2018 Camp Workcoeman Boy Scout Program Guide
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welcome to camp workcoeman
Dear Scoutmaster,
Welcome to the 2018 summer camp season at Camp Workcoeman! Founded in 1924, countless boys
have experienced the benefits of the summer camp program at this special place with a long tradition of a
fun-filled camp program on the shore of West Hill Pond. Camp Workcoeman is one of the longest running
camps in the country to offer a summer camp experience to Scouts.
A summer camp experience at Camp Workcoeman will make your Scout troop grow. It is here that the
Scouts advance and grow in confidence and skills.
In 2009, a camp study report evaluating the camping programs in Connecticut Rivers Council was
compiled by “The Camp Doctor, Inc.” The following are statements from the report:
“Good traditional Scout camping needs to survive, for this is where real Scout camping happens...
The basic Boy Scout program at Camp Workcoeman was the best of the council’s camps.”
At Camp Workcoeman, our task is to work side-by-side with you to tailor a program that best fits your
troop. The staff is ready for this challenge. Once again, many of the old familiar staff veterans will be returning
along with new, energetic characters. Many of which come from troops like yours!
Now is the time your troop should begin the process of planning for summer camp. Besides this program
guide, the camp website, campworkcoeman.org, can assist you in finding information about programs, camp
arrival procedures, staff contact email addresses and all related camp forms. Comments from leaders about the
web site indicate that it is easy to navigate and provides a wealth of information.
This year’s theme will be “Hawaiian paradise!” Break out the Hawaiian Shirts! This year come
celebrate the summer with an adventure in the islands as Workcoeman hosts a week long Hawaiian
Luau. The spirit of the islands will come alive with skits and activities throughout the week. Your troop
can participate by decorating your campsite with Hawaiian props, shirts, grass skirts, and anything else
to welcome the spirit of the islands at Workcoeman. It’ll be a luau your Scouts won’t want to miss!
Please contact us if you have any questions or special requests with your summer camp plans. We are here
to help you prepare for a summer camp experience second to none.
2
Lou Seiser
Camp Director
lseiser@campworkcoeman.org
Tom Leisten
Program Director
tleisten@campworkcoeman.org
Dan Ruede
Asst. Camp Director
druede@campworkcoeman.org
Jim Waters
Council Support Services Director
jawaters@bsamail.org
Campworkcoeman.org
table of contents
The Camp............................................................... 4
The Staff................................................................. 4
The Summer Camp Program................................. 4
Troop Leadership in Camp.................................... 4
Pre-Camp Information.......................................... 5
Program Planning Meetings
Troop Activity & Merit Badge Sign-up
Camp Medical Form Information......................6-7
Who Needs a Medical Form?
General Camp Information
Mail..................................................................................................8
Phone Use Policy........................................................................8
Parking/Vehicles.........................................................................8
Wrist Bands...................................................................................8
Check-in/out Procedures........................................................8
Visitor Procedures......................................................................8
Troop Photos...............................................................................8
Lanterns, Stoves, Liquid Fuel.................................................8
Fire Safety.....................................................................................9
Dining Hall Conduct.................................................................9
Troop Leader Assistance..........................................................9
Commissioner Service..............................................................9
Daily Campsite Visitations.......................................................9
Directions to Camp...................................................................9
Damage to Camp Property....................................................9
Camp Discipline Policy.............................................................9
Sunday Check-In.................................................. 10
Arrival Information
After Check-in Schedule
Friday at Camp..................................................... 11
Court of Honor and Family Bar-B-Que
Check-Out Procedure
New For 2018....................................................... 12
The Merit Badge Program................................... 13
Merit Badge Time Schedule................................ 14
Merit Badge Info Guide................................. 15-21
Times, Locations, Prerequisites, Recommendations
Achievement Awards & Recognitions................ 22
The Tenderfoot’s Compass Program.................. 23
Program Highlights & Schedule
3
Program Area Highlights.................................... 24
Troop Activity Suggestions................................ 25
COPE .................................................................... 26
Weekly Contests.................................................. 27
Fishing Derby
Cardboard Boat Regatta
Shooting & Sport Tournaments
Scavenger Hunt
Class “A” Troop.................................................... 27
Order of the Arrow.............................................. 27
2018 Camp Theme............................................... 28
Special Programs and Events............................. 29
The Spirit Stick
Shawtown Wilderness Trek
Discover Scuba
Huck Finn Tube Ride
Farmington River Kayak Trip
Buckskin Tomahawk Throw
For Leaders Only.................................................. 30
Lou’s Lounge
WiFi Internet Service
Adult Leader Roundtables
Adult Leader Activities & Awards
Scoutmaster Training Sessions........................... 31
Veteran Camper Award....................................... 32
Daily Camp Schedule.......................................... 33
Master Time Schedule......................................... 34
Camp Forms Section...................................... 35-53
Summer Camp Prep Form
Bar-B-Que Sign-up Form
Camp Photo Order Form
Leader Name Badge Order Form
Medical Form
Medication Administration Form
Medical Screening Questionnaire
Off-Camp Activity Permission Form
Pistol Program Participant Form
Camper Release Form
Scouter Resource Form
Merit Badge Prerequisite Forms
Campworkcoeman.org
camp workcoeman
Camp Workcoeman
is located on beautiful West Hill Pond in New
Hartford, Connecticut. Established in 1924, it is one of the oldest continuously operated
Scout camps in the country. For 94 years, thousands of Scouts and Scouters have had
unforgettable Scouting experiences at Camp Workcoeman. This fine tradition of
Scouting continues today.
The Camp Workcoeman Staff
is chosen by a Camp Director with
38 years experience. The staff is highly skilled and trained with all key staff trained by
the Boy Scouts of America at their National Camping Schools. Camp Workcoeman’s
veteran staff has a positive impact on a quality program.
The Summer Camp Program at Camp Workcoeman
contains valuable opportunities for skill instruction, advancement and FUN and is available to every troop and
Scout. The quality of your troop’s summer camp experience rests with you, the Scoutmaster, and your troop’s
junior leadership. Use this program guide to learn about camp procedures and policies. You will then be able to
inform all Scouts and parents. You and your Scouts can collectively select from among the many program
opportuities that meet the needs of your troop.
Troop Leadership in Camp
The National Council of the Boy Scouts of America requires that
each troop must have at least two adult Scouters in camp at all times. One of the Scouters must be 21 years of age
or older while, the second leader must be at least 18 years of age. All adults must have completed Youth Protection
Training. These Scouters stay at camp free of charge. The cost of any additional adults is determined by the
number of Scouts in your troop at camp. The following table indicates the cost of additional adults.
4
# of youth
per program
# of free
Scouters
Each additional
adult
1 - 10
11 - 20
21 - 30
31 - 40
2
3
4
5
$100
$100
$100
$100
Campworkcoeman.org
Pre-camp information
Pre-Camp Program Planning
Two pre-camp planning meetings are scheduled for your troop leadership to meet with key members of the camp
staff and develop a program that meets your needs. Your CAMP SCOUTMASTER and SENIOR PATROL LEADER are
encouraged to attend ONE of these meetings. You will also be given information regarding camp policies, medical forms and related health information, as well as procedures for your Sunday arrival and check-in. A visit to your
campsite is possible with a Camp Commissioner.
2018 Camp orientation meetings are scheduled for:
Saturday, May 5
or
Saturday, May 12
both beginning at 1:30 PM
in the Camp Workcoeman
Dining Hall.
An additional planning meeting will take place
in Long Island:
Saturday, April 28th at 10:00 AM
Notre Dame Parish Rectory
45 Mayfair Road
New Hyde Park, NY
Troop Activity and Merit Badge Sign-up
Your troop should sign up for merit badges and troop activities prior to camp. This will be done
online using a fillable Google Form for which the appropriate links will be emailed to troop
contacts following each program planning meeting. Link information can also be found on the
Camp Workcoeman website or by emailing the Program Director at tleisten@campworkcoeman.org.
Merit badge selections should be submitted online at least three weeks prior to your
week at camp. The Program Director will be in contact to verify receipt of selections and work with
you in regards to any necessary program changes. A list of merit badge offerings can be found on
pages 14-22 of this guide.
Troop activity requests should be submitted online at least three weeks prior to your
week at camp. We will develop a schedule for your troop from the requested activities. Please understand that we will make every effort to schedule your desired troop activities. Some activities are
in high demand and we want to be fair to everyone. Suggested activities can be found on page 25
of this guide. A blank schedule to begin planning your troop’s week can be found on page 33.
Staff resources are allocated based on sign-ups done ahead of time.
As a result, some programs might not be available without pre-camp sign-ups.
5
Campworkcoeman.org
medical form information
Who Needs a Completed Medical Form?
All Scouts and Scouters staying more than 24 hours need parts A, B, C and D of the BSA Annual Health & Medical
Record form completed and submitted along with any applicable Medication Administration and Food Allergy
Treatment Plan forms!
PLEASE ONLY USE THE MEDICAL FORMS FOUND IN THIS GUIDE OR ON:
CAMPWORKCOEMAN.ORG
These sites contain only the appropriate forms that need to be completed. We can no longer accept forms
that were published before the 2014 printing (located on lower right hand corner of form).
Check the following items BEFORE submitting all Medical Forms:
Part A & B (both pages) completed with:
NOTE: Parts A & B must be completed even if submitting a
State (School) Physical form.
• Emergency contact information
• Copy of insurance card
• Allergies
• Immunization history with dates or copy of
immunization history from MD
(Writing up-to-date is not acceptable.)
• Tetanus must be within 10 years
(Scouts and Scouters)
• Medical History
• Part A SIGNED and DATED by parent or guardian
• MEDICATIONS: Connecticut has specific requirements for
the administration of medications at camps. Part D includes a
Medication Administration Form:
• Medication forms must be completed for all prescription and daily administered non-prescription medications (e.g. over the counter allergy medications) with
name of medication, strength, and frequency.
• Medication forms need to be signed by BOTH MD
and parent or guardian OR Standard school
Authorization for Administration of Medication signed by BOTH MD and parent or guardian.
• It is not necessary to bring or have medication forms
for over the counter medications that are taken on an
as needed basis such as Tylenol, Motrin, and Benadryl. These are on hand in the health lodge. See Part D
for a list of available Over the Counter medications.
6
list of medications that can be administered at camp without
a physician’s order. All other medications, both Prescribed
and Over The Counter, require a MEDICATION ADMINISTRATION AUTHORIZATION FORM to be completed and signed by
the physician and parent. A separate form is required for each
medication.
Part C – Physical Examination:
• SIGNED and DATED by MD within 1 year of first day of
camp
• Copy of school physical is acceptable if it is SIGNED and
DATED within 1 year of first day of camp and parts A & B
are completed.
Part D Connecticut Rivers Addendum required for all
Scouts and Scouters:
• SIGNED and DATED by parent, guardian or self
• All Scouts with medications in camp, and their parents, must see the Camp Nurse at check-in, including
those with orders to self-carry (e.g. Inhalers, epipens). All self-carry meds must be seen by the nurse
at check in!
• All medications will be administered at the Health
Lodge before meals. It will be the Scouters’ responsibility to get the Scouts there.
• Please only bring enough of each medication for
the week plus ONE extra pill. Example - A once daily
medication will require only seven (7) doses.
Food Allergy Treatment Plan:
• Completed as necessary
Campworkcoeman.org
medical form information
make copies of all medical forms prior to submission!
All Medical Forms SHOULD be submitted to camp at least 3 weeks prior to your week at camp.
• Please include a roster of those Scouts and Scouters attending camp when sending medical forms.
• Include phone and email contact information for one primary contact for all medical form questions.
Mail all forms to:
Camp Workcoeman
169 Camp Workcoeman Road
New Hartford, CT 06057
Attn: Camp Nurse
Do not fax or email forms to camp!
Our Health Officers will review all forms and inform your Troop Medical Contact or parents with any problems to
address prior to your arrival at camp. Please understand that submitting all forms three weeks ahead of your Troop’s
week at camp will help streamline your check-in process.
Upon arrival, all Scouts and Scouters must fill out a medical survey. The survey form can be found
in the “Camp Forms” section of this guide. These surveys are to be turned in to the Health Officers
during your Sunday medical check-in.
One week prior to your arrival at camp, Troop leadership will be provided a time for your Sunday
check-in with the Health Officers. Failure to follow this procedure will negtively affect the
check-in schedule of all troops in camp.
