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!
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