Narrow Way Youth Retreat

Youth Contact Info. Dustin Hall: (816) 517-1650; [email protected] Shane Hall: (816) 204-4304; [email protected] Narrow Way Youth Retreat 2016 REGISTRATION FORM

Camp will take place June 23-26 at Camp Imprint in Edwards, Mo. (www.campimprint.com) Check-in time will be early Thursday afternoon (plan to eat lunch before you come), and pick-up time will be around 3 p.m. Sunday afternoon. Specific details will follow.

Please fill out one form per camper, include payment, and give to Shane or Dustin Hall by Sun., June 5.

CAMPER INFORMATION

Last Name: ______First Name:______

Parent(s) Name(s): ______

Completed Grade: _____ Sex: M / F Age as of June 5: _____ Birthday: _____ -_____ -______

Address:______

Phone: (____)______Can you receive text messages? YES/NO

Email: ______

PAYMENT INFORMATION

The cost of the camp is $75 per camper. Campers must be age 9 or older unless their parents will be attending camp as part of the staff.

Families may enclose one check for several campers, but each camper must have his/her own registration form. Checks should be made to Warrensburg church of Christ.

If you need help paying for camp, or would like to donate money to help others attend, please check the appropriate box below.

Amount Enclosed: ______

I am interested in sending ______children to camp, but I need help paying. Please contact me.

I am interested in donating $_____ so other children may attend camp. Please contact me.

Forms can be mailed to Warrensburg Church of Christ, 722 S. Maguire St., Warrensburg, MO 64093 Continued on back … PARENT/GUARDIAN SECTION:

Name______Contact Number(s) ( ) ______or ( ) ______

Primary Insurance: ______Policy Number: ______

Does the camper have any relevant health issues including allergies, medications, or chronic / recurring illnesses?

Please list and explain: ______

______

Permission to swim: Y / N Physical within last 12 months? Y / N

Date of last tetanus shot:______

Date of last medical exam: ______Physician: ______

I (the parent/guardian) have read with my child the information on this registration form. My child agrees to follow the rules, dress code, and all other guidelines set forth by Camp Imprint and youth leaders.

I give consent for the use of photos of my child ______to be posted on the Warrensburg and/or Blue River church of Christ websites, www.cofcwsbg.org and www.bluerivercofc.org, the Warrensburg and Blue River church of Christ Facebook pages, church bulletin boards and/or other promotional material, Y / N

Parent / Guardian Signature: ______

Date: ______

T-Shirts

Each camper will receive a T-shirt. Please mark what size is needed.

Youth: XS S M L

Adult: S M L XL XXL

Additional information for Camp Impact 2016

WHAT TO BRING: Bible, Bedding (Sheets, Blanket, Pillow, Sleeping Bag), Towels / Soap / Toiletries, Modest clothing, Appropriate Swim Attire, Robe / Cover-up, Jacket / Sweatshirt, Lifejacket or floaties if needed, Extra Shoes, Spare Clothes, Flashlight, Bug Repellant, Sunscreen, Camera, Notebook, Pens / Pencils, fishing gear if you want to fish.

NO CELL PHONES ALLOWED by campers. We are at camp to learn about God, encourage one another and build relationships with God and with one another, not to text and be on Facebook. Cell phones can be checked in with the youth directors to be used in case of emergency only or to call home at the end of the day. Don’t plan to use it as a bible or flashlight.

DRESS CODE:

- Swimming suits: Modest one-piece or T-shirt over a two-piece suit. - Shorts must be at least fingertip length. No short, tight shorts. Campers that don’t comply with this rule will be asked to change. - Tank tops: No strappy tanks or racer backs that reveal bra straps, or regular tank tops that reveal cleavage. - Sleepwear: Modest sleepwear or robes must be worn for nightly bathroom visits outside cabin.

SLEEPING ARRANGEMENTS

Children ages 9 and up will be separated into boys and girls cabins with counselors.

HEALTH/WELLNESS:

1. All medications brought to camp must be kept and administered by the camp nurse. 2. Label medication with the user’s name and exact instructions. 3. Please check your child for head lice before camp. 4. Campers may not share bunks.

PROHIBITED ITEMS:

Campers are not allowed to have the following items:

- Cell Phones, Tablets / Computers / e-Readers, Gaming Devices, Video Devices, Pocket Knives, and any Items intended for pranks, hazing, or other unapproved use.

The following items are prohibited for campers, staff or visitors:

- Weapons, Firearms, Explosives, Alcohol, Tobacco, Recreational Drugs