Email all medical related questions to: nurse@campworkcoeman.org or call 860-379-1756
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Campworkcoeman.org
general camp information
Mail
is received at camp and distributed daily. Outgoing mail is brought to the post office on a daily basis too.
Stamps are available in the Trading Post. Incoming mail should be addressed as follows:
Camp Workcoeman
169 Camp Workcoeman Rd.
New Hartford, CT 06057
Scout’s Name
Troop # _____
Campsite __________________________
Telephone It is highly recommended that Scouts do not bring cell phones to camp. The cell service is very
limited, and charging is not available. Any important incoming messages can be made to the Camp Director’s
phone. Camp Office: 860-379-2207 Fax: 860-379-1311 Camp Health Lodge: 860-379-1756
Parking/Automobile Use
No vehicles may be taken into campsites, program areas, or on camp
roads. Please see the Camp Director or Ranger if you have any need for the use of a vehicle to your campsite.
Parking will be in designated areas only. No passengers are ever to ride in the back of trucks.
All vehicles are required to have a parking permit displayed on the dash board while in camp. ALL leaders and visitors
must display this permit. Parking Permits can be obtained in the camp office.
Wrist Bands All Scouts, Scouters, staff and visitors must wear a wrist band. Visitors must check-in at the
camp office to obtain a wrist band.
Check-in/Check-out and Visitor Procedures Anyone arriving or departing camp
after Sunday check-in MUST sign in or out at the Camp Office. This includes any temporary Scouters and ALL
VISITORS. Visitor meal costs are: Breakfast $4.00, Lunch $5.00, Dinner $6.00. Visitor meals can be paid for at the
Camp Office before meals.
Any Scout leaving camp during the week for any reason with someone other than his parent or guardian must complete a special permission form. See the “Camp Forms” section of this guide for a sample of this form. This form must
be completed and submitted at the time of arrival.
*If your troop leadership will change during the week, please submit a list of names and a day/ time schedule
for leader rotation. Please submit this list to the camp office or at the Sunday Scoutmaster meeting.
Troop Photos
will be taken each week on Tuesday at lunch. A photo order form can be found in the
“Camp Forms” section of this guide. Orders and money for photos are due in the Camp Office by Monday at noon.
Photos will be delivered to camp and distributed on Friday night. The cost of an 8x10 photo is $10. Please be sure
that all checks are made out to: Connecticut Rivers Council, BSA.
Lanterns, Stoves and Fuels
Lanterns and stoves using liquid and propane fuels are permitted
provided they are used in compliance with BSA policy as detailed in the “Guide to Safe Scouting.” This includes following the policy excerpts below:
• Scouts or youth visitors under the age of 18 may not
fuel or refuel any stoves, lanterns or appliances on CRC
property.
• A quantity of liquid fuel not to exceed 32 ounces per
appliance may be kept in a “Sigg” type container, stored
in accordance with National BSA Policies and never in
tents or buildings. Any fuel in excess of this amount is to
be turned over to the Camp Ranger for proper storage.
No candles, lanterns or other flames are permitted in tents at any time!
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Campworkcoeman.org
general camp information
Fire Safety
Campfires are permitted ONLY in the fire pit in your campsite and should never be left unattended.
Proper methods to extinguish fires should be available at all times. When the fire is out cold, stack partially burnt wood
near the pit for future use. Disposing of cold ash should be done regularly. This can be arranged through the Commissioners or the Scoutcraft staff. Trees are not to be cut down.
Dining Hall Conduct All meals are served family style and use the host system. Every table in the din-
ing hall should have at least one Scouter sitting with the Scouts. Scouters ensure proper table manners, safety and
Scout-like behavior.
Troop Leader Assistance Troop leaders hold a wealth of information and are a great source of assistance to the staff. You are asked to share your talents in a particular program area. Please complete the Adult Resource
Form in the “Camp Forms” section of this guide and return it to the Program Director.
Commissioner Service -
“Your Source For Help at Camp” The Camp
Workcoeman Commissioners are here for any assistance to your troop while at camp. Program changes,
campsite needs & repairs, as well as any special requirements are all ways that we can make your stay at
camp as best it can be. Each morning before reveille, the Commissioners will visit your campsite to bring
coffee and deliver your daily copy of the “Chief Tunxis Times.”
Daily Campsite Visitations A Scout is Clean. While your Scouts are at morning merit badge sessions,
the Commissioners will visit your campsite. A colored feather will be placed in the tent that is best arranged and tidiest.
The top three scores will be announced during lunch in the dining hall. A sample visitation rating sheet will be distributed at the Sunday afternoon leaders meeting. The Commissioners will visit with leaders to address any health and safety
concerns and will be looking for top notch, clean campsites.
Directions to Camp Workcoeman Camp Workcoeman is located off West Hill Road in New Hartford.
From the south (Middletown, Waterbury, etc.): take Route 8 North to the Pinewoods Road Exit 46. Take a right at the
end of the exit ramp past the Chatterley’s Banquet Hall to the intersection of Route 183. Go left on Route 183 and take
the next right onto West Hill Road. Follow the signs to Camp Workcoeman from there.
From the Hartford area: follow Route 44 to Winsted. Go left onto Route 183 and take a left onto West Hill Road. Follow
the signs to Camp Workcoeman from there.
Damage to Camp Property and Equipment The cost of camp equipment such as tents,
mattresses, bunks and campsite tables is quite expensive. For any camp property that is deliberately damaged, lost or
stolen, the unit will be charged for the cost of repair or replacement.
Camp Disciplinary Policy The Scout Oath and Law is the basis for the conduct of Scouts, Scouters
and staff in camp. Scouts who display improper conduct will be asked to leave camp immediately with their parents.
Troop leaders will be informed by the camp staff of any Scouts displaying misconduct. The following are examples of
conduct that will result in the expulsion of an individual from camp: deliberate injury to another person, theft, vandalism, fighting and the use of alcohol or drugs. Prescription and over-the-counter medications must be submitted to the
Camp Nurse. Improper use of drugs is strictly prohibited. Possession or use of alcohol and the improper use of drugs will
result in the expulsion from camp and referral to law enforcement agencies.
9
Campworkcoeman.org
sunday check-in procedures
Check-in Begins at 2:00 PM
Immediately Upon Arrival
1. The Scoutmaster must check in with the Camp Director PRIOR to going to your campsite.
No Scouts will be allowed in the campsite until the Scoutmaster arrives and checks in
with the Camp Director.
You will need to submit the following:
• An accurate roster of Scouts and Scouters in camp. This list should include any
leaders rotating during the week with names and times of arrival and departure.
• All payment balances due for Scouts and extra leaders should be paid prior to
camp. Payments for last minute additional Scouts and extra leader fees must be
paid upon arrival.
2. All Scouts will be directed to their campsites to check-in with Troop leadership. Be sure to inform the camp
administration if you plan to gather Scouts and parents in a location other than your campsite.
One week prior to camp, you will receive an assigned time for your medical check-in with the nurse. Please arrive at the
parade ground pavilion at your assigned time with completed Medical Screening Forms for all Scouts and Scouters. Any
Scout with medications should accompany the leader including those with orders to self-carry.
*If medical forms are incomplete or not submitted ahead of time, your Troop will have to wait until the
end of check in to see the nurse.*
It’s very important that you follow the assigned times. Arriving before or after your time will affect everyone’s schedule.
Please keep your troop together through this process.
3. A Camp Staff Guide will be assigned to your troop to assist you and your Scouts with all check-in
procedures.
Sunday After Check-in
4:00
Scoutmaster Meeting in the Dining Hall
5:40
Parade Ground for Camp-wide Retreat and Staff Introductions
6:00
Dinner
Here you will receive information from the Camp Commissioners, the number
of waiters that you will need for meals and updates from the Program Director.
At least one leader from each troop must attend this meeting.
AFTER DINNER...
10
7:30
Camp Orientation - A review of Aquatic, Shooting Sports and General Camp
8:30
Opening Campfire hosted by the Camp Staff
Rules will be given at specific locations to be announced. A Merit Badge Sign-Up
Session will be held at the Parade Ground pavilion for any last minute changes.
Campworkcoeman.org
friday at camp workcoeman
friday night
family bar-b-que &
Court of honor
family bar-b-que
Our traditional Family Bar-B-Que will begin the evening festivities in the Dining Hall
for all Scouts, Scouters, parents and visitors with reservations. Our serving time is
approximately 6:00 p.m. Reservations are required for all visitors. Be sure to submit
your “BAR-B-QUE RESERVATIONS FORM” (found in the “Camp Forms” section) to the
Camp Business Manager by Tuesday at noon. The cost for family and visitors is $8
for adults and $5 for children ten and under.
Campfire & COURT OF HONOR
The Campwide Campfire and Court of Honor will be conducted on Friday evening
after dinner in the amphitheater. In addition to Troops and the Staff performing
traditional skits, songs and cheers, advancement and other awards, some goofy, will
Don’t forget to visit the Trading Post for all of the goodies that you’ve had your eyes
Eachbadges
troop will
have
an opportunity
to present
on all week. Don’t forget to be
getpresented.
those Scout
likealso
Mile
Swim,
BSA Lifeguard
as an Honor Camper
award
a Scout
they feel best deserves the accolade. Additionally, Scouts will be
well as camp patches, shirts,
hatstoand
more.
presented their Veteran Camper awards, while troops fulfilling the requirements
for the CLASS “A” TROOP distincton will also be recognized.
check-out procedures
On Saturday, Troops will enjoy a continental breakfast with check out following. The Commissioners will distribute to
all troops a Campsite Check-Out form. Please complete the form and return it to your Camp Commissioner prior to
leaving camp. Your Camp Commissioner can assist with all check-out procedures.
•
•
•
•
•
•
11
PLEASE BE SURE ...
that all tent flaps are down and bunks are moved to the center of each tent.
to bring all trash to the dumpsters behind the Ranger’s Shop.
the latrine is cleaned and ready for the next troop.
to pick up any medications from the nurse prior to departure.
to bring to the camp office your evaluation forms and any other business forms or borrowed items
that you have reserved a campsite for 2019 online before you depart!
Campworkcoeman.org
PROGRAM HIGHLIGHTS
Camp Workcoeman continues to be a leader in
Scouting Shooting Sports programs as one of the
initial camps to offer a Pistol Shooting Program.
This program is open to Scouts who are at least 13
years old and have completed the eighth grade.
There are two options for Scouts to participate:
• A Five-Day Program consisting of a Winchester/NRA
Marksmanship Qualification course
Monday: Orientation
Tuesday – Friday: Range Training and Qualification Sessions
• A One-Day Open Shoot consisting of safety review followed
by an open shoot session
Participation forms signed by parents are required. The form is available in the Forms Section in this guide. There is a
strict instructor to shooter ratio of 1:2. The number of participants could be limited based on available instructors.
DRONE PILOTING
9-SQUARE IN THE AIR
12
TROOP QUIDDITCH
FLYING SQUIRREL
Campworkcoeman.org
the merit badge program
The Merit Badge program at Camp Workcoeman is extensive and includes approximately 45 badges spread over
three morning sessions and an afternoon period.
Troops are requested to complete merit badge selections prior to arriving at camp through a fillable Google
Form that will be emailed to troop contacts in May. Troop leadership will be able to complete merit badge registration for each Scout, or Scouts will be able to complete the information themselves. Please make sure your
merit badge selections are submitted at least three weeks prior to your arrival at camp. The Program Director will be in contact with any necessary information and program changes.
GENERAL GUIDELINES
• It is suggested that Scouts who have not attained the First Class rank utilize the “Tenderfoot’s Compass Pro-
gram.” Included in the Tenderfoot’s Compass curriculum is Swimming Merit Badge, which will take place during
the 11:15 merit badge time. Earning Swimming Merit Badge opens the door to many challenging aquatic opportunities for Scouts.
• A limit of 3 merit badges is recommended for Scouts, especially if difficult badges are being considered. If the
advancement load of a Scout is too heavy, an otherwise fun week becomes one of disappointment.
• Advancement is one of eight methods of Scouting. **Don’t overload advancement at the expense of patrol and
troop activities.**
• Scouts should follow the buddy system for merit badge selection and are encouraged to sign-up with troop
buddies.
PRE-CAMP PREPARATIONS
• Some merit badges offered at camp may have prerequisites, while others require double time sessions for
completion at camp. The information in the following pages details the times at which merit badges are offered
as well as information that should be considered when making merit badge selections.
