Gospel Hill Summer Camp 2012 - Registration

PLEASE NOTE: We have reached capacity for BOTH Day Camp Sessions, and ALL overnight camps EXCEPT Adventure Camp! Registration for these camps are now closed. If you'd like to be placed on the wait-list, please fill out the online registration. You will be notified if space becomes available.

We are still accepting registrations for Adventure Camp (15-18 year old overnight camp)!

GENERAL INFORMATION
Name:  
Gender:   Male     Female
Birthdate:   XX/XX/XXXX
Parent's Email:  
Parent's Name  
Parent's Phone  
School Name:  
Grade in 2011-2012:  
     

MEDICAL INFORMATION
Will your child be on medication this summer?  Yes      No

If Yes, list medication:

  
Will they need to take their medication while at camp?  Yes      No
Does your child have any allergies that we should be aware of?  Yes      No
Would you like to receive a form to list your child's allergies and/or medications in detail?  Yes      No
     
YES, By checking this box, I agree to the following: (REQUIRED)
  1. In the event I cannot be reached in an emergency, I hereby give my permission to the physician selected by Union Gospel Mission to hospitalize, to secure proper treatment for and/or order an injection, anesthesia, or surgery for my child as deemed necessary.
  2.  By this Agreement, I authorize Gospel Hill Camp staff/agent to administer First Aid (including over-the-counter medicines) as required for illness and injury. The signature of the parent or guardian below is intended to serve as a medical release.
  3. As parent or guardian of the above-named camper, I hereby agree to allow him/her to participate in all Gospel Hill Camp activities. I realize that unanticipated and unexpected dangers may arise during and associated with the camp activities. I voluntarily agree to accept any and all risks of injury arising from the camp activities.
  4. Union Gospel Mission may use comments, photos, and video of the camper named above in its promotional materials.
  5. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and medical release. I am agreeing to it of my own free will.
     
CAMP INFORMATION
Which camp(s) would your child like to attend? (Check all that you would like)
     

Children's Camps

    

Day Camps

    

(ages 6-11)

   Session 1 • June 11 - July 6, 2012   SORRY, FULL!
    Session 2 • July 23 - August 17, 2012   SORRY, FULL!

Pricing

   IF payment is received by:
   
  • April 27 - $13 per session
  • May 11 - $15 per session
  • After May 11 - $20 per session

Overnight Camps

    

(ages 6-11)

   Super Kids • June 13 - 15, 2012

(ages 9-11)

   Super Stars • June 18 - 22, 2012

(ages 9-11)

   Boys & Girls Sports Camp • July 9 - 13, 2012

Pricing

   IF payment is received by:
   
  • May 11 - $8 per camp
  • After May 11 - $10 per camp

Teen Camps

    

Overnight Camps

    

(ages 12-18)

   Arts Camp • June 25 - 29, 2012

(ages 12-18)

   Sports Camp • July 16 - 20, 2012

(ages 12-14)

   Explore Camp • July 30 - August 3, 2012

(ages 15-18)

   Adventure Camp • August 5 -10, 2012

Pricing:

  
  • 1 camp - $15
  • 2 camps - $20 (save $10)
  • 3 camps - $24 (save $21)