation, and to use its facilities, I hereby acknowledge and agree as follows:

I recognize that my child’s participation in the Distance Running Camp is with some risk of bodily injury.  I accept those risks with full knowledge of the dangers involved, and hereby certify that I know of no physical or medical problems that would increase my child’s risk of illness or injury, as a result of participating in the Distance Running Camp. 

In the event of an injury or sudden illness, I consent to the administration of first aid and resuscitative measures performed on my child’s behalf by trained or qualified personnel.  I assume full responsibility for all medical expenses incurred as a result of injuries suffered by my child’s participation in the Distance Running Camp.  My health insurance provider is ______________________, Group No. ____________.

I agree that my child’s participation in the Distance Running Camp is strictly voluntary, and that the Camp Directors, Dana Neer, Michael Chastain and Joe Mendelson or their staff, will directly supervise my child.  Further, I agree that my child must comply with the requests, directions, and instructions of the individuals offering this Distance Running Camp, and his/her failure to do so may result in his/her removal from the program.  I understand that supervised lodging and transportation may be provided while my child is participating in this camp, and that the use of additional training facilities, including weight training and swimming activities, may be provided as well.  I further understand that meals, snacks, or refreshments may be provided, and I have listed below any and all items that my child should not be given.  No alcoholic beverages or non-prescription drugs are to be brought with the athlete or used by the athlete while at this camp.  Any prescription medication for your child must be remain locked in the lock box in the dorm room and only used by your child under the prescription terms.

I hereby release and discharge The Culver Educational Foundation, its agents, students, coaches, employees, representatives, the building and grounds owners, any related entities, and all others from any and all liability, responsibility, loss, damage, costs, claims, and causes of action (including, but not limited to, those for bodily injury, death, and property damage or loss to me and/or my child) arising out of or resulting from my child’s use of or presence upon these facilities and/or participation in this camp, specifically including, but not limited to, any and all liability, responsibility, loss, damage, costs, claims, and/or causes of action that arise from or are caused by the negligence or fault of The Culver Educational Foundation, its agents, students, coaches, employees, representatives, the building and grounds owners,  any related entities, or other participants in the Distance Running Camp program.

I understand that my child will use many facilities at the Academy including McMillen Athletic Center, Lowenstine Pool, Lake Maxinkuckee, Academy Grounds, as well as wooded trails and area country roads.

I have read the entire Consent and Release Agreement and accept the conditions stated herein as a requirement for my child’s participation in this camp. 

Camp dates: 

June 20-June 23, 2010

PARENT SIGNATURE  _____________________

PRINTED NAME               _____________________

DATE                                    _____________________

EMERGENCY #                _____________________