• The merit badge counselors have identified activities appropriate for Scouts with different experience levels and
listed necessary prerequisite merit badge requirements that cannot be completed at camp. Please be advised
that the list of prerequisites may be incomplete as a result of requirements changing between the publication of
this guide and the summer camp season. Scoutmasters and Scouts should review badge requirements ahead of
time to make sure each Scout is signed up for ability appropriate merit badges and comes to camp with necessary materials.
• Please see the appendix for merit badge specific prerequisite requirement sign-off sheets. These forms should
be completed to ensure Scouts are given credit for work that must be done outside of camp.
• We want Scouts to have an enjoyable time at camp and come away from the week with a feeling of accomplishment having earned merit badges towards which they have worked. The Workcoeman counselors encourage
you to use your experience as a Scoutmaster to guide your unit towards a successful and fun week at camp!
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Campworkcoeman.org
2018 merit badge time schedule
9:15 - 10:00 AM
Swimming
Astronomy
Rifle Shooting
Chess
Metalwork
Lifesaving (9:15-11:00)
Archery
Plant Science
Personal Fitness
Camping
First Aid (10:15-12:00)
Tenderfoot’s Compass (9:15-12:00)
Canoeing
Wilderness Survival
Orienteering
Environmental Science (Scouts in high school)
Basketry
Environmental Science (Scouts in middle school) (9:15-11:00)
BSA Lifeguard (9:15-12:00)
10:15 - 11:00 AM
Archery
Space Exploration
Personal Fitness
Kayaking
Camping
Small-Boat Sailing (10:15-12:00)
Orienteering
Insect Study
Wood Carving
Rifle Shooting
Soil and Water Conservation
Climbing
Swimming
Leatherwork
Mining in Society
11:15 AM - 12:00 PM
Weather
Athletics
Communication
Cooking (11:15-1:00)
Textile
Emergency Preparedness
Leatherwork
Nature
Electricity
Rowing
Shotgun Shooting
Climbing
Geocaching
Robotics
OTHER
Scouting Heritage (1:15-2:00 PM)
Bird Study (6:30-7:15 AM)
Forestry (1:15-2:00 PM)
Snorkeling BSA (1:15-2:00 PM)
BSA Stand Up Paddleboarding (1:15-2:00 PM)
Bold Type - Eagle Required
All merit badge times are subject to change due to staff and equipment limitations. Any changes will be disclosed at the leader
orientation meetings on April 28, May 5 & 12 and will be posted on the CampWorkcoeman.org website.
For up-to-date information or special requests contact Program Director: Tom Leisten at tleisten@campworkcoeman.org
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Campworkcoeman.org
merit badge info guide
The following information suggests difficulty levels appropriate for a Scout’s experience at camp. Prerequisites are
requirements that cannot be met at camp. Please see the Camp Workcoeman website for up-to-date prerequisite Information.
(E) Indicates an Eagle required merit badge.
Ecology and Conservation
BIRD STUDY
Environmental Science (E)
Times:
Location:
Prerequisites:
Note:
6:30 – 7:15
Henry Griffin Nature Center
#5 should be started in advance
Recommended for 3rd year camper or older
Times:
9:15 – 10:00 – Scouts in High School
9:15 – 11:00* – Scouts in Middle School
Henry Griffin Nature Center
None - Recommended for 3rd year campers or older
Location:
Prerequisites:
* Double session for middle school age Scouts, single session
recommended for high school age Scouts
FORESTRY
INSECT STUDY
NATURE
PLANT SCIENCE
15
Times:
Location:
Prerequisites:
Note:
1:15 – 2:00
Henry Griffin Nature Center
None
Recommended for 2nd year campers or older
Times:
Location:
Prerequisites:
Note:
10:15 – 11:00
Henry Griffin Nature Center
#5 should be started in advance
Recommended for all Scouts
Times:
Location:
Prerequisites:
Note:
Times:
Location:
Prerequisites:
Note:
11:15 – 12:00
Henry Griffin Nature Center
None
Recommended for all Scouts
9:15 – 10:00
Henry Griffin Nature Center
None
Recommended for all Scouts
Campworkcoeman.org
merit badge info guide
The following information suggests difficulty levels appropriate for a Scout’s experience at camp. Prerequisites are
requirements that cannot be met at camp. Please see the Camp Workcoeman website for up-to-date prerequisite Information.
(E) Indicates an Eagle required merit badge.
Ecology and Conservation continued
soil & water conservation
weather
Times:
Location:
Prerequisites:
Note:
11:15-12:00
Henry Griffin Nature Center
None
Recommended for 2nd year campers
Times:
Location:
Prerequisites:
Note:
1:15 – 2:00 PM
Henry Griffin Nature Center
None
Recommended for all Scouts
additional merit badge opportunities
COMMUNICATION (E)
emergency preparedness (E)
Times:
Location:
Prerequisites:
Note:
11:15 – 12:00
To be announced at camp
#5, 7 & 8
Recommended for 3rd year campers and older.
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00
Sturge Shields Campcraft Area
#1, #6c, #8b, #9 - May earn First Aid simultaneously
Recommended for 3rd year campers and older.
**Please see pre-requisite sign-off sheet in the appendix
Times:
Location:
Prerequisites:
Note:
10:15 – 12:00
Sturge Shields Campcraft Area
#2d
Recommended for 3rd year campers and older
Time:
Location:
Prerequisites:
Note:
1:15 - 2:00
Parade Ground Pavilion
#5 & 6
Recommended for all Scouts.
first aid (E)
SCOUTING HERITAGE
16
Campworkcoeman.org
merit badge info guide
The following information suggests difficulty levels appropriate for a Scout’s experience at camp. Prerequisites are
requirements that cannot be met at camp. Please see the Camp Workcoeman website for up-to-date prerequisite Information.
(E) Indicates an Eagle required merit badge.
Outdoor skills
Camping (E)
Times:
Location:
Prerequisites:
Note:
Cooking (E)
Times: 11:15 – 1:00 – 2 Sections with max of 8 Scouts in each section
Location: Sturge Shields Campcraft Area
Prerequisites: #4
Note: Recommended for Scouts with significant cooking experience.
Scouts will eat lunch in the Campcraft area on Wednesday,
Thursday and Friday.
**Extra cost of $10 per participant to cover cost of equipment
ORIENTEERING
GEOCACHing
Wilderness Survival
17
9:15 – 10:00, 10:15-11:00
Sturge Shields Campcraft Area
#4b, #5e, #7b, #8d, #9a, #9b
Recommended for Scoits atlesat First Class rank
**Please see pre-requisite sign-off sheet in the appendix
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00, 10:15 – 11:00
Sturge Shields Campcraft Area
None
Recommended for Scouts that have completed First Class
rank requirements 4a and 4b.
Times:
Location:
Prerequisites:
Note:
11:15 – 12:00
Sturge Shields Campcraft Area
#7 and signed off-camp permission slip
Recommended for Scouts that have completed Orienteer
ing merit badge or have experience geocaching.
**Scouts should bring a GPS receiver or other device that
can be used to find geocaches
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00, 10:15 – 11:00
Sturge Shields Campcraft Area
#5
Recommended for Scouts who have completed Camping
Merit Badge. Scouts will participate in a survival overnight,
leaving from the Campcraft area at 7:00 on Thursday.
Campworkcoeman.org
merit badge info guide
The following information suggests difficulty levels appropriate for a Scout’s experience at camp. Prerequisites are
requirements that cannot be met at camp. Please see the Camp Workcoeman website for up-to-date prerequisite Information.
(E) Indicates an Eagle required merit badge.
Aquatics
Canoeing
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00
Waterfront Boating Area
Successful completion of the BSA swimmer test (Blue tag)
Recommended for 2nd year campers or older
Times:
Location:
Prerequisites:
Note:
10:15-11:00
Waterfront Boating Area
Successful completion of the BSA swimmer test (Blue tag)
Recommended for 3rd year campers or older.
Class size limited to 8 Scouts.
Times:
Location:
Prerequisites:
Note:
9:15 – 11:00
Waterfront Swimming Area
Successful completion of the BSA swimmer test (Blue tag)
Recommended for strong swimmers having already
completed Swimming Merit Badge
Times:
Location:
Prerequisites:
Note:
11:15 – 12:00
Waterfront Boating Area
Successful completion of the BSA swimmer test (Blue tag)
Recommended for 2nd year campers or older
Times:
Location:
Prerequisites:
Note:
10:15 – 12:00
Waterfront Boating Area
Successful completion of the BSA swimmer test (Blue tag)
Recommended for 3rd year campers or older
Times:
9:15 – 10:00, 10:15 – 11:00
Kayaking
Lifesaving (E)
Rowing
Small-Boat Sailing
Swimming (E)
(The 11:15 session is reserved for the Tenderfoot’s Compass Program only)
Location:
Prerequisites:
Note:
18
Waterfront Swimming Area
None
Recommended for all Scouts
Campworkcoeman.org
merit badge info guide
The following information suggests difficulty levels appropriate for a Scout’s experience at camp. Prerequisites are
requirements that cannot be met at camp. Please see the Camp Workcoeman website for up-to-date prerequisite Information.
(E) Indicates an Eagle required merit badge.
Shooting sports
Archery
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00, 10:15 – 11:00
Archery Range
None
Recommended for 2nd year campers or older
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00, 10:15 – 11:00
Rifle Range
None
Recommended for 3rd year campers or older
Times:
Location:
Prerequisites:
Note:
11:15 – 12:00
Shotgun Range
Must be age 13
Extra cost of $10 per participant to cover cost of equipment
Rifle shooting
shotgun shooting
field sports & Climbing
Climbing
19
Times:
Location:
Prerequisites:
Note:
10:15 – 11:00, 11:15-12:00
Climbing Tower on Sports Field
None
Scouts must be at least 13 years of age
Personal Fitness (E)
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00, 10:15-11:00
Sports Field
#1, #6, #7, #8
Recommended for 2nd year campers and older
Scouts must be prepared with proper footwear and clothing
**Please see pre-requisite sign-off sheet in the appendix
ATHLETICS
Times:
Location:
Prerequisites:
Note:
11:15 – 12:00
Sports Field
#2a
#3a, 3b and 5 cannot be completed at camp
Recommended for all Scouts
Scouts must be prepared with proper footwear and clothing
Campworkcoeman.org
merit badge info guide
The following information suggests difficulty levels appropriate for a Scout’s experience at camp. Prerequisites are
requirements that cannot be met at camp. Please see the Camp Workcoeman website for up-to-date prerequisite Information.
(E) Indicates an Eagle required merit badge.
handicraft
basketry
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00
Handicraft Chapel
None
Recommended for all Scouts
Additional material costs at the Trading Post - $11-$22
depending on project kit
Times:
Location:
Prerequisites:
Note:
10:15 – 11:00, 11:15 – 12:00
Handicraft Chapel
None
Recommended for all Scouts
Additional material costs at the Trading Post ($4-$8 kit cost)
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00
Handicraft Chapel
None
Recommended for Scouts 13 years or older
Additional material costs at the Trading Post ($15 kit cost)
Times:
Location:
Prerequisites:
Note:
11:15 – 12:00
Handicraft Chapel
#2a
Recommended for all Scouts
Times:
Location:
Prerequisites:
Note:
10:15 – 11:00
Handicraft Chapel
Totin’ Chip Card
Recommended for 2nd year campers and older
Additional material costs at the Trading Post ($3 kit cost)
leatherwork
metalwork
TEXTILE
wood carving
20
Campworkcoeman.org
merit badge info guide
The following information suggests difficulty levels appropriate for a Scout’s experience at camp. Prerequisites are
requirements that cannot be met at camp. Please see the Camp Workcoeman website for up-to-date prerequisite Information.
(E) Indicates an Eagle required merit badge.
STEM
Science • Technology • Engineering • Math
astronomy
Times:
Location:
Prerequisites:
Note:
9:15 – 10:00 AM, plus additional times for observations
STEM Explorations Center
None
Recommended for 3rd year campers or older.
Please remember that Scouts must complete a three hour
observation lasting from 9pm-12am on one night.
Observations and other requirements also depend upon the weather.
Times:
Location:
Prerequisites:
Note:
9:15-10:00
STEM Explorations Center
None
Recommended for 2nd year campers and older.
Times:
Location:
Prerequisites:
Note:
11:15-12:00
STEM Explorations Center
#2 and #8
Recommended for all Scouts.
Times:
Location:
Prerequisites:
Note:
10:15-11:00
STEM Explorations Center
None
Recommended for 3rd year campers or older.
Times:
Location:
Prerequisites:
Note:
11:15-12:00
STEM Explorations Center
None
Recommended for Scouts age 13 or older.
