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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