2006 - ClubRunner
2010
June 10th to June 13th
Rotary District 5790
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2010
Table of Contents
2010 RYLA Steering Committee 3
2010 Time Schedule for Clubs 4
Map to Texas Woman’s University, Denton, TX 5
Student Participant Application 7
Information for Participants in University Affiliated Programs 8
Texas Woman’s University Medical Liability Release Form 9
Health Information Form 10
Items Needed for RYLA Stay 11
RYLA Fact Sheet 12
Club Sponsorship Opportunities 13
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2010 RYLA Steering Committee
District RYLA Chair RYLA Director: RYLA Treasurer
Bridgett Williams Clint Ishmael PDG Dan Morales
10332 Gentry Drive 5960 CR 304 4304 Kenwood Ct
Justin, TX 76247 Grandview, TX 76050 Fort Worth, TX 76103
H 940-648-2130 H 817-866-3979 W 817-261-6284
H 817-531-3804 W 817-645-0964 H 817-531-3804
bridgewilliams@ C 817-774-6305 F 817-277-8130
clint.ishmael@ C 817-994-7575
workoutdan@
RYLA Administrators
Helen Wilson Janelle Kavanaugh
580 W. Green Street 3201 East First Street
Stephenville, TX 76401 Fort Worth, TX 76111
W 254-968-7330 H 817-831-1360
H 254-968-7330 F 817-831-4816
wilson40@our- janelle.rotary@
RYLA Steering Committee Members
Kathy Bauer Kent Brown Mary Ann McDuff
128 N. Ash Street 1208 N. 5th Street 2233 Hollyhill Drive
Muenster, TX 76252 Abilene, TX 79601-5020 Denton, TX 76205
W 325-677-2688 W 940-898-3310
H 940-759-2573 F 325-677-2923 H 940-382-7478
F 940-759-4441 kebrown@ F 940-898-3386
krbauer@ mmcduff@twu.edu
John Erickson Jim Reed
500 Pin Oak Trail 540 Oak Hill Drive
Keller, TX 76248 Southlake, TX 76092
C 817-209-5685 W 817-430-5303
H 817-656-1940 H 817-442-5260
F 817-656-1940 F 817-430-5333
johnerickson@ Jpatrickreed@
jreed@
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2010 – Time Schedule for Clubs
By January 15th, 2010 – We ask that clubs submit the number of students they will send to RYLA Administrator, Helen Wilson. As most clubs will indicate two students, we ask that you limit your number to four until we have heard from all the clubs in our district.
By January 31st, 2010 - School Counselor or youth organization personnel are contacted to introduce the RYLA program and submit RYLA applications to students. School Counselor will need to return completed application to Club RYLA Chair. You may use the RYLA Fact Sheet, the RYLA PowerPoint, past RYLArians, and members of the RYLA Steering Committee to help explain the program.
By March 1st, 2010 - Return CLUB SPONSORSHIP OPPORTUNITY FORM (available on the District Website, ) along with the appropriate monetary requirement to RYLA Administrator Helen Wilson, 580 W. Green Street, Stephenville, TX 76401H 254-968-7330, wilson40@our-
Before March 15th, 2010 - Collect and review the applications. Then with the assistance of two or more Club Rotarians interview the students. Complete recruiting, interviewing and selecting your RYLA students.
By March 15th, 2010 - Club returns completed 2010 PARTICIPANT APPLICATIONS, the District 5790 Health Information Form, the Texas Woman’s University Medical Liability Release Form along with photo and tuition. Parents, student, club president and interviewers will need to sign the application. Checks should be made payable to Rotary District 5790 RYLA. Send to RYLA Administrator Helen Wilson, 580 W. Green Street, Stephenville, TX 76401
H 254-968-7330, wilson40@our-
By April 15, 2010 - Host an orientation session with the selected students and their parents. The orientation should consist of information about Rotary and the RYLA program. You may wish to invite students and parents to a club meeting prior to RYLA. Be sure the parents understand and are comfortable with a Rotarian’s driving the students to and from Texas Woman’s University in Denton. Make arrangements with students for times and places to meet. Most importantly, explain that a Rotary Club is providing a $425.00 tuition for a student to attend the leadership experience.