Class may also meet during Siesta to complete requirements.
Times:
Location:
Prerequisites:
Note:
11:15-12:00
STEM Explorations Center
None
Recommended for 2nd year campers and older.
Additional material costs at the Trading Post ( $11 kit cost)
chess
ELECTRICITY
MINING in SOCIEty
robotics
space exploration
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Campworkcoeman.org
achievement awards & recognition
22
BSA LIFEGUARD
This aquatics certification is available to both Scouts and Scouters. Candidates must spend all
three morning merit badge sessions and additional time in the afternoon. CPR certification is
required, and it is recommended to come to camp with this requirement completed. Participants must be at least 15 years old per BSA requirement and have strong swimming ability
and watercraft proficiency. Scouts taking BSA Ligeguard should have already earned Lifesaving Merit Badge. Participants are required to attend all three merit badge times (9:15 - 12:00)
mile swim bsa
Designed to teach Scouts and Scouters about the endurance and training necessary to swim
long distances, the Mile Swim award can be completed during your week at camp. Scouts and
Scouters are encouraged to follow the Mile Swim build up standards available around the rim
of your buddy tag, working up to the completion of a full mile by weeks end. Qualifications
and actual times for practice and instruction will be announced at camp.
polar bear swimmer
Imagine waking from a restful night’s sleep to “plunge” into beautiful West Hill Pond before
reveille. Your troop is welcome every morning to do just that! You’ll be surprised how many
other Scouts and leaders will be there too! You’ll receive a special Polar Bear patch if you
attend 4 out of 5 days during the week!
paul bunyan woodsman award
This award recognizes advanced axemanship and is offered by the Scoutcraft staff by appointment. A minimum 2 hour commitment is required for this award in addition to troop
instructional time. Contact anyone in the Scoutcraft area to arrange a time.
iron man challenge
A great test of a Scout’s strength and endurance is the Iron Man Challenge. Scouts must swim
1 mile, run 2 miles, and canoe 2 miles. The tests are conducted at various times during the
week and a special patch is awarded at the Friday Court of Honor to all “Iron Men!”
bsa stand up paddleboarding
The BSA Stand Up Paddleboarding Award introduces Scouts to the basics of stand up paddleboarding on calm water including skills, equipment, self rescue and safety precautions. This
award also encourages Scouts to develop paddling skills that promote fitness and safe aquatics recreation. Offered during Siesta.
SNORKELING BSA
Snorkeling BSA is intended to introduce Scouts and Scouters to the special skills, equipment,
and safety precautions associated with snorkeling, which encouraged the development of
aquatics skills that promote fitness and recreation, providing a foundation for those who
thrive to participate in more advanced underwater activity. Qualifications and actual times for
practice and instruction will be announced at camp.
Campworkcoeman.org
the tenderfoot’s compass program
Introducing young Scouts to what Scouting is all about
The Tenderfoot’s Compass program is designed for first year and all young Scouts new to
the summer camp experience. By participating in the program, Scouts are introduced to
camping at Workcoeman, have the opportunity to learn cooperatively using the patrol
method, learn about the history of Scouting and can even complete Swimming Merit
Badge.
Program Highlights
• Patrol based activities
Show the Scouts what they have to look forward to in
years ahead
• Cooperative patrol learning
Scouts develop and reinforce skills with their friends
• Scout skills instruction
Learn how to be a true Boy Scout
• Swimming Merit Badge
Multiple counselors providing individualized instruction
• Rank requirements
Skill development so Scouts can work towards
Tenderfoot, 2nd Class and 1st Class ranks
• Scouts will complete a 5 mile hike
Thursday from 10:00 a.m. - 2:00 p.m.
Scouts spending their week in Tenderfoot’s Compass will meet for all three periods of the
morning merit badge sessions. The program is divided into three portions:
• 9:15 – 10:00 –
• 10:15 – 11:00 –
• 11:15 – 12:00 –
Scouts learn about camp and essential skills necessary for rank advancement
Scouts meet in the program area for skill instruction and patrol competition
Participants meet at the waterfront for Swimming Merit Badge – this swimming
class is only open to Scouts in the Tenderfoot’s Compass Program
The patrol method is an integral component of Scouting. During the week, Scouts will be learning and practicing skills within patrols composed of Scouts of their own and other troops. The teamwork and cooperative spirit will be an experience that Scouts can bring back to their own troops.
All Scouts participating in the Tenderfoot’s
Compass Program will receive a special patch!
Enroll your new Scouts into Tenderfoot’s Compass.
It will be an adventure that defines their Scouting
experience for years!
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Campworkcoeman.org
program area highlights
waterfront...
The waterfront at Camp Workcoeman is the finest in the council!
It has all the facilities for the best aquatic programs. The camp’s fleet of boats and
canoes includes many varieties of sail boats for beginners and experts. West Hill Pond
is also a great place to try your hand at sailing and kayaking. The swimming opportunities are superb, offering a world of water fun and knowledge always under the
utmost safety. Mile Swim, Snorkeling BSA, and Lifeguard BSA are among the special
awards instructed by our trained aquatics staff.
ecology/conservation... Camp Workcoeman is the location of the
Henry Griffin Nature Lodge. It is the center of the outdoor laboratory for all of its
programs, an excellent demonstration area and example of wilderness management. Many displays and activities let Scouts experience the need for nature and
conservation. Come see all of the live exhibits in the Nature Lodge.
shooting and field sports... This is the camp’s center for fitness development. Activities are inter-troop, patrol and individually centered. Our basketball
court is a real hit. Rifle shooting, shotgun shooting and archery are always popular
activities. Muzzle loading rifle shooting is a great part of the Shawtown Wilderness
Trek for older Scouts.
scoutcraft...
The Sturge Shields Scoutcraft area offers patrols and troops a
wide variety of outdoor activities.These programs encourage self-reliance and foster an
appreciation of the enviornment, all while having fun. Many of these activities include
demonstrations that show Scouts the techniques of camping, ranging from basic cooking to advanced survival. The Scoutcraft Staff offers training for both youth leaders and
Scouters, with a special emphesis on Leave No Trace. Most Scoutcraft activities occur at
the Stuge Shields Campcraft Area located at the beginning of the Red Trail; however,
many activities can be conducted in your campsite.
handicraft...
The Handicraft Area offers a choice of formal or informal
programs for those Scouts who would like to try their hand at a specific craft. The
Trading Post carries a large variety of craft supplies in addition to materials on hand
in the Handicraft Pavilion. You are always welcome to bring your own supplies and
finished work to show others.
climbing and rappelling... This new 4 sided, 32’ tall rock climbing
tower is for Scouts who want to test their strength and ability to conquer the various new slopes and obstacles that makes this an extreme challenge. “The Wall” is
located at the Activities Field where Scouts are shown the proper use of technical climbing equipment including climbing harnesses, ropes and belay devices.
24
Campworkcoeman.org
troop activity suggestions
The following is a list of fun program activities that your troop can consider when planning your afternoon and evening camp
program. They are listed by program and are simply a list of suggestions. Please don’t hesitate to ask for any assistance with
any other programs not listed here.
WaterfronT
Farmington River Tubing (out of camp)
Swimming Instruction
Water Trampoline
Fishing Trip Around the Lake
“THE MAT”
Water Polo
Watermelon Polo
Funyaking
Troop Swim
Water Basketball Troop Sailing
Troop Canoeing Team Canoe Hike
Paddleboarding
shooting sports
Rifle Shoot
Shotgun Shoot
BSA Pistol Shooting Program
(must meet eligibility requirements)
Target Archery
field sports
Basketball
Soccer
Whiffle Ball
Ultimate Frisbee
Capture the Flag
9-Square in the Air
Volleyball
Softball
KanJam
Quidditch
Gaga Dodge Ball
Climbing & Rappelling
Troop Climb
Initiative Games
Flying Squirrel
handicraft
(may require items available at the Trading Post)
Woodcarving & Whittling
Leatherworking
Troop Plaque Painting
Neckerchief Slides
Scout Staves
Duct Tape Crafts
ecology/conservation
Underwater Nature Hike
Edible Plant Hike & Bite
Nature Trail Hike
Troop Fishing
Star Gazing
Nature Games
Conservation Project
25
Scoutcraft
Cooking
Backpacking Meals
Box Oven Basics
Camp Stove Baking
Dutch Oven Essentials
Fundamentals of Foil
Iron Chef Challenge
Kabobery
Menu Planning
Pocket Knife Cookery
Stove Safety
Wok Cookery
Many Scoutcraft activities can be
conducted in your troop’s site.
Arrangements for this can be
made with the Scoutcraft Director.
FIRECRAFT
Advanced Fire Starting
Campfire Basics
Primitive Fire Starting
Hiking and Backpacking
Five Mile Hike
Overlook Hike
Water Treatment on the Trail
Navigation
Compass Challenge
Cross-Country Orienteering Course
First Class Orienteering Course
GeoScouting
Map Reading
Navigation Without a Map or Compass
Trail Briefing
Ropework
Advanced Pioneering
Basic Knots
Monkey’s Fist
Rope Making
Rudiments of Splicing
Turks Head Kerchief Slides
Additional Programs
Campsite Selection
Leave No Trace orientation
Survival Techniques
Tomahawk Throw
Camp Sanitation
Packing a Backpack
Bear Briefing
STEM
Troop/Patrol Chess Tournament
Patrol Excape Room (Patrol of Scouts age 15+)
Drone Piloting (Scouts age 14+)
Essentials of Cell Phone Photography
Campworkcoeman.org
cope • challenging outdoor personal experience
COPE is a national program of the Boy Scouts of America which stands for
“Challenging Outdoor Personal Experience”.
The program consists of initiative games, trust events and low and high challenge course events.
There are activities that challenge the entire group of participants, while others develop individual
skills and agility. Participants climb, swing, balance, jump, rappel and devise solutions to a variety of
problems. Most participants achieve much more than they imagined they could.
As a non-competitive program, COPE permits every participant to achieve their personal best!
Group activities are ideal for enhancing the leadership and teamwork within Scout units.
COPE emphasizes eight major goals:
• Communication
• Teamwork
• Decision Making
• Trust
• Planning
• Problem Solving
• Leadership
• Self-Esteem
COPE SCHEDULE
Monday thru Thursday from 2:00-4:00 pm.
Participants must be 13 years of age. It is highly recommended that
participants be in a leadership position within their individual units.
Program Outline:
Monday :: Participants will take part in a series of initiative games
that will challenge communication and develop teamwork and trust
within the group.
Tuesday and Wednesday :: Low-course elements - Participants will
be challenged to work as a team to solve problems, effectively communicate and practice effective leadership.
Thursday :: High-course elements - Participants will travel to Camp
Mattatuck to challenge themselves and the team on the high COPE
elements.
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Campworkcoeman.org
weekly contests
camp workcoeman fishing derby :: Each week a camp wide fishing derby will be held. Scouts should
have their fish measured at the waterfront. We encourage catch and release. The Scout that catches the biggest fish will be
presented a prize.
shooting tournaments :: Archery and rifle shooting tournaments are scheduled for all camp “Sharp Shooters”.
Events will be held Friday during the Camp Wide activities session.
scavenger hunt :: You never know what you can find at Camp Workcoeman! The hunt runs all week and is
coordinated by the Nature Lodge. A special ribbon is presented to the winner.
WORKCOEMAN WATER CARNIVAL
NEW for 2018
Friday afternoons on beautiful West Hill Pond will
be a variety of troop and patrol competitions. From
a Water Polo tournament to canoe races and other
events, Scouts will have the opportunity to work
together as troops and patrols to compete with
others and winners being recognized. Event details
and official rules with be distributed ahead of time
for Scouts to prepare.
become a workcoeman class “a” troop
This is a weeklong opportunity for all troops to work toward earning Class “A” status. Being recognized as a Workcoeman Class “A”
Troop is a mark of full participation in nearly all camp programs from those listed below. All troops completing the requirements
will earn this distinction and will be listed on a special “Class A Honor Board”. Troops will also be recognized at the Court of Honor
where they will receive a ribbon and plaque and each Scout receives a shoulder patch.
During the week, any troop that meets a minimum standard of points in various camp wide activities will have the distinction of
being named a Camp Workcoeman Class “A” Troop.
Those camp wide activities are as follows:
1.
2.
3.
4.
