Camp Indianhead Registration Form July 6-11, 2014 You may type your information into the boxes, save it, then e-mail or mail it NO LATER THAN JUNE 7 to Lutheran Island Camp (the location of Camp Indianhead this year; see addresses below). Please complete a separate form for each camper.

Camper Name_ Birth Date / / Age:

Address_ City_ St_ Zip_ -

Grade completed in Spring of 2014_ Male Female (Please Check One)

Home Church Name & Pastor_ City_

E-Mail_ Parent/Guardian Name:_

Address:_ City_ St_ Zip_ -

Home Phone: Cell Phone Work Phone

Cabin Mate choice 1: Cabin Mate choice 2:

Camp Fees (Please check either A, or B, or C. D is optional.) A. I have included the total camp registration fee of $250. B. I have included a portion of the camp registration fee, the remainder to be paid by my church. - Portion I have included: $_ - Remainder to be paid by my church*: $_ (the church will pay this remainder directly to camper’s parents, or, send it to the camp)* C. I have included the minimum deposit of $75. D. (Optional) Besides one of the amounts included above, I have also included a prepaid Canteen amount of (see Canteen next page): $_ [FOR OFFICE USE ONLY: Total amount included with this form $______] [FOR OFFICE USE ONLY: Balance Due upon arrival at camp $______] * Check with your pastor or youth group before determining this amount and whether this amount will paid directly to camper’s parents or sent directly to camp)

* Check with your pastor or youth group before determining this amount Check enclosed or Please charge my credit card (a $5 fee may be charged)

Credit Card information: Visa Mastercard Card #:

Expiration date: _ /_ Cardholder Name_

Cardholder signature:______date:______

Check payable to: Lutheran Island Camp. Mail this registration BY JUNE 7th to Lutheran Island Camp, 45011 230th St, Henning, MN 56551. You may also email it to [email protected]. Canteen money: Some parents prefer to write out one check or make one credit card charge; so if you want to include canteen money now, you may do so. Otherwise canteen money will be collected when your child arrives. Your child will have a credit for the amount deposited at the canteen. Canteen money may be used for souvenirs, candy, pop, ice cream products, clothing, or special activities such as horseback riding (see below). The decision as to how much is between parents and children. Candy bars and pop are a dollar or less. Souvenirs range up to $5.00. Clothing can range from $10 for a t-shirt to $30 for a sweatshirt or jacket. Any unused canteen money will be returned to your child on the last day of camp. Horseback riding: This year we will offer horseback riding as an activity. The cost will be $20 for a one hour ride and will be subject to availability. This amount will be taken out of canteen money so make sure you send in or bring with you this amount along with the amount you will need for other canteen expenses. Medications: It is important that we be made aware of any medications, allergies, special diets, or other medical, social, or mental health issues that your child may have. We want your child’s experience to be a quality one and that happens only if we are aware of any issues that can affect your child at camp. All medications must be given to our staff at the time of arrival at camp. What to Bring: Sleeping bag (or, blanket & bed sheets), pillow, pillow-case, towel, wash cloth, jacket, flashlight and batteries, swimsuit, clothing for outdoor activities, bag for dirty laundry, rain gear, chap stick, soap, shampoo, toothbrush, toothpaste, deodorant, and other toiletry articles, sun screen, insect repellant, Bible, Small Catechism, notebook, pen or pencil, camera and film, money for canteen ($15-$45 recommended), softball glove (optional). What Not to Bring: Food, knives, balloons, TVs, fireworks, cell phones, anything illegal, boom boxes, mp3 players, iPods, etc. (these will be confiscated). Arrival and Departure: Check-In will be from 4:00-6:00 p.m. on Sunday. Plan on arriving at camp as near 4:00 p.m. as possible. At that time you will pay the remainder of your camp fees, be assigned a cabin, deposit canteen money, and be given any additional instructions. As a rule, all cabin assignments are final. No switching of cabins without director approval. Check–Out time is 11:00 a.m. on Friday. No one will be permitted to leave until all the rooms and grounds have met inspection. All campers must be off the grounds by noon on Friday. Camper Responsibility and Behavior (Philippians 1:27; Romans 13:1-2) General Policies Respect your counselors, pastors and staff. Respect your fellow campers. Respect God’s nature. Respect Lutheran Island property. Respect modesty, decency, and common sense. Specific Rules: Campers are not allowed to visit cabins of the opposite sex at any time. Campers are not permitted, alone or in groups, to travel further than eyesight of staff without permission. No one may be in the lake without permission. Campers are not to leave their cabins between 9:45 p.m. (10:30 on Thursday night) and 7:45 a.m. Appropriate dress is required for meals. Boys will act as gentlemen and girls as ladies; modesty and courtesy will be honored; no private or public displays of personal affection. Campers and their parents will be held responsible for damage to property. Consequences for Policy/Rules Violations: Limitation of activities, fines, and/or, in the case of persistent or gross disregard for the policies or rules, immediate dismissal. When the latter occurs parents will be notified immediately and asked to come and pick up their child or be made aware of the penalty imposed. Any camper who is dismissed will not be allowed to return the following year. If you have questions or suggestions, you can e-mail or phone the Camp Indianhead co-director, Pastor David Thompson, at [email protected] or 218-439-6259