On June 10th, 2010 - Rotarians transport student participants to RYLA at Texas Woman’s University in Denton, arriving between 8:00 and 9:30 AM.
On June 13th, 2010 - Between 10:30 and 11:30 AM – Rotarians return to Texas Woman’s University to drive student participants home after the RYLA program ends at 11:00 AM
Map to Texas Woman’s University, Denton, TX
The city of Denton sits at the top of a triangle, with Dallas to the southeast and Fort Worth to the southwest. Texas Woman’s University’s high-rise buildings are visible for miles, so keep an eye out for them as you approach Denton.
US Highway 380 is the major east-west thoroughfare in Denton. Known in the city as University Drive, it borders the northern edge of the TWU campus.
From Dallas Area
Take Interstate 35E to Denton, exiting at Loop 288 (Denton/McKinney exit) and follow the TWU signs to the University Drive exit. Go west on University Drive. Follow University Drive to Bell Avenue, which runs through the heart of the TWU campus. Turn left on Bell Avenue. Immediately turn right into the parking lot of the Guinn-Stark residence halls (two tall towers). RYLA registration is in Guinn-Stark (the northwest corner of University Drive and Bell Avenue).
OR
From Fort Worth Area and From North
Take Interstate 35W to Denton, exiting at University Drive (US 380). Go east right on University Drive. Follow University Drive to Bell Avenue, which runs through the TWU campus. Turn right on Bell Avenue. Immediately turn right into the parking lot of the Guinn-Stark residence halls (two tall towers). RYLA registration is in Guinn-Stark (the northwest corner of University Drive and Bell Avenue).
June 10th, 2010 –
Rotarians drive RYLA student participants to TWU in Denton. Registration is between 8:00 AM and 9:30 AM
June 13th, 2010 –
Rotarians pick up students at TWU. Check out is 11:00 AM – 12 Noon.
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Complete the following items and return to
RYLA Administrator, Helen Wilson, 580 W. Green Street, Stephenville, TX 76401
1. Student Application with picture, signatures from parent and Rotary Club President
2. District 5790 Health Form
3. Texas Woman’s University Liability Form
4. Participant Photo
5. Check made payable to District 5790
______________________________________________________________
The Club’s RYLA chairperson provides the following information
to students and parents
1. “Items Needed for RYLA” Sheet – provided in this packet
2. RYLA Fact Sheet – provided in this packet
3. Club contact person and contact numbers
4. Name and contact information of Rotarian transporting students to and from RYLA – This is a requirement of Rotary International.
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2010 Student Participant Application
Applications Due By March 15th, 2010
Student’s Name_____________________________
Address___________________________________________________________
City____________________________ Zip__________ Student’s Email __________________________
Home Telephone ________________________ Parent’s Work Phone ___________________________
Parent’s Cell Phone_________________________ Student’s Cell Phone _________________________
High School _______________________________________Grade in Fall of 2010_________________
M _____ F _____ Date of Birth ___________ Student must be 16 yrs of age by June 10th, 2010
T-shirt size: S M L XL XXL
Note: If additional space is needed for the following, please attach a separate sheet.
List Academic Accomplishments: ____________________________________________________________
_______________________________________________________________________________________
List School Activities & Recognitions: _________________________________________________________
_______________________________________________________________________________________
List Hobbies, Community Service Activities, & Outside Interests ____________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Rotary Club of ___________________________ Club RYLA Chair _________________________________
Phone # ___________________Fax ___________________ email_________________________________
Club President’s signature_______________________________________ Phone # ___________________
Interviewed by Rotarians: ______________________________ ________________________________
I agree to allow the RYLA medical staff to dispense any non-prescription drug such as aspirin, Tylenol, cough syrup, etc. to my child, if needed. In case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I herby give permission to the physician selected by the RYLA Directors or staff to hospitalize and secure any necessary professional medical treatment for my child, as named above.