Daily Campsite Visitation Results
Flag Ceremony Appearance
Veteran Camper Awards
Nature Scavenger Hunt
5. Camp Wide Game
6. Program Area Challenges
7. Patrol Competition
8. Religious Service Attendance
order of the arrow
OA members are encouraged to bring their sashes with them to camp and wear them on OA day. An OA service
project will be conducted and all members are asked to participate. This can be used for credit on the Veteran Camper
Award. Brotherhood Ceremonies will also be conducted some weeks for those Ordeal members wishing to advance
their OA membership. A special crackerbarrel is planned for Order of the Arrow members on Tuesday at 9:00 PM in
the campfire circle. This is a great time to share lodge and chapter customs or otherwise socialize with OA members.
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Campworkcoeman.org
2018 camp theme
Aloha from Camp Workcoeman!
Break out the Hawaiian Shirts! This year come celebrate the summer with
an adventure in the islands as Workcoeman hosts a week long Hawaiian Luau. Your week at
camp will be a memorable experience of palm trees, grass skirts, and island games.
The spirit of the islands will come alive with skits and activities throughout the week. Your
Scouts will be challenged and their skills put to the test with a variety of trials and tasks
that tie in Polynesian cultures with Scouting fundamentals.
Your troop can further participate by decorating your campsite
with Hawaiian props, shirts, grass skirts, and anything else
to welcome the spirit of the islands at Workcoeman. It’ll be
a Luau your Scouts won’t want to miss!
Mahalo and Aloha from Workcoeman!
2018 Theme Days
This is a fun way to enhance your week at camp. Come to morning colors dressed up for the day! An entirely frivolous way to have
some fun and bond with your fellow Scouts. Participation is always
optional and does not impact Spirit Stick or Class “A” points.
Troop Shirt Monday _ Start the week showing off your troop
pride. Wear what you’ve got to show what sets your troop or patrol aside from everyone else.
Color Wars Tuesday _ As a troop, pick a color and have everyone
dress head-to-toe. See if your troop can outdo the others.
Waikiki Wednesday _ Wear your Hawaiian gear and get ready for
the Wednesday night Luau!
Crazy Hat Day Thursday _ Let go of your inhibitions as anything
that fits on your head counts as a hat. Let’s see who comes up with
the wildest head gear in camp!
Workcoeman Shirt Friday _ What better way to show you’ve had
a great time at camp during the week than wearing a camp t-shirt!
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Campworkcoeman.org
special programs and events
“the spirit stick”
The Spirit Stick is awarded every evening to the troop that shows the most spirit in camp. Winners of the
Spirit Stick earn a right and a responsibility for the troop. The “right” is to be the first troop dismissed out of
the dining hall after meals. The “responsibility” is that the troop must affix a small totem to the Spirit Stick
which indicates they earned the stick for the day.
Shawtown outpost trek
This trek for veteran Scouts offers boys a chance to experience Camp Workcoeman’s frontiersman past.
Scouts will trek out of camp after lunch, fire muzzle-loading rifles and spend the afternoon and night
hiking the trails of camp, throwing tomahawks, trail cooking, and learning Shawtown folklore. Scouts
will hike back in time for Polar Bear Swim the next morning. This program is an excellent opportunity
for Scouts to learn advanced
discover scuba
Every Wednesday PADI certified instructors from Enfield SCUBA will come to camp and offer a
full Discover Scuba course. The weekly experience is open to Scouts age 13 and over. Adult leaders are also welcome to participate. This program requires an extra fee of $50 per-participant and
there is a minimum of four participants required to run the program. Registration with the Program
Director prior to your week at camp is requested to reserve your spot. This makes a great activity for an
older boy patrol!
farmington river tubing
Your troop can arrange for a tubing trip down the Farmington River through Satan’s Kingdom; a great way
to spend a hot summer afternoon! Reservations must be made two weeks in advance by contacting the
Program Director. Transportation to and from the river is up to the troop. An additional fee and a completed
parental permission form is required for all youth participants. This form can be obtained by going to the
following web site - www.farmingtonrivertubing.com. As this is considered an individual troop activity, a
Tour Permit must be submitted. This can be done at the Camp Office.
farmington river kayak trip
This trip on the Farmington River is a fun activity, especially for those working on Kayaking BSA. It’s a great
way to use your kayaking skills. Scouts must be 13 years old and a blue tag swimmer. Scouts depart Thursday
after lunch and return prior to dinner.
camp wide games
Wednesday evenings from 7:00-9:00 pm are set for inter-troop patrol competition. Each program area will
host an activity to challenge your Scouts to work together as well as compete against the rest of the camp.
The winner will be recognized at Friday’s Court of Honor.
buckskin tomahawk throw
Located in the Sturge Shields Campcraft Area, this fun activity tests your ability to learn a special buckskin
skill. This activity is offered by the Scoutcraft Staff during troop activity periods and during the 4 o’clock
free period.
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Campworkcoeman.org
this page “for leaders only”
“Lou’s Lounge”
This is a special place for leaders to enjoy a break from all of the action. It is located in the conference room area below the dining
hall. Leaders are also welcome to relax and put your feet up or just use the rest rooms. Occasionally a “snoring contest” occurs! This
special place is off limits to Scouts.
WiFi Internet Service
is available as a courtesy for all leaders.
The signal is available anywhere around the parade ground area. “Leaders Only!”
Please request the password at the camp office.
Leader’s Roundtables
Held twice during the week, at 8:00 PM on Monday night in the downstairs dining hall conference room and Thursday at 10:30 AM at
a location to be announced. This open forum is an opportunity for troop leaders and key staff to gather and answer questions, solve
problems and discuss concerns, as well as share your suggestions and camping experiences. As always, the Commissioner Staff is
available to assist with anything during the week.
Activites & Awards for Leaders
Scoutmasters should have fun too!
camp workcoeman rusty man
A great opportunity for leaders who would like to earn the Iron Man Award but can’t because time has began to make the iron
“rust.” This event is designed especially for them. The leaders must complete a 1/2 mile run, 1/4 mile swim and a 1/2 mile canoe to
be dubbed a “Camp Workcoeman Rusty Man.”
scoutmaster shoot-off / Corn Hole competition
These events are held during the Friday open programing time. Leaders can demonstrate their ability in a rifle and archery shootoff competition. Another leader event offered at this time is a Corn Hole tournament. Special presentations will be made during
the Friday evening Court of Honor.
cast iron chef
Try your hand at this Scoutmaster Dessert Cook-off! This competition is held on Wednesday during the campsite dinner program.
Your dish will be judged on creativity, taste and originality by a panel of staff dessert experts! The winning dish will be announced
at the Friday Court of Honor with the winning chef receiving a special prize.
scoutmaster merit badge
Any leader can earn the Scoutmaster Merit Badge patch by completing the following requirements:
•
•
•
•
Assist with 3 free swims throughout the week
Participate in 3 polar bear swims as a swimmer or lifeguard
Help out in a program area at least 2 days
Participate in one of two Scoutmaster competitions:
the Scoutmaster Shoot-off or the Scoutmaster Horseshoe Competition
• Explain in 50 word or less what “Scout Spirit” means to you
• Read Grace at 1 meal
If you have previously earned the SM Merit Badge patch, you can complete additional requirements for additional years.
30
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scout leader training
A series of leader training opportunities will again be offered this summer. We invite any of your troop leaders who are in camp to attend these
sessions as well. Pocket certificates will be presented to all that complete these sessions.
BSA AQUATIC SUPERVISOR
Swimming & Water Rescue
This national program provides leaders with information and in-the-water skills to prevent,
recognize and respond to swimming emergencies during unit swimming activities. This
training will replace Safe Swim Defense as the certification required on the Unit Tour Permit.
Participants must be at least 16 years old and must be a blue swimmer. Daily at 11:15 a.m.
Paddle Craft Safety
This is the companion course that expands on Safety Afloat training to include the basic skills
and knowledge needed for a unit leader to supervise most float trips using canoes. This
training will replace Safety Afloat as the certification required on the Unit Tour Permit.
Development of personal canoeing skills is emphasized. Those taking the course must be 16
years old and be able to pass the BSA Swimmer test. Daily at 3:15 p.m.
TREK SAFELY
The Trek Safely Program is a BSA course conceived to help youth leaders and Scouters plan
and carry out a safe trekking experience for the members of their troop. The course does not
teach specific skills like backpacking or caving, but rather instructs participants in planning
and contingency preparation. This training can be arranged by request in the Sturge
Shields Campcraft Area.
“Leave no Trace”
Outdoor Ethics
The Leave No Trace program instills in Scouts and Scouters an outdoor ethic that encourages
responsible use of the outdoors, an ethic that reaches to the core mission of the Boy Scouts
of America. Camp Workcoeman offers both BSA Leave No Trace 101 and BSA Outdoor Ethics
Orientation. These programs are best for individual patrols or a Patrol Leaders’ Council, but
we can tailor a program to suit specific goal or groups of varying experience, ranging from
a single activity session to a Leave No Trace Overnight. This training can be arranged by
request in the Sturge Shields Campcraft Area.
IOLS
Introduction to Outdoor Leader Skills
This time intensive training provides Scouters with the basic camping abilities needed
to manage a boy-led program. Interested participants must register in advance with the
program director at tleisten@campworkcoeman.org. A minimum number of participants is
necessary for the course to be offered. Registration intent must be received three weeks in
advance in order to arrange for staff.
Interested participants MUST register IN ADVANCE with the program director.
A minimum number of participants is necessary for the course to be conducted.
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Veteran Camper Award
*Each Scout is responsible for securing staff signatures
*Completed forms due to the camp office by 5 pm, Friday
Scout’s Name: ___________________________ Troop: __________Campsite: __________________
*See Program Director for acceptable substitutions
1st Week – Hiker
Complete at least 10 requirements for TF, 2nd, or 1st Class ranks
Troop Leader:
__________
Classify as a red tag swimmer
Aquatics Staff:
__________
Complete 1-hour in camp service/conservation projects
Project Leader:
__________
Be an active member of your troop and patrol
Senior Patrol Leader:
__________
Complete at least 20 requirements for TF, 2nd, or 1st Class ranks
Troop Leader:
__________
Classify as a blue tag swimmer
Aquatics Staff:
__________
Complete 2 additional hours of in camp service/conservation projects
beyond 1st week requirements
Project Leader:
__________
Earn 1 Handicraft merit badge
Troop Leader:
__________
Troop Leader:
__________
Troop Leader:
__________
Project Leader:
__________
Senior Patrol Leader:
__________
Troop Leader:
__________
Earn Environmental Science and one additional Nature merit badge
Troop Leader:
__________
Complete 3 additional hours of in camp service/conservation projects
beyond 3rd week requirements
Project Leader:
__________
Participate in an older Scout camp program
(Discover SCUBA, Shawtown Trek, Pistol Shooting, Kayak Trip)*
Program Leader:
__________
Complete the Star Scout Rank
Troop Leader:
__________
Assist staff with instruction for 5 merit badge sessions
Staff Instructor:
__________
Participate in one camp training program
(COPE, Lifeguard BSA, CIT Week)*
Course Instructor:
__________
Lead Grace before a meal in the Dining Hall
Dining Manager:
__________
E
L
2nd Week – Camper
P
rd
3 Week – Pioneer
Complete the First Class rank
Earn Swimming and 1 Handicraft merit badge beyond 2nd week requirements
Complete 2 additional hours of in camp service/conservation projects
beyond 2nd week requirements
M
Hold a troop leadership position during camp
A
4th Week – Frontiersman
Earn Camping and one additional Scoutcraft merit badge
S
32
5th Week – Workcoeman Chief
Mystery task – See the Program Director early in the week
Program Director:
__________
th
6 Week – Workcoeman Legacy
Only for those Scouts that have truly stood the test of time. See the Program Director for details!
Scouts that successfully complete the program receive a personalized framed certificate recognizing their
Campworkcoeman.org
achievements.
