August 13th 17th

T Register, g t Registratin Prcess https://regnag.brushfire.cm/events/444326?grup=9368ec5b-4db0-4ad7-b527-80009df990bf Pay the $50 depsit and/r the amunt that yur family can cver withut schlarship Camp Registratin Clses August 2. After this date, all camper registratins must be apprved and are subject t availability. N walk-n campers will be allwed.

Requirements WESTERN KIDS CAMP Aug 13-17, 2018 @ KELLOGG SPRINGS REGISTRATION INSTRUCTIONS Kids Camp Grade Requirements: Entering Grades 2-6 nly All Campers must have their parent/guardian cmplete the nline Camper Activity Participatin Agreement & pay the $50 Nn-refundable depsit. If the Activity Participatin Agreement is nt cmpleted, they will nt be allwed t stay, and the return hme will be n the hst church s behalf and expense. All Adults must cmplete the nline Camp Adult Applicatin and be apprved by the Lead Pastr prir t July 26. This includes Cabin Leaders, Camp Staff and Adult Vlunteers (all adults) at camp. Lead Pastr must apprve all Camp Adult Applicatin registratin frms. Student Ministry Team. SMT Vlunteers must be between 15 and 17 years f age. The SMT rle is t help serve the entire camp under the direct supervisin f the Camp Crdinatr. All SMTs must be pre-apprved by the camp crdinatr and have their parent/guardian cmplete the nline Activity Participatin Agreement. SMT members will be allwed t pay a reduced rate f $115. A camp T-shirt will nly be prvided fr Campers and Cabin Leaders registered by the EARLY DEADLINE. Csts & Deadlines The Registratin Deadline with $50 Depsit per Camper is: Early Registratin: $200.00 by July 26 Family Discunt - $190.00 fr each additinal camper frm same family. Late Registratin: $220.00 after July 26 N Family Discunt ffered n Late Registratins. Camp Highlight Pht DVDs are $5.00 each. Cabin Leader Registratin Fees Waived fr thse wh fall int the required ratis indicated belw. Church grups are required t prvide their wn Cabin Leaders. Cabin Leader Requirement Ratis: One male Cabin Leader fr every 1 t 6 bys and ne female Cabin Leader fr every 1 t 6 girls. All Cabin Leaders must be at least 19 years f age and have an apprved Camp Adult Applicatin n file. (All churches that cannt prvide Cabin Leaders based n this rati f Campers t Cabin Leaders will be subject t a $40.00 charge per camper t cver the cst f prviding ne fr yur grup.) Additinal Cabin Leaders, nt fitting int these ratis, will be charged at a discunt rate f $161. If yu need assistance meeting the required rati, please cntact the NextGen ffice. All Cabin Leaders must be at least 19 years f age and have cmpleted the Camp Adult Applicatin and been apprved by their Lead Pastr. Hme Missins Church PK s: If a camper wh attends is a child f a Hme Missin Church Pastr, please cntact Next Generatin Ministries fr schlarship pprtunities. T Register, g t Registratin Prcess https://regnag.brushfire.cm/events/444326?grup=9368ec5b-4db0-4ad7-b527-80009df990bf Pay the depsit and/r the amunt that yur family can cver withut schlarship Camp Registratin Clses August 2. After this date, all camper registratins must be apprved and are subject t availability. N walk-n campers will be allwed.

WESTERN KIDS CAMP 2018 CAMPER/PARENT GUIDE Aug 13-17 Entering Grades 2-6 Family Discunt available fr EARLY registratin nly T-Shirt nly guaranteed if registered by the EARLY DEADLINE Cmplete nline applicatin and pay depsit Pay remaining balance t yur church by due date Register here: https://regnag.brushfire.cm/events/4 44326?grup=9368ec5b-4db0-4ad7-b527-80009df990bf The Experience: Field game activities Zip line Swimming Mvie night S mres Archery Crafts Outstanding speakers Awesme wrship AND MORE Dvd: Remember t get a Camp Highlight DVD fr just $5! Order when yu register r purchase at camp. What T Bring: Tiletries / Cmb / Brush / Dedrant Twels fr swimming & shwering Tthbrush / Tthpaste Clthes fr chapel and activities Sleeping Bag / Pillw Swimsuit Bible / Ntepad / Pen Expectancy t see Gd mve in yur life and yur grup! Spending mney fr snack shack and/r Camp DVD What T Nt Bring: NO drugs / cigarettes / alchl / marijuana Firewrks / matches Fire arms / knives Prtable music r game devices DVD players / laptp cmputers Clthes: Casual clthes during the whle camp and sme warm clthes fr the evenings and cl clthes fr day time activities. All shrts must be mdest in length. Girls: Skirts and dresses must be mdest. NO back-less r halter -type dresses. NO belly shirts r spaghetti strap tps withut a shirt underneath. Mdest, ne piece swimsuits NO bikinis. Guys: Swim wear must be mdest. NO Speeds r shwing f under garments. Medicatins: Turn in all medicatin t ur Kids Leader BEFORE LEAVING FOR CAMP. Leaders turn in t First Aid persnnel upn arrival (Except Inhalers). All medicatin a camper is presently taking, including ver the cunter, must be in riginal bttle frm pharmacy indicating dsage, intervals and camper s name. Medicatins: Turn in all medicatin t ur Kids Leader BEFORE LEAVING FOR CAMP. Leaders turn in t First Aid persnnel upn arrival (Except Inhalers). All medicatin a camper is presently taking, including ver the cunter, must be in riginal bttle frm pharmacy indicating dsage, intervals and camper s name. Emergency Numbers: Phne is available t campers fr emergency use nly. Kellgg Springs Camp: (541) 459-1511 1111 Kellgg Camp Lane Oakland, OR

