2015 Youth Summer Camps Registration Form

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1 2015 Youth Summer Camps Registration Form

2 Silver Lake Camp in Medical Lake, WA Junior High Camp: July 6-10th Early Registration is $255 due by 6/21 Standard Registration is $280 Senior High Camp: July 13-17th Early Registration is $255 due by 6/28 Standard Registration is $280

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4 CAMPER REGISTRATION General Information Camper s name Male Female Mark CLEARLY the Camp you will be attending: COMBO CAMP EAST - SILVER LAKE JUNE th JR HIGH - SILVER LAKE JULY 6-10 th COMBO CAMP WEST - CEDAR SPRINGS - JULY st HIGH SCHOOL - SILVER LAKE JULY th ANY REGISTRATIONS POSTMARKED AFTER THE EARLY REGISTRATION DEADLINE WILL BE CHARGED THE STANDARD REGISTRATION FEE. ALL APPLICATIONS MUST BE RECEIVED 1 WEEK PRIOR TO THE FIRST DAY OF THE CAMP YOU WILL BE ATTENDING TO AVOID ADDITIONAL CHARGES. Camper s Address Street Address City State Zip Birth Date Age Grade Entering Parent or Guardian s Name Parent or Guardian s Home Phone Parent or Guardian s Work Phone Church with which camper will be attending camp with City Phone Occasionally, Northwest Ministry Network, Silver Lake Camp and Cedar Springs Camp take photographs or make audio/video recordings of campers and/or adults involved in camp activities to be used in future promotional materials. Each Camper consents to the use of any photographs, audio or video recordings and grants permission to the Northwest Ministry Network, Silver Lake Camp or Cedar Springs Camp to take such photographs and for use them in promotional activities and materials. Complete BOTH SIDES of this form. If you are attending with your church, give this form and payment to your youth pastor/leader. Otherwise, return with payment to: Northwest Ministry Network Camps, Attn: Angela Crawford SE Douglas Street, Suite 200 Snoqualmie, WA 98065

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7 CHURCH PERMISSION SLIP CHILDS NAME: GENDER: BIRTHDATE: AGE: I hereby grant permission for my child to participate in Summer Camp 2015 between July 6th-10th or July 13th-17th with Merge (the student ministries of The Church at Maltby Monroe). I understand that due care and caution will be used. However, in the event of accident/injury, I release The Church at Maltby Monroe, its staff and volunteers from all liability. In case of accident or serious illness, I request that the church contact me. If the church is unable to reach me, I hereby authorize the church to call the physician below and follow his/her instructions. If it is impossible to contact the physician, the church may make whatever arrangements deemed necessary. It is my responsibility to comply with procedures if my insurance company requires notification in an emergency. PARENT/GUARDIAN SIGNATURE: PRINTED: DATE: Please return this permission slip to Pastor Tyler What to Bring: Bible and journal, sleeping bag, pillow, comfortable clothes, long pants, warm jacket and/or sweater, several changes of clothes, appropriate shoes, towels, toiletries, swimsuit, insect repellent and flashlight. Optional money for offering, camp store and snack bar. What Not to Bring: Cell phone, any music device such as an MP3 or ipod, gaming devices, weapon of any kind, illegal substances, alcohol, tobacco.

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