Monday
Tuesday
7:00 AM
Religious Service
Wednesday
Thursday
7:00 AM
Religious Service
Merit Badge Instruction
Scoutmaster
Roundtable
Merit Badge Instruction
Merit Badge Instruction
Friday
6:00
Family Bar-B-Que
Campwide
Campwide
Campfire
Activities
&
Night
Court of
Honor
Saturday
Continental
Breakfast
Campsite
Clean-up
Departure
Waiters:
Set Times
7:45, 12:15
and 5:45
1:15 -2:00
8:30
Siesta
Mon.-Thur. 2:00-4:00
Taps
Flag Retreat
9:30
5:45
4:00 Daily
General Swim & Boating
Open Rifle & Archery Shoot
Tomahawk Throw
Open Climbing Wall (Mon & Wed only)
COPE
Campsite Clean-up
7:15
7:45
8:00
12:30
6:00
Workcoeman Scout Reservation Boy Scouts of America
Sunday
Time Off
For Staff
Staff
Meeting
12:00
Check-In:
Health Check
Swim Test
4:00
SM Meeting
(in the Dining Hall)
Camp
Orientation
MB Sign-up
Opening
Campfire
Reveille
Morning Colors
Breakfast
Lunch
Dinner
Troop #
Program Schedule
Campsite
All Periods
45 min
9:15
10:15
11:15
2:15
3:15
7:00
8:00
Scoutmaster
Roundtable
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33
Monday
Weekly Program & Training Schedule
Daily at 11:15
Swimming & Water Rescue
Tuesday
7:00 AM
Religious Service
6:30 AM
Iron Man Run
Wednesday Thursday
7:00 AM
Religious Service
Merit Badge Instruction
10:30 AM
Scoutmaster
Roundtable
Merit Badge Instruction
Merit Badge Instruction
Siesta:
Iron Man Canoe
Friday
10:00 – 2:00
Five Mile Hike
Departing After
Lunch
Farmington River
Kayak Trip
Open Program
2:15-5:00
Tomahawk
Tournament
Campwide
Games
7:00 PM
Scoutmaster
Shoot-Off
Campwide
Campfire
&
Court of
Honor
Intro Pistol Shoot
Intro Pistol Shoot
1:30-3:00
1:30-3:00
6:00
Family Bar-B-Que
SM Corn Hole
Tournament
Siesta:
Sailing Regata
11:00 – 1:00 – Pistol Range Sessions – Tues. – Fri
Troop Photos
begin at noon
Siesta M/W/Th : Snorkling BSA
3:15
Paddle Craft Safety Daily
Pistol Shooting
Orientation
7:00-9:00
8:00
SM Roundtable
in Lou’s Lounge
Saturday
Continental
Breakfast
Campsite
Clean-up
Departure
7:45, 12:15
and 5:45
Set Times
Reveille
Morning Colors
Breakfast
Lunch
Dinner
Waiters:
1:15 -2:00
8:30
Siesta
Mon.-Thur. 2:00-4:00
Taps
Flag Retreat
9:30
5:45
4:00 Daily
General Swim & Boating
Open Rifle & Archery Shoot
Tomahawk Throw
Open Climbing Wall (Mon & Wed only)
COPE
Campsite Clean-up
7:15
7:45
8:00
12:30
6:00
Workcoeman Scout Reservation Boy Scouts of America
Opening
Campfire
MB Sign-up
Camp
Orientation
(in the Dining Hall)
4:00
SM Meeting
Check-In:
Health Check
Swim Test
Staff
Meeting
12:00
Time Off
For Staff
Sunday
Use this as a guide to develop your troop’s week at camp.
All Periods
45 min
9:15
10:15
11:15
2:15
3:15
7:00
8:00
9:00 PM
OA Gathering
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34
camp forms
• Summer Camp Prep Form
• Bar-B-Que Sign-up Form
• Picture & Name Badge Order Form
• Medical Form
• Medication Administration Form
• Medical Screening Questionnaire
• Off Camp Activity Permission Form
• Pistol Program Participant Form
• Camper Release Form
• Scouter Resource Form
• Merit Badge Participation Forms
35
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Summer Camp Prep Form
Use this form to prepare for your week at summer
Send the following items at least 3 weeks prior to your week of camp.
•
•
•
•
•
•
Medical Forms - and related Medication Authorization Forms
(Send copies of Medical Forms as they are not returned)
Troop Activity Sign-up Form
Troop Roster
Adult Resource Form
Troop Leader Name Tag Order Form
Special Activity Form
Additional items requiring payment at camp:
Friday Bar-B-Que
# of Youth age 10 and under _____ x $5.00 = ______
# of Adults _____ x $8.00 = ______
Troop Photographs
# of Photos_____ x $10.00 = ______
We strongly suggest that you bring at least 3 troop checks to cover the costs at camp.
Contact Information
Camp Workcoeman
169 Camp Workcoeman Road
New Hartford, CT 06057
Office-860-379-2207
Fax- 860-379-1311
For information regarding
Camp Administration, Programs, Schedules contact:
Lou Seiser, Camp Director
860-806-0751
lseiser@campworkcoeman.org
36
Connecticut Rivers Council, BSA
60 Darlin Street
East Hartford, CT 06128
For information regarding
payments & reservations contact:
Kelly Dolnack, Executive Secretary
860-913-2752
kelly.dolnack@scouting.org
Jim Waters, Support Services Director
860-913-2750
jwaters@bsamail.org
Campworkcoeman.org
Camp Workcoeman
Bar-B-Que Sign-up Sheet
Troop #_______________Campsite___________________Camp Leader______________
# _______ Scouts & Leaders attending (no Charge)
# _______ Family members 11 years and older @ $8.00 each
$________
# _______ Family members 10 years and younger @ $5.00 each
$________
# _______ Total Attending Bar-B-Que
Total
$________
Please make all checks payable to CT RIVERS COUNCIL
Please have all Bar-B-Que reservations submitted into the camp office by noon
Tuesday. Tickets will be issued for all Scouts, Leaders and Guests Friday Morning.
Be sure that the number attending above is accurate.
Cash
Check
Received by__________________
This part returned to Troop Leader
Troop #_______________Campsite_____________________
Camp leader___________________
# _______ Scouts & Leaders attending (no charge)
# _______ Family members 11 years and older @ $8.00 each
$________
# _______ Family members 10 years and younger @ $5.00 each
$________
# _______ Total Attending Bar-B-Que
Total
Cash
37
Check
$________
Received by__________________
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Camp Workcoeman Troop Picture Order Form
Leader Name __________________________________________ Week _______________ Unit ___________________
Address ________________________________________
Telephone (_____) _______________________________
City/Town ____________________________ State _________ Zip _______________ Date _______________________
( ) Initial Order
( ) Additional Order
Print All Information
Name
# Amount Paid
Name
# Amount Paid
# Amount Paid
Name
1.
13.
25.
2.
14.
26.
3.
15.
27.
4.
16.
28.
5.
17.
29.
6.
18.
30.
7.
19.
31.
8.
20.
32.
9.
21.
33.
10.
22.
34.
11.
23.
Total Photographs Ordered ____________
12.
24.
Total Amount Paid ___________________
Make checks payable to C.R.C
Camp Workcoeman Troop Leader Name Badge Order Form
Leader Name __________________________________________ Week _______________ Unit ___________________
Address ________________________________________
Telephone (_____) _______________________________
City/Town ____________________________ State _________ Zip _______________ Date _______________________
Print All Information
Name
1.
Order name badges for your troop’s summer camp leaders.
Clearly print names in the space to the left.
3.
Send this form with payment 3 weeks prior to your week of camp
and the name badges will be there when you arrive.
4.
Badge Price: $5.00 ea.
2.
5.
6.
7.
8.
9.
10.
11.
12.
38
Camp Workcoeman
Summer Camp Troop Leader
Your Name Here
Total Name Badges Ordered _______ x $5.00 = _____________
Send this form and payment to:
Camp Workcoeman Trading Post
169 Camp Workcoeman Road
New Hartford, CT 06057
Make checks payable to C.R.C
Campworkcoeman.org
A
Part A: Informed Consent, Release Agreement, and Authorization
High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
Informed Consent, Release Agreement, and Authorization
I understand that participation in Scouting activities involves the risk of personal
injury, including death, due to the physical, mental, and emotional challenges in the
activities offered. Information about those activities may be obtained from the venue,
activity coordinators, or your local council. I also understand that participation in
these activities is entirely voluntary and requires participants to follow instructions
and abide by all applicable rules and the standards of conduct.
In case of an emergency involving me or my child, I understand that efforts will
be made to contact the individual listed as the emergency contact person by
the medical provider and/or adult leader. In the event that this person cannot be
reached, permission is hereby given to the medical provider selected by the adult
leader in charge to secure proper treatment, including hospitalization, anesthesia,
surgery, or injections of medication for me or my child. Medical providers are
authorized to disclose protected health information to the adult in charge, camp
medical staff, camp management, and/or any physician or health-care provider
involved in providing medical care to the participant. Protected Health Information/
Confidential Health Information (PHI/CHI) under the Standards for Privacy of
Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc.
seq., as amended from time to time, includes examination findings, test results, and
treatment provided for purposes of medical evaluation of the participant, follow-up
and communication with the participant’s parents or guardian, and/or determination
of the participant’s ability to continue in the program activities.
(If applicable) I have carefully considered the risk involved and hereby give my
informed consent for my child to participate in all activities offered in the program.
I further authorize the sharing of the information on this form with any BSA volunteers
or professionals who need to know of medical conditions that may require special
consideration in conducting Scouting activities.
or staff position: ___________________________________
With appreciation of the dangers and risks associated with programs and
activities, on my own behalf and/or on behalf of my child, I hereby fully and
completely release and waive any and all claims for personal injury, death, or
loss that may arise against the Boy Scouts of America, the local council, the
activity coordinators, and all employees, volunteers, related parties, or other
organizations associated with any program or activity.
I also hereby assign and grant to the local council and the Boy Scouts of America,
as well as their authorized representatives, the right and permission to use and
publish the photographs/film/videotapes/electronic representations and/or sound
recordings made of me or my child at all Scouting activities, and I hereby release
the Boy Scouts of America, the local council, the activity coordinators, and all
employees, volunteers, related parties, or other organizations associated with
the activity from any and all liability from such use and publication. I further
authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage,
and/or distribution of said photographs/film/videotapes/electronic representations
and/or sound recordings without limitation at the discretion of the BSA, and I
specifically waive any right to any compensation I may have for any of the foregoing.
!
NOTE: Due to the nature of programs and
activities, the Boy Scouts of America and local
councils cannot continually monitor compliance
of program participants or any limitations
imposed upon them by parents or medical
providers. However, so that leaders can be as
familiar as possible with any limitations, list any
restrictions imposed on a child participant in
connection with programs or activities below.
List participant restrictions, if any:
!
None
________________________________________________________
I understand that, if any information I/we have provided is found to be inaccurate, it may limit and/or eliminate the opportunity for participation in any event or activity. If I
am participating at Philmont, Philmont Training Center, Northern Tier, Florida Sea Base, or the Summit Bechtel Reserve, I have also read and understand the supplemental
risk advisories, including height and weight requirements and restrictions, and understand that the participant will not be allowed to participate in applicable high-adventure
programs if those requirements are not met. The participant has permission to engage in all high-adventure activities described, except as specifically noted by me or the
health-care provider. If the participant is under the age of 18, a parent or guardian’s signature is required.
Participant’s signature: ________________________________________________________________________________________ Date: ______________________________
Parent/guardian signature for youth: _____________________________________________________________________________ Date: ______________________________
(If participant is under the age of 18)
Second parent/guardian signature for youth: ______________________________________________________________________ Date: ______________________________
(If required; for example, California)
Complete this section for youth participants only:
Adults Authorized to Take to and From Events:
You must designate at least one adult. Please include a telephone number.
Name: ______________________________________________________
Name: ______________________________________________________
Telephone: __________________________________________________
Telephone: __________________________________________________
Adults NOT Authorized to Take Youth To and From Events:
Name: ______________________________________________________
Name: ______________________________________________________
Telephone: __________________________________________________
Telephone: __________________________________________________
680-001
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B
Part B: General Information/Health History
High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
or staff position: ___________________________________
Age:___________________________ Gender: ________________________ Height (inches): __________________________ Weight (lbs.): ____________________________
Address: ________________________________________________________________________________________________________________________________________
City: __________________________________________ State: __________________________ ZIP code: ______________
Telephone: ______________________________
Unit leader: ________________________________________________________________________________ Mobile phone: _________________________________________
Council Name/No.: __________________________________________________________________________________________________ Unit No.: ____________________
Health/Accident Insurance Company: _________________________________________________ Policy No.: ___________________________________________________
!
Please attach a photocopy of both sides of the insurance card. If you do not have medical insurance,
enter “none” above.
!
In case of emergency, notify the person below:
Name: ___________________________________________________________________________ Relationship: ___________________________________________________
Address: ____________________________________________________________ Home phone: _______________________ Other phone: _________________________
Alternate contact name: ____________________________________________________________ Alternate’s phone: ______________________________________________
Health
History
Do you currently have or have you ever been treated for any of the following?