CROSS ROAD FLORENCE Permissin Slip and Medical Release Frm Please print: Child s Name Date f Birth Address Parent/Guardian Phne In case f emergency, cntact Phne Activity Western Oregn Kids Camp Date(s) August 13th-17th, 2018 Lcatin(s) Kellgg Springs Camp (Oakland, OR) Medical Histry Allergies 1. Insect Stings: YES NO (If yes please explain) 2. Penicillin: YES NO Other (specify) Current prescribed medicatin (specify) Please specify any ther health cncerns, physical activity restrictins, r ther infrmatin yu want the chaperns r directr f this activity t be aware f n behalf f yur child s welfare. Als indicate if yur child requires any special dietary needs. Crss Rad 1380 10 th St, PO Bx 3347, Flrence, OR 97439 Office@flrencecrssrad.rg 541-997-3533

Family Medical and Hspitalizatin Cverage Name f Insurance Cmpany r Gvernment Prgram Identificatin/Plicy # Family Physician s Name and Phne Number In rder t participate with Crss Rad Kids at _Western Oregn s Kids Camp August 13 th -17 th, 2018, I (we), (Name/date/lcatin f trip r activity) (Name f Parent/Guardian r participant ver 18 yrs ld) n behalf f myself r my/ur child participant d hereby release, frever discharge and agree t hld harmless Crss Rad Assembly f Gd, the staff and vlunteers theref frm any and all liability, claims r demands fr persnal injury, sickness r death, as well as prperty damage and expenses, f any nature whatsever which may be incurred by the undersigned and the participant that ccur while said participant is participating in the abve described trip r activity. Furthermre, I/we, assume all risk r persnal injury, sickness, death, damage and expense as a result f participatin in transprtatin, recreatin and wrk activities invlved therein. Further, authrizatin and permissin is hereby given t said church t furnish any necessary transprtatin, fd and ldging fr this participant. I hereby give my child permissin t fully participate (subject t the restrictins nted) in Crss Rad Kids s activity n the date(s) and at the lcatin(s) indicated abve. I permit the use f any phts, slides, films, r sketches f him/her taken during the activity fr publicity, advertising, and prmtin. I further grant permissin t the directr f the activity (r authrized designee) t dispense t my child any prescribed medicatin he/she is currently taking. I understand that I will be ntified in case f serius injury r illness. Hwever, in the event that I cannt be reached, I hereby give permissin fr my child named abve t be medically treated by a physician r medical facility as apprpriate. Signature Date Parent r Guardian Crss Rad 1380 10 th St, PO Bx 3347, Flrence, OR 97439 Office@flrencecrssrad.rg 541-997-3533

Our desire is t give all students the pprtunity t participate in all kid s trips & events, and we understand there are times when the cst may be ut f reach. Fr this reasn, we have created a Schlarship Fund with the purpse f prviding financial assistance t thse wh wuld nt therwise be able t attend. The Schlarship Fund is made pssible thrugh dnatins received frm many thughtful individuals wh recgnize the valuable spiritual impact that trips & events can have in a student s life. Schlarship Specifics: 1. Assistance is nrmally granted n a partial basis as need is determined. The maximum amunt this prgram can prvide fr any individual is up t ne half (50%) f the trips ttal cst. If yu can financially cver ver half, we ask that yu d s t make available schlarship funds fr ther students als seeking assistance. (Cnsider using ur Payment Plan fr the remaining balance if needed. Email us t get that frm.) 2. Schlarships are given n a first cme first serve basis. 3. Students must have all registratin paperwrk, depsits, and the schlarship applicatin submitted befre the EARLY BIRD deadline t be eligible fr schlarships. Schlarship Prcess: Fllw the steps belw in rder t get yur schlarship frm prcessed. Register fr Camp & Pay Depsit Submit Schlarship Applicatin t yur Children s Pastr Yur Children s Pastr will cntact yu (after the early bird deadline) when/if yur schlarship request has been apprved. If the cst is the nly reasn fr nt attending a trip r event and ur schlarship prgram wn t fund enugh, please let us knw s we can prblem-slve mre. We dn t want finances t be the reasn yu can t attend camp. Crss Rad 1380 10 th St, PO Bx 3347, Flrence, OR 97439 Office@flrencecrssrad.rg 541-997-3533

SCHOLARSHIP FORM Applicatin Trip Name: Western Oregn Kid s Camp Trip Date: August 13 th -17 th, 2018 Applicants Name: Street Address: City: State: Zip: Hme Phne: Cell Phne: Parent Email Address: Student Email Address: Trip Cst: $200 Depsit Required: $50 Amunt Needed: $ Have yu received schlarship assistance frm us in the past? If Yes, What Trip: Amunt Received? $ Please describe the circumstances surrunding yur need fr financial assistance: (Use back f sheet if necessary.) Will a 50% schlarship meet yur financial needs? If nt, let us knw s that we can lk at ther financial ptins. Sign this applicatin stating yu have a true financial hardship that wuld prevent yur child frm attending camp withut financial assistance. Signature f Parent r Guardian (required) Crss Rad 1380 10 th St, PO Bx 3347, Flrence, OR 97439 Office@flrencecrssrad.rg 541-997-3533