REGISTRATION PACKET: Fill out the attached Saddleback Church registration form Fill out the attached Thousand Pines registration form Fill out the

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1 REGISTRATION PACKET: Fill out the attached Saddleback Church registration form Fill out the attached Thousand Pines registration form Fill out the payment form Bring your completed forms to: SSM on Northwood High School, the Saddleback church Irvine office OR mail to 3002 Dow Ave. Suite 514 Tustin Attention: Matt Hall

2 WILDSIDE SUMMER CAMP AT THOUSAND PINES Join the junior high ministry, as we head up the mountain for an amazing week away. Our hope is that this week would be life changing for you. You will experience an awesome camp environment that includes new friendships, amazing counselors, the most incredible camp facilities ever and of course.an incredible time with God. Please do not miss out on this unique opportunity! REGISTRATION The cost of summer camp is $370. The cost includes lodging, food, most camp activities, and $10 in camp bucks. A non- refundable deposit of $150 is due at registration. The registration deadline is July 28 unless camp fills to capacity before that date. Your student is NOT registered for camp until the SSM OFFICE receives ALL of the completed forms. PARENT INFORMATION MEETING Join the Wildside team of Lake Forest on Sunday, July 28 from 1-2pm in the Refinery GYM, for an in depth look at summer camp. Final balances are due at this time. DEPARTURE & RETURN Saddleback Church/Lake Forest Campus LOWER Parking lot at 7:30am on Monday, August 5. We will return home to the Saddleback Church/Lake Forest Campus LOWER Parking lot at 11:30am on Friday, August 9. WHAT THOUSAND PINES HAS TO OFFER Rock Climbing Wall Zipline Ropes Course Paintball Archery Malt Shop Recreation Games Swimming Pool Skate Park Mountain Biking*Coffee Shop*Craft Shop*Cabins*Dining Hall*Incredible Counselors from Saddleback Church*Chapel Worship*Frisbee Golf and more! THINGS TO BRING Bible, Comfy Clothes, Overnight toiletries, Sleeping Bag/Pillow, Bathing Suit/Towel, Sunscreen, Bug repellent, team color clothing, Sweatshirt, Tennis shoes, Flip flops, skate gear, DEODORANT. EXTRA MONEY IS OPTIONAL Every camper will get $10 in camp bucks that can be used at the Malt Shop, Coffee Shop, and the paintball course. However, it s recommended to bring extra spending money. ARE THERE SCHOLARSHIPS AVAILABLE? Thousand Pines has scholarships available (forms attached). They are on a first come first serve basis. Any scholarship questions Matt at matth@saddleback.com.

