SC23 Registration Form

Camper Info

Camper Name

Select one

Male Female

Date of Birth

Address

Mailing Address (if different)

Church you attend

Shirt Size

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL Adult 2XL

You may write the name of ONE camper that you wish to share a cabin with. Please note that this does not guarantee that you will be in the same cabin as this camper.

Cabin Mate Choice

Parents may choose between the camp for the grade the camper just completed or the grade they will enter in the fall.

Camp Attending

High School Camp 7th - 8th Grade Camp 5th - 6th Grade Camp 3rd - 4th Grade Camp

Parent/Guardian Info

Parent/Guardian #1 (first and last names)

Relationship

Phone

Does this phone receive texts?

Yes No

This address will receive a confirmation email

Parent/Guardian #2 (first and last names)

Relationship

Phone

Does this phone receive texts? Yes No

This address will receive a confirmation email

Pick-Up

Who will be PICKING UP camper at camp? (first and last names)

Relationship to camper

Phone (if different from parent)

Does this phone receive texts? Yes No

Medical information

Emergency Contact (in case parent can’t be reached) First and last name

Relationship to camper

Phone

does this phone receive texts?

Yes No

Physician & Insurance Information

Doctors Name

Phone

Health Insurance Provider

Policyholder

Group ID #

Policy #

Health History

Camper health and medical information need to be made known to the camp. Camp personnel will hold this information in confidence. If space is insufficient, please use the “Notes” section at the end of this form.

Severe reactions to food, bee stings?

Yes No

If yes, please explain

Restrictions of activity due to disability or for medical reason?

Yes No

If yes, please explain

Any allergies?

Yes No

If yes, please explain

Any special diet needs? (Diabetic, food allergies, etc.)

Yes No

If yes, please explain

Other medical conditions the camp staff should be aware of?

Yes No

If yes, please explain

Medications

All Medications (including “over-the-counter” meds) must be turned in to the camp medic at registration. No medications will be distributed without their ORIGINAL container. If additional space is required, please use the “Notes” section at the end of this form.

Medicine #1

Dose

Condition

Instruction

Medicine #2

Dose

Condition

Instruction

Medication Permission

Allergic to any medication?

Yes No

If yes, please explain

Other Medical Information

Use the space below to NOTE any additional medical concerns.

Payment

The cost of summer camp is $145 for 3rd and 4th grade and $165 for 5th - 12th grade. You may mail a check or pay at the door.

At the door, you may pay with cash or check.

If you wish to Mail a Check, please make it out to Fir Point Bible Camp and send it to the following address:

Joyce Miller
Fir Point Bible Camp
127 Fortune Branch Rd
Glendale, OR 97442

*if the camp you plan to attend is less than a week away, please pay at the door to be sure we receive your payment on time.

Select the payment method you intend to use

Pay at the door Mail a check I have a scholarship Other (please explain)

If 'other' or 'I have a scholarship' please explain here

Description

Welcome to Fir Point Bible Camp!

High School Camp
July 10th - 14th | $165

7th & 8th Grade Camp
July 17th - 21st | $165

5th & 6th Grade Camp - THIS CAMP IS CURRENTLY FULL
July 23rd - 27th | $165

3rd & 4th Grade Camp
August 1st - 4th | $145

Welcome to the Great Adventure!
Join us at camp this summer where we’ll explore how each of our lives is a great adventure orchestrated by God. Camp is a great way to get outdoors, have a lot of fun, and most importantly grow deeper in your relationship with Jesus Christ! Come join the excitement as we dive into God’s Word through Bible teachings, small group discussions, fun activities, and more!

SC23 Registration Form

Description

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