Parent’s Signature ___________________________________________ Date ________________________
Parent’s Name (Print) _______________________________
Submit Application to RYLA Administrator, Helen Wilson, 580 W. Green Street, Stephenville, TX 76401
Texas Woman’s University - Student Health Services
Information for Participants in University Affiliated Programs
Location:
The TWU Student Health Service Clinic is located at 305 Administration Drive (lower level of Hubbard Hall). Its mission is to provide quality primary and preventative health care to the students of Texas Woman’s University. Two family nurse practitioners and two board certified medical doctors make up the medical provider staff at Student Health Services. Clinic hours are Monday through Friday from 8:00 a.m. until 5:00 p.m. The main phone number is 940-898-3826.
Fees:
A fee is charged for office visits as well as other services rendered during the visit. The current office visit charge is $35.00 for non-TWU students. Additional charges for laboratory tests, medications, treatments, and supplies may be applied to the cost of the visit. Prescriptions written by a provider can be filled at the clinic’s pharmacy or at any off campus private pharmacy. Payment is required at the time of service and extension of credit is not permitted. Payment can be made by cash, check, or credit card (Visa or Master Card). TWU Student Health Services cannot file insurance claims.
Hospitals:
The nearest full-service hospital is Presbyterian Hospital of Denton (Denton Community Hospital), located at 3001 N. I-35. The phone number is 940-898-7000.
Other hospitals in Denton include:
Denton Regional Medical Center North Texas Hospital
3535 N. I-35 2801 S. Mayhill Road
940-384-3535 940-220-0600
Participant Information:
Participants of University affiliated programs, workshops, and camps are eligible for services through the duration of their program. Minor persons participating in University affiliated programs must present a completed minor consent form signed by a parent or guardian prior to receiving medical services. (Forms will be given to camp directors by the Director of Conference Services prior to camp start date; completed forms are to be submitted to Conference Services upon arrival for start of camp.)
Texas Woman’s University
MEDICAL/LIABILITY RELEASE
I hereby and fully release and hold harmless the Texas Woman’s University, its officers, regents, employees, and agents from any and all liability resulting from or as a consequence of any illness and/or injury to me/my child which may be suffered during RYLA held on June 10 - 13, 2010.
Further, I hereby give my consent for RYLA to seek and obtain appropriate emergency medical treatment for me/my child and agree to hold harmless from loss, the Texas Woman’s University, its officers, regents, and employees and any such personnel or agents of the treating medical facility whether it be the Texas Woman’s University of any other external facility, which may provide emergency medical care.
If my child is the participant and medical treatment is called for, I consent to allow a representative of RYLA to transport me/my child to the appropriate medical facility for treatment and hereby give my consent to the medical facility to treat me/my child if admitted by a valid representative of the organization.
I understand that I am responsible for payment of all expenses incurred related to my own or my child’s medical treatment.
My medical insurance provider is ___________________________________________
Policy Number________________________
PARTICPANT:
Name (please print) _________________________ Date of Birth __________________
Address _______________________________ Home Phone _____________________
City/State ____________________________________ Zip _____________________
PARENT OR GUARDIAN (Required if Participant is Under 18 Years of Age):
Name (please print)___________________________ Relation to minor______________
Address __________________________________ Home Phone __________________
City/State ____________________________________ Zip ______________________
Home Phone ( )_________________ Work or Mobile Number ( )_______________
Signature _________________________________ Date _____________________
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Rotary International District 5790
HEALTH INFORMATION FORM
Name __________________________________________________________
(if Minor) Parent’s or Guardian’s Name _______________________________________
Address _______________________________________________________________
Home Phone __________________ Work _________________ Cell _______________
Medical Insurance Company __________________________Policy Number__________
Family Physician _____________________________________ phone ______________
Emergency Contact in case Parent/Guardian cannot be reached:
Name ____________________________
Home Phone __________________ Work _________________ Cell ________________
Please list any medical condition the student is currently being treated for____________________________________________________________________________________________________________________________________________
ALLERGIES: _____________________________________________________________
Current Medications: _______________________________________________________
List any special conditions or physical limitations: _________________________________
______________________________________________________________________________________________________________________________________________
PERMISSION FOR MEDICAL CARE:
I/WE AUTHORIZE THE ROTARY YOUTH LEADERSHIP AWARD COMMITTEE, ROTARY DISTRICT 5790, TO ACT FOR ME IN ANY EMERGENCY, ACCIDENT OR LLNESS DURING THE CAMP.