3 STUDENT INFORMATION: FIRST NAME: GRADE IN FALL 2013: 7 8 GENDER: M F WHAT IS YOUR HOME SADDLEBACK CAMPUS? LAST NAME: SCHOOL: [ ] Irvine [ ] The Grove [ ] Corona [ ] HB [ ] Lake Forest [ ] San Clemente [ ] Rancho Capistrano FRIENDS I WOULD LIKE IN MY CABIN: WE WILL DO OUR BEST TO HONOR ANY FRIEND REQUESTS. HOWEVER, DUE TO THE VOLUME OF PARTICIPANTS, ONCE CABINS HAVE BEEN ASSIGNED THERE WILL BE NO CHANGES, NO EXCEPTIONS. PARENT/GUARDIAN INFORMATION: NAME(S): ADDRESS: CITY: ZIP: PHONE: ( ) (REQUIRED FOR COMMUNICATION): (STUDENT S NAME) HAS MY CONSENT TO ATTEND THOUSAND PINES SUMMER CAMP ON AUGUST TO AUGUST 9, 2013, SPONSORED BY SADDLEBACK VALLEY COMMUNITY CHURCH AND TO PARTICIPATE IN THE ACTIVITIES INVOLVED IN THIS EVENT. IN THE EVENT OF A MEDICAL OR DENTAL EMERGENCY, I AUTHORIZE A REPRESENTATIVE OF SADDLEBACK VALLEY COMMUNITY CHURCH, PURSUANT TO THE PROVISIONS OF CALIFORNIA FAMILY CODE 6910, TO CONSENT TO MEDICAL OR DENTAL CARE, OR BOTH, FOR THE ABOVE STUDENT. I UNDERSTAND THAT ALL HEALTH AND ACCIDENT POLICIES TERMINATE. CHURCH COVERAGE IS ONLY VALID WHEN OTHER INSURANCE HAS BEEN EXTENDED TO ITS LIMITS. I ALSO UNDERSTAND THAT IN THE EVENT OF REPEATED MISCONDUCT, THE STAFF IS AUTHORIZED TO SEND MY STUDENT HOME AT MY EXPENSE. REGARDING TRANSPORTATION, I AM AWARE THAT MY STUDENT WILL BE TRANSPORTED TO AND FROM THE EVENT IN A CHURCH RENTAL OR PRIVATE VEHICLE. I ALSO UNDERSTAND THAT IN THE EVENT OF REPEATED MISCONDUCT, THE STAFF IS AUTHORIZED TO SEND MY STUDENT HOME AT MY EXPENSE. I AM AWARE THAT THIS EVENT MAY BE VIDEO TAPED AND/OR PHOTOGRAPHED FOR THE PURPOSE OF PUBLICATION IN PRINT AND/OR ON THE INTERNET. PARENT SIGNATURE: DATE: I GIVE MY PERMISSION FOR MY STUDENT TO RECEIVE OVER- THE- COUNTER MEDICINES WHEN NEEDED I GIVE MY STUDENT PERMISSION TO BE PHOTOGRAPHED FOR OUR CAMP VIDEO AND WEBSITE I WANT TO HELP FINANCIALLY SEND OTHER KIDS TO CAMP EMERGENCY INFORMATION: NAME: PHONE: ( ) NAME: PHONE: ( ) PAYMENT INFORMATION: I WOULD LIKE TO PAY IN FULL *Please fill out the payment form on the backside of this form. I WOULD LIKE TO SIGN UP FOR THE PAYMENT PLAN *Please fill out the payment form on the backside of this form. I AM APPLYING FOR A SCHOLARSHIP WITH THOUSAND PINES (max is $200) *A Deposit is required

4 Saddleback Church Summer Camp 2013 Payment Form Wildside Junior High 2013 Summer Camp :: Thousand Pines :: August 5-9 :: $370 STUDENT INFORMATION: Last Name: First Name: Gender (circle one): Male Female Grade in the FALL (circle one): 7 8 PARENT INFORMATION: Last Name: First Name: Primary phone #: PAYMENT OPTIONS: [ ] Pay In Full - $370 [ ] Payment Plan - $370 over 4 payments ($150 down and three monthly payments of $73 each) PAYMENT INFORMATION: Credit/Debit Cards are the only form of payment accepted for payment plan Date of $150 Deposit: Day of the month to charge balance payments (circle one): 1 st [ ] I would like to pay in full via check [check # ] or 15 th Card Type (check one): [ ] Visa [ ] Mastercard [ ] Discover [ ] American Express Credit Card #: Expiration: / Security code: Zip Code: Signature: toni@thousandpines.com FOR OFFICE USE ONLY: Date Received: Approval: Date of Deposit: Balance Paid in Full:

