Brighton Lds Girls Camp Registration Form printable pdf download

2014 BRIGHTON LDS GIRLS CAMP REGISTRATION FORM

Camper Name: ________________________________________________ Dates Attending Camp: _______ to _______

First Name

Last Name

Month/Day

Check one: Entering □ 7

grade or □ 8

Current age: ______

Birthdate: ___ / ___ / ___

grade in September 2014

Month / Day / Year

Check one: □ 1

□ 2

Check one: □ 1

□ 2

year Beehive

year at Brighton

Each camper receives an adult-size T-shirt at camp.

Circle size preference: X-Small / Small / Medium / Large / X-Large

Bunkmate(s): List two bunkmate choices. We will make sure you are with at least one of them.

1. _____________________________________________

2. ______________________________________________

(Bunkmate camper name)

Camper lives with: □ Both parents □ Mother □ Father □ Other Camper primary language: _____________________

Parent(s) or Guardian(s): ______________________________ Contact Phone(s): ________________________________

Home Address: _____________________________________________________________________________________

Street

City

State

Zip

Camper Religion: □ LDS □ Other (If other, please specify: _________________) Camper attending with the following:

Stake: _________________________________________

Ward: ___________________________________________

Bishop’s contact phone number: ______________________

Bishop: ________________________________________

Policy and Consent Information:

My daughter and I acknowledge that we have read the “Information and Policies for Campers and Parents / Brighton

LDS Girls Camp” and we agree to abide by its contents. We understand that failure to do so may result in the

camper being sent home from camp.

CELL PHONES AND ELECTRONIC DEVICES ARE NOT ALLOWED AT CAMP. I agree not to send a cell

phone or electronic device with my daughter. My daughter agrees not to bring a cell phone or electronic device to

camp. I understand that if this policy is disregarded, any cell phone or electronic device brought to camp will be

gathered, held by the camp leadership and returned at the end of the camp week.

I understand that refunds are not given. If I am not able to attend Brighton Camp the week scheduled, I can “sell” my

reservation to another camper on the waiting list, attend a different week (depending on availability) or consider my

registration fee a donation to the camp. No refunds are given for leaving camp early.

I give permission for appropriate photographs and/or videos to be taken of my daughter while participating in

program activities at camp. These may be used for information and publicity for Brighton LDS Girls Camp.

I give permission for my daughter to participate in the activities at Brighton LDS Girls Camp, which include

physically challenging activities such as rappelling, zipline and obstacle courses.

6. In consideration of the benefit to be derived from participation in Brighton LDS Girls Camp, I hereby waive any and

all claims or liability against Brighton LDS Girls Camp, the Church of Jesus Christ of Latter-day Saints, or any

subdivision thereof.

CAMPER SIGNATURE: (Required) __________________________________________________________

PARENT/GUARDIAN SIGNATURE: (Required) ________________________________________________

Brighton Lds Girls Camp Registration Form

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