Home Phone _____________ ___________________________ Cell _________________________
Camper’s Church ____________________
Minister’s name/phone number__________________
Children’s Name Ages and Birthdates: ______________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________
HEALTH RECORD: What restrictions, if any should be observed in ACTIVE camp life?
Indicate any medications to which camper reacts adversely and should not be administered
Name of camper’s doctor ________________________________________ Phone _________________
The campers will be supervised and if serious illness or injury develops, medical and/or hospital care will be provided. I further understand that in case of serious injury or illness, I will be notified. If it is impossible to contact me, I give permission for emergency treatment or surgery as recommended by the attending physician. I have read and understand the above information.
Printed Name: Signature:
Family Camp Sep 7-9 2018 - $20 per person $80 Immediate Family Max Please Pre-register by mailing this form and payment back to the camp. Mail to: MVCSC, 24201 State Route 100, Pittsfield, IL 62363
What to Bring:
Clothing: Modest clothing for classes, recreation, evening, rain gear, sweater/jacket. While choosing your clothing for camp, please remember that modesty is the key. Please, no bikinis, short shorts, halter tops, etc. Bedding: single sheet, pillow with case, blanket and/or sleeping bag Personal Items: Bible, towels, washcloth, soap, shampoo, toothpaste, toothbrush, comb, hairdryer, sunscreen, notebook, pen/pencil. CANTEEN/WATERBOTTLE Money: Offerings will be taken. Medication – you are responsible for your own family’s medications. Personal Electronics: Please refrain from using Please ensure all valuable and personal items are marked with the camper’s name. Not responsible for lost, stolen or damaged items
Check in Begins at 3pm on Friday. Supper will be at 5pm and the Concert at 6:30 Family Camp ends after Sunday evening worship. Immediate Family is two resident guardians and minor children
Save the Dates!
High School Camp June 10-15 2018 Jr High Camp June 17-22 2018 Jr Week June 24-28 2018 Christian Climbers July 1-3 2108 First Chance Camp July 5-6 2018 Day Camp July 7 2018 Mission Trip July 15-21 2018 Wilderness Camp August 5-9 2018 Sportsman (and Ladies) Camp August 12-15 2018 Family Camp Sep 7-9 2018