Medical Information:
Last Tetanus booster ____/____/_____
Known Allergies? Yes
No
If yes, please list? __________________________
___________________________________________
___________________________________________
All medications sent with your child MUST be
in their ORIGINAL bottle/package with
pharmacist’s instructions listed. List
medications and time to be taken:
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
Campers Doctor:
___________________________
Phone: (___)________________________________
Insurance Company:
___________________________________________
Policy #
___________________________________________
Any camper activity restrictions?
___________________________________________
___________________________________________
___________________________________________
My signature certifies that the registrant (camper) is
in good health and may participate in the activities of
Camp Faith. Exceptions are listed. In case of
medical emergency, when legal guardian cannot be
reached, I authorize the Camp officials to secure
appropriate medical personnel and/or treatment for,
and to order injection, anesthesia, dentistry, or
surgery for the camper named on this form. Should
it become necessary for the camper to return home
because of illness, or for any other reason, I will
abide by Camp Faith’s decision (at my or the
church’s own expense). I give my permission to use
photos including the camper in camp publicity. My
signature certifies that the camper will abide by the
Camper’s Code of Conduct and all regulations
governing personal conduct and the use of camp
property and will participate fully in the camp
program.
Guardians Signature ____________________
Date: _____/_____/_____
Hebrews 11:6a
But without faith it is impossible to please HIM.
CAMP FAITH
321 Sugar Camp Rd.
Shinnston, WV 26431
Phone: 304-629-8359 or 304-592-5756
Email: [email protected]
www.campfaithinwv.com
Camp Registration: $95
Registrations received before due date will
receive a $20 discount.
$75 payable to Camp Faith
Registrations will be accepted as long as space
is available. Please bring $5 to $10 for snack
shack.
Check In Registration Starts:
Monday at 10:00am
Check Out:
Friday at 10:00 am for Jr. Camp
Junior Camp (Ages 7-12) June 15-19, 2015
Registration due by May 25, 2015.
Speaker for Junior Camp
To Be Announced
Camper Code of Conduct
- Medications are NOT to be kept by any campers and/or
counselors. ANY AND ALL medications either
prescription or otherwise must be turned in to camp
senior staff upon arrival.
- Physical contact between male and female campers is
NOT permitted and strictly forbidden.
- Camp Faith reserves the right to ask ANY camper to
change attire if it is deemed inappropriate.
- No inappropriate advertisements on clothing please.
LADIES:
- Dress clothes for chapel: modest loose fitting skirts,
dresses covering the knee, and tops.
- Activity clothes: loose fitting shorts covering the knee and
t- shirt.
- Modest sleepwear covering the knee.
- Swimwear: One piece swimsuit with cover up/robe or
dark loose fitting shorts covering the knee with a dark
t-shirt.
GENTLEMEN:
- Dress clothes for chapel: collared shirt and pants.
- Activity clothes: loose fitting pants or shorts covering the
knee and t-shirt.
- Swimwear: swim trunks covering the knee and dark
t-shirt.
What to Bring to Camp:
Teen Camp (Ages 12-18) July 13-18, 2015
Registration due by June 22, 2015.
Pastor Burton Gates
Liberty Baptist Church
Philadelphia, PA
Music:
• The Vaughan’s
• Blessed Point
KJV Bible, notebook, pen, pillow, sleeping bag or bedding
for twin bed, washcloths, shower towel, pool towel,
toiletries, dress clothes for chapel, activity clothes,
comfortable pair of tennis shoes, spending money,
flashlight, sunscreen, and yourself!
CAMPER REGISTRATION FORM
Registration for Jr. Camp is due May 25, 2015
Teen Camp is due June 22, 2015.
Please return this form completed with
registration fee.
Make Checks payable to Camp Faith.
Camp Faith
321 Sugar Camp Rd
Shinnston, WV 26431
Phone: 304-592-5756
Camper Information:
Name______________________Sex M or F
Birthdate ____/____/____ Grade: _________
Guardian:____________________________
Address:_____________________________
City:_______________State_____Zip______
Home Phone (____)____________________
Parent’s Cell Phone (____)_______________
Email:_______________________________
Emergency Contact: (if parent can’t be
reached)
Name:___________________________________
Relationship to Camper:_____________________
Home Phone (____)________________________
Work
Phone(____)______________________________
Cell Phone (____)__________________________
What NOT to Bring to Camp:
- Electronic media devices of ANY kind, including cell
phones!
- Tobacco, alcoholic beverages, or controlled substances.
- TVs, magazines, or any other questionable reading
Speakers:
material.
- Knives• or
weapons
of ANY
kind.
Pastor
Charles
V. Madaus
- Fireworks, lighters or matches.
• Pastor
Dan Vaughan
- Clothing
with inappropriate
advertisements, sleeveless or
tight fitting shirts.
- No food or drinks should be brought to camp.
We encourage parents to send mail to campers.
Email:____________________________________
Church Information:
Church
Name:___________________________________
Pastors Name:_____________________________
City:________________________State_________
Continued on Reverse side