Online Camper Registration and Health Record
Address
Campers name First & Last
Birthdate (mm/dd/yy)
Parents e-mail address
Age
Church you attend
Church address, City, State, Zip
Parents or Guardians names: Father 1st, Last.
Mother 1st Last.
All children’s camps run from Sunday afternoon through Friday 10 AM except the 7-10 year old camp which ends Wednesday at 10 AM.
COST: Camper fee is $125. All campers who register *(postmarked) before June 1st will receive $5 free in our canteen (store). Note: Our actual cost for a week of camp is approximately $200 please keep that in mind as you consider a donation to send with your registration. The camper fee is $100 for the 7-10 Year old Camp. All money for Crafts, Canteen and Offering will be deposited into a separate account for each camper.
Please indicate the amount you paid on previous page.
$29 Pre-Registration fee (Includes $4 online registration surcharge)
+ Remaining camper fee ($100 OR $75 for 7-10 camp.)
+ Canteen Fund (Suggested canteen fund $15-$20)
+ $1 for picture of cabin group
+ $15 for a Camp Joy t-shirt. Size needed
+ Camp Donation: (Not necessary but appreciated!)
= Total enclosed
Bunkmates (Limit 2)
A maximum of 4 from any church / or
town allowed to stay in the same
cabin. We want you to make new
friends!
Any excess canteen money at the end of
the week can be refunded or donated.
If you choose to donate it will go toward
missions.
Please indicate your choice.
If space is unavailable we will contact you.
**This is optional, Write name’s in ONLY if you are concerned about unauthorized pick up. Please list the adults who are authorized to pick up your child after camp is over, again, only
if you are concerned about unauthorized pick up:
Occasionally we will use camper photos in our Newsletter or on our website. Check here if you do not want pictures of your child used in our publications.
When you are finished be sure to click on the submit button - thanks!
Health Record
Responsible party to be notified in case of illness or injury:
Name
Relationship to camper
Phone number
Cell #
Allergies camper has
Diseases camper has
Reactions to drugs
Check any of the following that pertain
Does your child have any other special needs we should be aware of in advance? We need to know in advance if there is any need for extra supervision so we can place them in the proper cabin and so we can make appropriate plans ahead of your arrival. We want your child to have a terrific camping experience!
Activity limitations?
IMMUNIZATION RECORD - DATES REQUIRED OF LATEST INOCULATION
MMR
DTP
TETANUS BOOSTER
We must have dates of immunizations.
In case of an emergency, I understand every effort will be made to contact the parents or guardians of the camper. In the event they cannot be reached, I hereby give permission to the physician selected by the camp supervisor to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for the child named on this form.
Name of person giving consent
Date
Health Insurance Company
Policy #
Parents Health Insurance is primary insurance. Camp Joy’s Insurance will cover injuries above what the parents Insurance will cover.
Mail completed Registration and Health record to:
Camp Joy Bible Camp
32521 380th ST
Dent, MN 56528
City
Make sure you have completed your payment on the payment page. Fill this form out and click submit. For information on what to bring etc. go here.
If you encounter any problems please notify us by e-mail at dale@campjoy.net
Zip
State
Home Phone
Food allergies camper has
Please e-mail us if there are severe food allergies. IE: camper is not able to eat normal cafeteria food. dale@campjoy.net
Our theme for the summer of 2012 for the last supper of the week is Faith Heroes. We would like our campers to pick some one who has been a big part of their faith growth. This person could be a Biblical person, who has taught them a life lesson. It could also be some one in their own life, like a Sunday School teacher or pastor or a parent! Then come prepared to dress up as that person and tell us who they are!
Check week attending
All camps start at 3 PM
The 14-17 year old camp is designed for teens deeply committed to Christ. In order to attend you must be at least 14; your Cabin Leader from a prior year must have recommended you; OR you must have a reference from your Pastor if you didn’t attend Camp Joy last year. (We will provide the form for this.) If you have questions write or call for more details. dale@campjoy.net Or (218) 758- 2924