Yes
No
Condition
Diabetes
Explain
Last HbA1c percentage and date:
Hypertension (high blood pressure)
Adult or congenital heart disease/heart attack/chest pain
(angina)/heart murmur/coronary artery disease. Any heart
surgery or procedure. Explain all “yes” answers.
Family history of heart disease or any sudden heartrelated death of a family member before age 50.
Stroke/TIA
Asthma
Last attack date:
Lung/respiratory disease
COPD
Ear/eyes/nose/sinus problems
Muscular/skeletal condition/muscle or bone issues
Head injury/concussion
Altitude sickness
Psychiatric/psychological or emotional difficulties
Behavioral/neurological disorders
Blood disorders/sickle cell disease
Fainting spells and dizziness
Kidney disease
Seizures
Last seizure date:
Abdominal/stomach/digestive problems
Thyroid disease
Excessive fatigue
Obstructive sleep apnea/sleep disorders
CPAP: Yes £
No £
List all surgeries and hospitalizations
Last surgery date:
List any other medical conditions not covered above
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B
Part B: General Information/Health History
High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
or staff position: ___________________________________
Allergies/Medications
Are you allergic to or do you have any adverse reaction to any of the following?
Yes
No
Allergies or Reactions
Explain
Yes
No
Allergies or Reactions
Medication
Plants
Food
Insect bites/stings
Explain
List all medications currently used, including any over-the-counter medications.
CHECK HERE IF NO MEDICATIONS ARE ROUTINELY TAKEN.
Medication
YES
NO
Dose
IF ADDITIONAL SPACE IS NEEDED, PLEASE
INDICATE ON A SEPARATE SHEET AND ATTACH.
Frequency
Reason
Non-prescription medication administration is authorized with these exceptions:_______________________________________________
Administration of the above medications is approved for youth by:
_______________________________________________________________________ / _______________________________________________________________________
Parent/guardian signature
MD/DO, NP, or PA signature (if your state requires signature)
Bring enough medications in sufficient quantities and in the original containers. Make sure that they
are NOT expired, including inhalers and EpiPens. You SHOULD NOT STOP taking any maintenance
medication unless instructed to do so by your doctor.
!
!
Immunization
The following immunizations are recommended by the BSA. Tetanus immunization is required and must have been received within the last 10 years. If you had the disease,
check the disease column and list the date. If immunized, check yes and provide the year received.
Yes
No
Had Disease
Immunization
Tetanus
Pertussis
Diphtheria
Measles/mumps/rubella
Polio
Chicken Pox
Hepatitis A
Date(s)
Please list any additional information
about your medical history:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
DO NOT WRITE IN THIS BOX
Review for camp or special activity.
Reviewed by:____________________________________________
Hepatitis B
Date: ___________________________________________________
Meningitis
Further approval required:
Influenza
Reason: ________________________________________________
Other (i.e., HIB)
Approved by: ____________________________________________
Exemption to immunizations (form required)
Date: ___________________________________________________
Yes
No
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C
Part C: Pre-Participation Physical
This part must be completed by certified and licensed physicians (MD, DO), nurse practitioners, or physician assistants.
High-adventure base participants:
Full name:
________________________________________ Expedition/crew No.: _______________________________
DOB:
________________________________________
or staff position: ___________________________________
You are being asked to certify that this individual has no contraindication for participation inside a
Scouting experience. For individuals who will be attending a high-adventure program, including one
of the national high-adventure bases, please refer to the supplemental information on the following
pages or the form provided by your patient.
!
!
Examiner: Please fill in the following information:
Yes
No
Explain
Medical restrictions to participate
Yes
No
Allergies or Reactions
Explain
Yes
No
Allergies or Reactions
Medication
Plants
Food
Insect bites/stings
Explain
Height (inches):__________________ Weight (lbs.):__________________ BMI:__________________ Blood Pressure:__________________/__________________ Pulse:__________________
Normal
Abnormal
Explain Abnormalities
Examiner’s Certification
I certify that I have reviewed the health history and examined this person and find
no contraindications for participation in a Scouting experience. This participant
(with noted restrictions):
Eyes
True
Ears/nose/
throat
False
Explain
Meets height/weight requirements.
Does not have uncontrolled heart disease, asthma, or hypertension.
Lungs
Has not had an orthopedic injury, musculoskeletal problems, or
orthopedic surgery in the last six months or possesses a letter of
clearance from his or her orthopedic surgeon or treating physician.
Heart
Has no uncontrolled psychiatric disorders.
Has had no seizures in the last year.
Abdomen
Does not have poorly controlled diabetes.
If less than 18 years of age and planning to scuba dive, does not have
diabetes, asthma, or seizures.
Genitalia/hernia
For high-adventure participants, I have reviewed with them the
important supplemental risk advisory provided.
Musculoskeletal
Examiner’s Signature: ___________________________________ Date: _______________
Provider printed name: ________________________________________________________
Neurological
Address: ______________________________________________________________________
City: _____________________________________ State: ____________ ZIP code: _________
Other
Office phone: _________________________________________________
Height/Weight Restrictions
If you exceed the maximum weight for height as explained in the following chart and your planned high-adventure activity will take you more than 30 minutes away from an
emergency vehicle/accessible roadway, you may not be allowed to participate.
Maximum weight for height:
Height (inches)
Max. Weight
Height (inches)
Max. Weight
Height (inches)
Max. Weight
Height (inches)
Max. Weight
60
166
65
195
70
226
75
260
61
172
66
201
71
233
76
267
62
178
67
207
72
239
77
274
63
183
68
214
73
246
78
281
64
189
69
220
74
252
79 and over
295
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Part D: Connecticut Rivers Council Addendum
Full Name:
Dates Attending:
Campsite:
Unit:
Scout
Scouter
Staff
This addendum to the Annual BSA Health and Medical Records is for youths and adults who are
participating in a CRC camp program. This is required to meet Connecticut Department of Public Health
requirements. Please read and sign the form at the bottom of the page.
If you disagree with any statements here, please cross out that section and initial it. Explain
your wishes in the comment section, attaching an additional sheet if necessary.
• This medical form is correct so far as I know, and the person named in Part A has permission to
participate in all camp activities except as noted on the form by me or by the doctor in Part C.
• I hereby request that the camp’s Health Officer administer the prescription and/or over-thecounter medication(s) ordered by my child’s doctor/dentist. I understand that I must supply the
camp with the prescribed medication in the original container as dispensed and properly labeled by
a doctor or a pharmacist and will provide no more than is appropriate for my child’s camp stay. I
understand that this medication will be destroyed if not picked up within one week after my child
leaves camp.
• I also give permission for my child to participate in trips sponsored by the camp and approved by
the adult/unit leader in charge. Examples of these trips are whitewater merit badge, orienteering
merit badges, or trips for rock climbing or mountain biking.
• I give my permission for the Camp Health Officer to administer over-the-counter medications as
directed for conditions as directed by the Camp Physician. Over-the-counter medications may
include WOUNDS: Hydrogen Peroxide, Neosporin, Bacitracin POISON IVY: Tecnu, Benadryl
cream CANKER SORES: Benzocaine cream PAIN: Tylenol, Ibuprofen DYSMENORRHEA:
Ibuprofen ABDOMINAL DISCOMFORT: Tums, Maalox HEADACHE: Tylenol, Ibuprofen
HYPOGLYCEMIA: Glucose Gel, Glucagon ALLERGIC REACTION: Benadryl or generic, Epipen
ATHLETE’S FOOT: Tinactin INSECT STING/BITE: Benadryl Cream, Hydrocortisone cream,
Caladryl or Calagel, Epipen TICK BITES: Alcohol or Hydrogen Peroxide 1st DEGREE BURNS:
Burn Jel, Aloe Spray EMERGENCIES: Oxygen. Generics may be substituted.
This section must be signed to indicate acceptance of conditions above.
Signature:
(Adults over 18 sign here. Parent/Guardian signs for camper.)
Name (print):
Date:
Relationship:
Comments:
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Authorization for the Administration of Medication by School, Child Care, and Youth Camp Personnel
In Connecticut schools, licensed Child Care Centers and Group Care Homes, licensed Family Care Homes, and licensed Youth Camps administering
medications to children shall comply with all requirements regarding the Administration of Medications described in the State Statutes and Regulations.
Parents/guardians requesting medication administration to their child shall provide the program with appropriate written authorization(s) and the medication
before any medications are administered. Medications must be in the original container and labeled with child’s name, name of medication, directions for
medication’s administration, and date of the prescription.
Authorized Prescriber’s Order (Physician, Dentist, Optometrist, Physician Assistant, Advanced Practice Registered Nurse or Podiatrist):
Name of Child/Student _________________________________ Date of Birth____/____/____ Today’s Date____/____/____
Address of Child/Student _______________________________________________________Town___________________
YES
Medication Name/Generic Name of Drug________________________________________ Controlled Drug?
NO
Condition for which drug is being administered: _____________________________________________________________
Specific Instructions for Medication Administration ___________________________________________________________
Dosage______________________________Method/Route_______________________________________
Time of Administration _________________________ If PRN, frequency_____________________________
Medication shall be administered: Start Date: _____/_____/_____ End Date: _____/_____/______
Relevant Side Effects of Medication _______________________________________________________
None Expected
Explain any allergies, reaction to/negative interaction with food or drugs__________________________________________
Plan of Management for Side Effects _____________________________________________________________________
Prescriber’s Name/Title ______________________________________________ Phone Number (_____) ______________
Prescriber’s Address _________________________________________________________ Town ___________________
Prescriber’s Signature __________________________________________________________
Date _____/_____/_____
School Nurse Signature (if applicable) ____________________________________________________________________
Parent/Guardian Authorization:
I request that medication be administered to my child/student as described and directed above
I hereby request that the above ordered medication be administered by school, child care and youth camp personnel and I give permission for the
exchange of information between the prescriber and the school nurse, child care nurse or camp nurse necessary to ensure the safe administration of
this medication. I understand that I must supply the school with no more than a three (3) month supply of medication (school only.)
I have administered at least one dose of the medication with the exception of emergency medications to my child/student without adverse effects. (For
child care only)
Parent/Guardian Signature___________________________________ Relationship______________ Date ____/____/____
Parent /Guardian’s Address ____________________________________________Town___________________State_____
Home Phone # (_____) ______-________ Work Phone # (_____) ______-________ Cell Phone # (_____) ______-_______
SELF ADMINISTRATION OF MEDICATION AUTHORIZATION/APPROVAL
Self-administration of medication may be authorized by the prescriber and parent/guardian and must be approved by the school nurse (if
applicable) in accordance with board policy. In a school, inhalers for asthma and cartridge injectors for medically-diagnosed allergies,
students may self-administer medication with only the written authorization of an authorized prescriber and written authorization from a
student’s parent or guardian or eligible student.
Prescriber’s authorization for self-administration:
YES
NO _________________________________________________________
Signature
Parent/Guardian authorization for self-administration:
YES
NO _____________________________________________________
Signature
School nurse, if applicable, approval for self-administration:
Date
YES
Date
NO ________________________________________________
Signature
Date
*********************************************************************************************************************************************************************************
Today’s Date ___________Printed Name of Individual Receiving Written Authorization and Medication _________________
Title/Position _____________________________ Signature (in ink or electronic) __________________________________
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Note: This form is in compliance with Section 10-212a, Section 19a-79-9a, 19a-87b-17 and 19-13-B27a(v.)
Campworkcoeman.org
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MEDICAL SCREENING QUESTIONNAIRE
This form must be completed by a ALL Scouts and leaders on the day of arrival at camp. It is to comply with
BSA National Camping Standards. Please have the forms completed and bring them with you at your designated check-in time with the Camp Nurse.
SCOUT’S NAME ______________________________
TROOP____________
CAMPSITE ______________
Please ask the scout named above the following questions. This must be done by someone 21 years or older.
If any question is positive, briefly describe under the proper question.
1. Any visit to a doctor or clinic since the last exam?
YES
NO
2. Any recent illness, injury, rash, or allergic reaction?
YES
NO
3. Any ongoing treatment or medication not handed into the nurse?
YES
NO
4. Any medication taken 30 days prior to camp, that you are not on now?
YES
NO
5. Do you feel fine and do they look fine at present?
YES
NO
_____________________________ _________________ _______________________________
Adult Signature
Date
Print Name
MEDICAL SCREENING QUESTIONNAIRE
This form must be completed by a ALL Scouts and leaders on the day of arrival at camp. It is to comply with
BSA National Camping Standards. Please have the forms completed and bring them with you at your designated check-in time with the Camp Nurse.