SIGNATURE OF PARENT/GUARDIAN __________________________________________
PLEASE PRINT NAME OF PARENT/GUARDIAN __________________________________________ DATE ___________
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2010 – Items Needed for RYLA Stay
1 Necessary items:
Bedding Sheets, blanket, and pillow
Bath Items Wash clothes, bath towels, beach towel, flip-flops for room and swimming
Clothing Shorts Jeans Casual Clothing
For Sleepwear Underwear Workout Clothes Days Swimsuits Closed-toed Shoes (Tennis Shoes)
T-Shirts (only 2 or 3 needed)
Four RYLA t-shirts will be provided to each RYLArian. NO tank tops, muscle shirts or half t-shirts are permitted.
Proper Dinner Attire for Etiquette Program
Young Women Young Men
Dress Slacks
Pant Suit Coat
Dress Shoes Tie
NO Sun Dresses Dress Shoes
NO Flip Flops NO Flip Flops
NO Jeans NO Jeans
Essentials Hygiene items Body & Hand Soaps Shampoo
Deodorant Toothpaste & Toothbrush Sunscreen
Alarm Clock
Optional Items: Items Not Permitted:
Musical Instruments Alcohol
Inexpensive cameras Drugs
Kleenex Tobacco products including dip Laptops
DVD’s, boom boxes, radios etc. Video Recorders
Note: Cell phones will be limited for use during free time. Cell phones are not permitted during sessions
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2010 RYLA Fact Sheet
Rotary Youth Leadership Awards - A Leadership Development Experience
What: In 1971 Rotary International adopted RYLA – an intensive leadership development program for youth leaders.
When: June 10th – 13, 2010
Where: Texas Woman’s University in Denton, Texas
Who: Students must be a high school junior or senior in the fall of 2010. Students must be between the ages of 16 and 18. Students should meet these qualifications:
• Leadership Experience or potential, demonstrated through participation in youth group or
service activities
• Cooperative nature and willingness to participate in a group
• Awareness of current events
• Strong communication skills
• Good performance in school and work
• Enthusiasm for sharing newly found skills.
Cost: $425.00 – A Rotary Club funds the sponsorship of the participant(s).
The RYLA Program is led in a professional, collegiate atmosphere where participants will:
• Develop leadership skills with the assistance of experts in social development in a classroom environment.
• Increase self-confidence and enhance teamwork skills through participation in low challenge course
exercises
• Learn proper social and business etiquette while participating in a formal dinner event.
• Observe how city government operates while participating in a Mock City Council Meeting.
• Expand their civic and patriotic skills in ethics and responsibility classes.
• Learn about the purpose and objectives of Rotary International while attending a Rotary club meeting. Learn about the Rotary Four Way Test.
• Prepare for the college experience
• Participate in a community service project
• Participate in a “Service Above Self” exercise called Promises, Promises
RYLA aims to:
• Demonstrate Rotary’s respect and concern for young people.
• Provide leadership concepts for selected youth leaders
• Encourage leadership of youth by youth
• Recognize publicly young people who are rendering service to their communities.
RYLA provides:
• An introduction of a variety of issues and people
• An opportunity to make new friends.
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2010 – Club Optional Sponsorship Opportunities
• Sponsorship for a student $425.00
• Welcome Luncheon June 10th $1500.00 SOLD
• Ropes Course - June 10th $500.00 (2)
• Chuck wagon dinner - June 10th $800.00
• Etiquette Dinner - June 11th $1500.00 (3)
• Ice Cream Social - June 12th $150.00 SOLD
• Snacks – June 10th, 11th, & 12th $100.00 each
• Service Project – June 12th $500.00
• DJ Party – June 12th $500.00
Writable Text Box Below
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Attach
Current
Photo
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1
2 Club Sponsorship Form
2 Rotary Club
Event or Material to Sponsor
Responsible Rotarian
Address
Email Telephone
Submit copy of this form with check made payable to Rotary District 5790. Send to District RYLA Treasurer, Dan Morales at 4304 Kenwood Ct. Fort Worth, TX 76103
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