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6 Non-Prescription Medication Available at Thousand Pines The medications listed below are kept in stock; do not feel obligated to send any of these items. Please check each box below to indicate your permission for the listed medication to be administered by the Camp Nurse or an authorized staff member. We will not administer any medication without your authorization. YES NO YES NO YES NO Benadryl (itch, insect bite, sinus) PeptoBismol (diarrhea) Tylenol (head/muscle aches/cramps) Caladryl Lotion (poison oak) Hydrocortisone Cream (itch/rash) Cough Drops (cough) Mylanta/Tums (upset stomach) Polysporin Topical (minor cuts/burns) Milk of Magnesia (constipation) Robitussin (cough) Betadine (disinfectant) Ibuprofen (pain reliever, fever reducer) Claritin (allergies) Non-Pseudo (sinus) Authorization For Medical Treatment SIGNATURE REQUIRED OR CAMPER CANNOT BE TREATED: I hereby authorize emergency medical or surgical care at the nearest hospital, should a medical emergency arise. I further authorize Thousand Pines personnel to assist me (or my minor/child) in the use of the medications indicated above and those listed on the prescription section of this form. Adult Camper or Parent/Guardian Signature: Date: Video & Photo Information Thousand Pines produces a weekly video recapping the activities the campers participated in, and the information they learned. The videos are primarily used for the guest s weekly recap presentation, on our website or in a promotional presentation, or as a generalpurpose preview of the Thousand Pines experience. These videos are solely the property of Thousand Pines C.C. and are given to participants as a keepsake. They are not to be used for commercial means. Adult Camper or Parent/Guardian Signature: Date: Physical Activity Release Camp activities include but are not limited to swimming, ropes course, skate-park, paintball, mountain bikes, team recreation, etc. There are risks of physical injury or harm from participating in activities. I voluntarily elect myself (or my minor/child) to participate in the activities and assume the risks of injury or harm that could result from participation. On my own behalf and that of my personal representatives and heirs, I hereby release Thousand Pines, its officers, employees, and agents from all liability for any injury or harm to me (or my minor/child) from participating in said activities. I have read and understood this release of liability. Adult Camper or Parent/Guardian Signature: Date: Behavior Agreement/Discipline Policy Please review the following camp rules and consequences for breaking the standards (and share with your minor/child if applicable). These simple standards will help ensure that every camper has a safe and successful experience. 1. Follow all normal organization/church/camp standards. Abide by all communicated camp guidelines. 2. Respect the rights of all people and their belongings. Be respectful towards and follow directions of all leadership/staff. 3. Participate in activities and maintain a good attitude. Use appropriate language at all times. 4. Keep hands, arms, and legs to yourself. Fighting, play fighting, roughhousing, and wrestling are not permitted. 5. Leave these items at home: alcohol, tobacco, all electronic devices, knives, weapons, matches/lighters, and valuables. 6. Be where you re supposed to be, Do what you re supposed to do, and Use Common Sense. If I don t follow these standards, I realize that I am choosing to accept the consequences for my behavior: 1. Be restricted from fun activities 2. Have to spend part or all of free time in work projects. 3. Call home to parents/guardians (if minor/child) 4. Be sent home and excluded from further attendance. The following behaviors are examples of what a misbehaving camper could be sent home for: 1. Hitting, fighting with, or threatening another camper 2. Vandalism, theft, or other inappropriate behavior 3. Being in the opposite gender s cabin 4. Repeated violation of camp guidelines I have reviewed the Thousand Pines Behavior Policy with my child and understand that all standards continue while in attendance at Thousand Pines. Should there be any serious difficulty with following the expectations, I support the implementation process (above) and, if necessary will leave the premises or bring my minor/child back home. Adult Camper or Parent/Guardian Signature: Date: I have reviewed the Thousand Pines Behavior Policy and agree to follow them as outlined. I understand that all church standards continue while at Thousand Pines. I understand that I may lose my privilege to attend Thousand Pines if I fail to follow them. Camper Signature (if Minor): Date: Reviewed By Organization (church or other) staff, Name: Signature: Date: Thousand Pines Christian Camps 359 Thousand Pines Rd. PO Box 3288 Crestline, CA info@thousandpines.com Page 2

7 JUNIOR HIGH SUMMER CAMP SCHOLARSHIP APPLICATION INSTRUCTIONS: Fill out the 2013 Summer Camp registration forms Fill out the attached Thousand Pines Scholarship request form Fax the Scholarship request from to Thousand Pines Bring your completed Saddleback Camp registration forms to: SSM on Northwood High School, the Saddleback church Irvine office OR mail to 3002 D ow Ave. Suite 514 Tustin Attention: Matt Hall

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