Office Use Only
Date Rec. _________ Number: _________
Amount Rec. ________ Due: ___________
TRANSPORTATION REQUEST FORM
Day Camp Transportation Requested
YES
NO
With your help we can plan adequate Day Camp transportation for
your child. When making transportation plans, please remember that
it is best for your camper that his/her ride be the same each day.
If your camper will be riding a Day Camp Van, please select your 1 st and 2nd
choice for meeting/ drop-off location (locations are subject to change):
□ Rite-Aide (Barger Area)
□ Fairfield School (Danebo Area)
□ Albertson’s (Santa Clara)
□ Guitar Ctr./Gold’s Gym Building (N. Eugene)
□ Lutheran Church (2200 Coburg Rd.)
□ Ben Franklin Crafts (Gateway)
□ Twin Rivers Baptist Church (Mohawk)
th
□ Albertson’s (58 & Main, Springfield)
□ Value Village (Centennial Blvd.)
□ Pleasant Hill Baptist Church
th
□ Shell Station (I-5, 30 exit, S. Eugene)
□ Creswell, Old Ray’s
□ Olivet Baptist in Veneta
□ Berean Baptist Church, Eugene
Please let us know if your transportation plans change. We will be
contacting you with further instructions closer to the camp date.
Send your registration with deposit to:
Child Evangelism Fellowship
PO Box 50131
Eugene, OR 97405
Questions, please call: 541 342-8682
Child Evangelism Fellowship, Inc. is a basic Bible
believing Christian missionary organization designed to
reach children with spiritual training by means of Good
News Clubs®, Released-Time Bible classes,
correspondence courses, summer camps, 5-Day Clubs®,
and fairs.
Camp is limited
to the first
110 campers with
completed registrations!
Contact:
CEF/Good News Day Camp
541 342-8682
Aug. 10-14, 2015
REGISTRATION FORM 2015
Please use ONE form for EACH CAMPER.
Enclose a $25 non-refundable deposit (per camper). Your
deposit will be applied to the total cost of camp. Make checks
payable to CEF-Camp.
August 10-14, 2015
Monday-Friday, 9:00-4:15
Boy
Girl
Camper’s Name: ___________________________________
Address: _________________________________________
City: ___________________________ Zip: ____________
Good News Day Camp is held at Living Waters Camp & Conference Center, on the McKenzie River,
approximately 10 miles from downtown Springfield, on Deerhorn Rd.
Transportation is available from various pick-up points around Lane County.
Home Phone: ______________ Work._________________
Emergency: ______________________________________
Who Can Come?
Date of Birth: Mo.: _______ Day: _____ Year: _________
Any child having completed 1st grade Through those entering 6th grade
Allergies:  YES  NO If yes, please list:
_________________________________________________
_________________________________________________
Medication your child will need to take during camp:
How Much does it Cost?
$85 per child, if pre-registered by July 1, 2015
$100 per child registered after July 1, 2015
What to Bring to Camp?
Your Smile! ☺
Sack Lunch (snacks and drinks will be provided)
Jacket,
One Piece swim suit, and towel
Wear sturdy play clothes
Have Camper’s Name on ALL belongings!
Some partial scholarships are available, contact us for application!
Grade this coming fall: ______________________________
_________________________________________________
_________________________________________________
Date of last Tetanus Immunization: ____________________
Doctor: _____________________ Phone: ______________
Parental Release and Permission
“I, the parent or legal guardian of the above named camper, do hereby give
permission to the camp staff to secure medical treatment for my child. I, the
parent or legal guardian of the above named camper, do hereby give
permission for my child’s picture or likeness to be used for Child
Evangelism Fellowship promotion and advertising.”
Parent Signature ____________________________________
_________________________________________Date
Parent Name (Please Print)
Please fill out the reverse side of this form
If transportation is needed!