Gnc 2015 Summer Camp Registration Form
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2GNC Summer Camp Registration Form
Name: ______________________________ Age: _______ Date of Birth: ______________ Boy: ______ Girl: ______ Grade Completed:
________
Address: _________________________________________ City: ________________________ State: __________________ Zip:
_______________
Email Address:
____________________________________________________________________________________________________________
Mother’s Name: _____________________________ Day Phone: _______________ Night Phone: _______________ Cell Phone:
_______________
Father’s Name: ______________________________ Day Phone: _______________ Night Phone: _______________ Cell Phone:
_______________
Home Church: ____________________________________________________
City:____________________________________________________
Cabin Mate Request: ______________________________________________ 2nd Choice:
______________________________________________
(Sorry, no guarantees, but every effort is made to honor your cabin mate requests.)
Summer Camp Schedule 2015
CHOOSE YOUR MAJOR FOR THE WEEK
Date
Camp
Cost
*In addition to all of our fantastic activities,
you will spend several hours each day at your
July 6-11
Elementary Camp
grades 3-5
$190
choice below.
July 13-18
Kampto
grades 7-12
$220
___ Paintball Camp
July 20-25
Jr/Sr High
grades 6-12
$190
___Art
August 9-14
Kampto
grades 7-12
$220
___Adventure
Date
Camp
__________
___________________________
*Please circle the camp you are registering for.
Photo Release
Photographs and video footage taken of my child as a result of participation in activities at Good News Camp may be used in camp
promotional materials or website.
Camper Release
Parents or guardians will be notified if their child receives treatments for an injury/illness that requires a physician. I understand
that there may be
elements of risk associated with activities at camp. I give permission for my child to participate in all activities at camp and hereby
release and agree to indemnify and hold harmless Good News Camp and its trustees, officers, employees, agents, and volunteers
from any and all claims of any nature arising from such participation. In signing this document, I hereby certify that the above
information is correct.
Signature (parent or guardian is required) ___________________________________________________________
Date: _________________________
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