SCOUT’S NAME ______________________________
TROOP____________
CAMPSITE ______________
Please ask the scout named above the following questions. This must be done by someone 21 years or older.
If any question is positive, briefly describe under the proper question.
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1. Any visit to a doctor or clinic since the last exam?
YES
NO
2. Any recent illness, injury, rash, or allergic reaction?
YES
NO
3. Any ongoing treatment or medication not handed into the nurse?
YES
NO
4. Any medication taken 30 days prior to camp, that you are not on now?
YES
NO
5. Do you feel fine and do they look fine at present?
YES
NO
_____________________________ _________________ _______________________________
Adult Signature
Date
Print Name
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Must be completed for River Kayaking trip and COPE
Camp Workcoeman
Off-Camp Activity Permission Form
I__________________________________, as Parent/Guardian of
Scout__________________________________________, give permission
to take part in the off-camp activity___________________________
sponsored by Camp Workcoeman (date)___________.
______________________________________________SIGNATURE
________________________________DATE
Must be completed for River Kayaking trip and COPE
Camp Workcoeman
Off-Camp Activity Permission Form
I__________________________________, as Parent/Guardian of
Scout__________________________________________, give permission
to take part in the off-camp activity___________________________
sponsored by Camp Workcoeman (date)___________.
______________________________________________SIGNATURE
________________________________DATE
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Campworkcoeman.org
Camp Workcoeman
Scouting Pistol Safety and Marksmanship Program
Participation and Hold-Harmless Agreement
Camp Workcoeman (Connecticut Rivers Council) is conducting a Scouting Pistol Safety and Marksmanship program. Scouts will be instructed how to handle, maintain, and shoot a pistol safely and be
provided instruction to increase their marksmanship skills. Scouts will have classroom instruction and range
instruction in which they will fire a pistol under the supervision of a trained Range Safety Officer and NRA
certified pistol instructor. Scouts will be required to wear eye protection and ear protection at all times
while on the range. Scouts are expected to abide by all safety rules and the instructions of the Range Safety
Officer(s) and pistol instructor(s).
I, the undersigned, give my child,
, permission to participate
in this program. I understand that participation in the activity involves a certain degree of risk. I have
carefully considered the risk involved and have given consent for my child to participate in the activity.
I understand that participation in the activity is entirely voluntary and requires participants to abide by
the rules and standards of conduct. I release the Boy Scouts of America, the local council, the activity
coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity
from any and all claims or liability arising out of this participation.
For safety, my child and I agree that he/she will do the following or he/she will be removed
from the program. I understand that any additional cost associated with participation in this program will
not be refunded if my child is removed due to behavioral problems.
1. Complete the FIRST Steps class taught at Camp Workcoeman.
2. Wear all safety gear at all times while on the range.
3. Follow all safety rules provided in the training class.
4. Follow the instructions of the Range Safety Officer(s) and pistol instructor(s).
5. Do not handle any pistols until instructed to do so by the pistol instructor(s).
6. Follow the instructions of the Range Safety Officer(s) at all times.
7. Is 14 years of age, or 13 and has completed the eighth grade, as of the start of the class and will be
in full compliance with all local, state, and federal guidelines, including age restrictions and original
equipment manufacturer standards.
Participant signature
Date:
Parent/guardian signature
Date:
Parent/guardian printed name
Home phone
Cell
Rev. Dec 2016
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Campworkcoeman.org
CONNECTICUT RIVERS COUNCIL
BOY SCOUTS OF AMERICA
Parent/Guardian Authorization for
Camper Release/Departure from Camp Facilities
All campers that must leave the camp property, to return at a later time or day, must have this
form completed in advance by a parent or guardian. This notice must be submitted to the camp
office at time of initial check-in at the camp.
This notice must include the following: day, date, and time of personal event, indicating nature of
activity; anticipated required departure and return to the camp facility; name, relationship, phone
number, and address of individual authorized to pick up and transport camper. Positive ID will
be required for the individual authorized to pick up and transport camper.
Please complete the below requested information for the camper, answer all questions and afix
parent or guardian signature as authorization.
Camper Name ____________________________________________
Camp _____________ Program _______________ Unit#__________
is authorized to leave the scheduled camp to participate in the following personal activity event.
Activity/Event_________________Day___________Date___________
Time of Departure_____________Time of Return______________
The following individuals are authorized to pick up my camper. (please include your own name.)
1. Name_________________________
Address_______________________
Relationship _______________
City/Town/State ____________
2. Name_________________________
Address_______________________
Relationship _______________
City/Town/State ____________
3. Name_________________________
Address_______________________
Relationship _______________
City/Town/State ____________
Parent/Guardian Signature_________________________Date________
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Camp Workcoeman
Scouter Resource Form
Scouters are the most important people in camp because they have the skills and training that is needed in a camp setting. We would like all of the leaders staying in camp to fill out one of the resource
questionnaires and return it before arriving at camp. We hope that you will spend some of your time
assisting us in providing a wonderful camp program for all of the boys in camp.
Name: Troop:
Week Attending Camp:
Campsite:
Please indicate the program area(s) that you would be willing to assist during the week you are in
camp. (Please circle or highlight those you would like to assist in)
Nature Waterfront Scoutcraft Tenderfoot’s Compass
Rifle Range
Archery Range
Climbing
Handicraft
Sports
Please indicate below those training opportunities you would like to attend during your week at camp.
(Please circle or highlight)
Aquatic Supervisor:
Leave No Trace
Water Rescue
Trek Safely
Paddle Craft
IOLS
Would you like to attend one of our overnight or out-of-camp activities? (Please circle those you would
like to attend)
COPE (drivers needed) Kayak Trip
Please list any merit badges that you would like to offer or assist with during your week at camp.
Is there any other way in which you would like to assist us while you are in camp?
Please return this form before your arrival at camp to:
Program Director
Camp Workcoeman
169 Camp Workcoeman Road
New Hartford, CT 06057
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Scouts Name: ____________________ Troop: ________ Camping Session: 9:15 or 11:15 Week: ________
Camping Merit Badge
Please initial the requirements that you Scout has completed
Make a written plan for an overnight trek and show how to get to your camping spot using a topographical map and compass or a topographical map and a GPS receiver.
Present yourselt yo your Scoutmaster with your pack for inspection. Be correctly clothed and
equipped for an overnight campout.
Prepare a camp menu. Explain how the menu would differ from a menu for a backpacking or float
trip. Give recipies and make a food list for your patrol. Plan two breakfasts, three lunches, and
two suppers. Discuss how to protect your food against bad weather, animals, and contamination.
Using the menu described above, cook at least one breakfast, one lunch, and one dinner for your
patrol. At least one of these meals must be a trail meal requiring the use of a lightweight stove.
Camp a total of at least 20 days and 20 nights. Sleep each night under the sky or in a tent you
have pitched. These 20 days and 20 nights must be at a designated Scouting activity or event.
You may use a week of long-term camp toward this requirement. If the camp provides a tent that
has already been pitched, you need not pitch your own tent.
One any of these above camping experiences, you must do two of the following, only with proper
preparation and under qualified supervision:
Hike up a mountain, gaining at least 1,000 vertical feet.
Backpack, snowshoe, or cross-country ski for at least 4 miles.
Take a bike trip of at least 15 miles or at least four hours.
Take a nonmotorized trip on the water of at lesat four hours or 5 miles.
Plan and carry out an overnight snow camping experience.
Rappel down a rappel route of 40 feet or more.
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Signature: _______________________________________
Date: ____________________________
Name (please print):_______________________________
Position: _________________________
Campworkcoeman.org
Scouts Name: ____________________ Troop: ________ Week: ________
Cooking Merit Badge
Please initial the requirements that you Scout has completed
Using the MyPlate food guide, plan a menu for three full days of meals (three breakfasts, three
lunches and three dinners) plus one dessert. Your menu should include enough to feed yourself
and at least one adult, keeping in mind any special needs (such as food allergies) of those to be
served. List the equipment and utensils needed to prepare and serve these meals. Then do the
following.
Create a shopping list for your meals showing the amount of food needed to prepare and
serve each meal.
Prepare and serve yourself an at least one adult, one breakfast, one lunch, one dinner
and one dessert from the meals you planned using at least five of the following methods:
baking, boiling, pan frying, simmering, steaming, microwaving and grilling.
Time your cooking to have each meal ready to serve at the proper time.
After each meal, ask a person you served to evaluate the meal on presentation and taste,
then evaluate your own meal.
Using the MyPlate food guide, plan a menu for trail hiking or backpacking that includes one
breakfast, one lunch, one dinner and one snack. These meals must not require refrigeration
and are to be consumed by three to five people (including you). List the equipment and utensils
needed to prepare and serve these meals. Then do the following:
Create a shopping list for your meals showing the amount of food needed to prepare and
serve each meal.
While on a trail hike or backpacking trip, prepare and serve two meals and a snack from
the menu that you planned. At least one of those meals must be cooked over an approved
trail stove.
For each meal prepared, use safe food handling practices. Explain how you kept foods
safe and free from cross-contamination. Clean up equipment, utensils and the site
thoroughly after each meal. Properly dispose of dishwater and pack out all garbage.
After each meal, have those you served evaluate the meal on presentation and taste, then
evaluate your own meal. Tell how better planning and preparation help ensure successful
trail hiking or backpacking meals.
The meals prepared for Cooking merit badge can only count towards fulfilling these requirements and will
not count toward rank advancement. Meals prepared for rank advancement cannot be used to complete
Cooking merit badge. Please refer to Cooking Merit Badge book for more information.
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Signature: _______________________________________
Date: ____________________________
Name (please print):_______________________________
Position: _________________________
Campworkcoeman.org
Scouts Name: ____________________ Troop: ________ Week: ________
Emergency Preparedness
Merit Badge
Please initial the requirements that you Scout has completed
Earn the First Aid merit badge.
Prepare a written plan for mobolizing your troop when needed to do emergency service. If there
is already a plan, explain it. Tell your part in making it work.
Take part in at least one troop mobolization. Before the exercise, describe your part to your counselor. Afterward, conduct an “after-action” lesson, discussing what you learned during the exercise that required changes or adjustments to the plan.
Signature: _______________________________________
Date: ____________________________
Name (please print):_______________________________
Position: _________________________
Emergency Preparedness Merit Badge
In addition to the requirements listed above, scouts should complete the following and bring the materials to camp
Identify the government agencies and organizations that normally prepare for emergency situations and
provide emergency services in your community
Find out who is your community's emergency management director and learn what this person does to
prepare, respond to, recover from, mitigate and prevent emergency situations.
Use the information you gained from your local emergency management director to prepare a chart as
described in Requirement 2.
Meet with your family and discuss how to prepare for the situations in your chart. With this in mind, work
with your family to assemble an emergency/evacuation kit and develop a family plan as described in the
Emergency Preparedness Merit Badge Pamphlet. Be prepared to discuss the outcomes of your family meeting at camp, and bring either your family’s kit or photographs of it to camp.
Create a personal emergency service pack, as described in the Emergency PreparednessMerit Badge
Pamphlet
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Scouts Name: ___________________ Troop: ________ Personal Fitness Session: 10:15 or 11:15 Week: ________
Personal Fitness Merit Badge
Please initial the requirements that you Scout has completed
Have your health-care practitioner give you a physical examination, using the Scout medical
examination form.
Have a dental examination. Get a statement saying that your teeth have been checked and
cared for.
Complete the aerobic fitness, flexibility and muscular strength tests, along with the body composition evaluation as described in the Personal Fitness merit badge pamphlet. Record your results
and identify those areas where you feel you need to improve.
Outline a comprehensive 12-week physical fitness program using the results of your fitness tests.
Be sure your program incorporates the endurance, intensity and warm-up guidelines discussed in
the Personal Fitness merit badge pamphlet. Before beginning your exercises, have the program
approved by your counselor and parents.
Complete the physical fitness program you outlined in requirement 7. Keep a log of your fitness
program activity (how long you exercised; how far you ran, swam or biked; home many exercise
repetitions you completed; your exercise heart rate; etc.). Repeat the aerobic fitness, muscular
strength and flexibility tests every two week and record your results. After the 12th week, repeat
all of the required activities in each of the three test categories, record your results and show
improvement in each one. For the body composition evaluation, compare and analyze your
prepogram and post-program body composition measurements.
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Signature: _______________________________________
Date: ____________________________
Name (please print):_______________________________
Position: _________________________
Campworkcoeman.org
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