2017 Michigan District Junior High Camp (Camper Ages 12-14 Registration)

BE SURE TO READ ALL THE WAY TO THE BOTTOM OF THIS SECTION!

Welcome to the 2017 Camp Season!

It is our privilege to invite you to this very special year! We believe the lives of our campers will be strengthened through the power of the Holy Ghost. Campers will make positive life long decisions through recreational activities, powerful God experiences and mentoring opportunities. Sending your child to camp is more than just a summer activity it’s an investment!

Registration Prices:

Pre-Registration- February 28th- June 14th (11:59pm)

$120.00 per camper for Crusaders, Junior High and Senior High

$90.00 per camper for Camp Junior

At the Door Registration- June 15th- First Day of Camp

$140.00 per camper for Crusaders, Junior High and Senior High

$110.00 per camper for Camp Junior

2017 Speaker Line-Up

Junior High & Senior High: Rev. Brocc Chavis, St. Louis, MO & L.J. Harry, Mt. Vernon, OH

Crusaders: Rev. Bruce & Jami Borlik, Mishawaka, IN

Camp Junior: Rev. Stan & Barb Russell, Battle Creek, MI

*All staff members must register for each camp they are working. Deadline for Staff Registration is May 1st!

**Pastor signatures are still required for all applications. Each applicant must print the order confirmation and have all the necessary signatures. The signed copy must be brought on the day of camp.

***There is an Offline Payment method available for those that wish to pay by check. All checks must be mailed to the district office before June 14th.

Follow us on Facebook for important announcements about camp and real time updates and pictures during the weeks of camp!

When you sign the application, you are authorizing the following policies and releases for your camper or as a staff member.

PARENT/GUARDIAN AUTHORIZATION

The camper is accepting the responsibility to conduct themselves pleasing to Christ and will be subject to the camp regulations and authorized personnel while enrolled. The camper will also remain on the Michigan District Campgrounds until released to their parents or one of the above specified adults. Furthermore, the above named camper has my permission as parent or guardian, to attend the Michigan District UPC Camp at 22400 B Drive North, Marshall, Michigan 49068, for the period indicated above and I will be responsible for the admission fee and any other costs that may be a result of willful destruction of camp property or of another’s personal property. I also grant permission to publish pictures for promotion purposes.

PRIVACY PRACTICES/PERMISSION/RELEASE:

We are required by applicable federal and state law to maintain the privacy of your child’s health information. We use and disclose your child’s health information for use in medical and dental treatment by a physician or hospital, payment to the physician or hospital, and healthcare operations such as release of notes re- garding an accident or incident. We are required by law to obtain your written consent prior to making certain disclosures of your health information. I understand in the event that an emergency would arise that would require medical care, use of a physician or hospitalization or surgery, I will be notified immediately. However, should camp authorities be unable to locate or not have time to contact the child’s parent’s or guardian, they may take such temporary measures as they deem appropriate and necessary. Also, I grant permission for routine nonsurgical medical care for the above named camper. I hereby authorize the release of pertinent medical/dental information to insurance companies and I hereby authorize the insurance benefits be paid directly to the provider of medical/dental services.

CAMP STAFF MEMBER AGREEMENT

The Information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for children or youth work. In consideration of the receipt and evaluation of this application by the Michigan District United Pentecostal Church , Inc., I hereby release any individual, church, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply, with this authorization, I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. I understand that the MI District Camp Administration reserves the right to run a criminal and sexual predator background check. Should my application be accepted, I agree to be bound by the policies of the Michigan District United Pentecostal Church, Inc. relating to camps and to refrain from unscriptural conduct in the performance of my services on behalf of the district. I understand that I am considered an “at will” camp worker. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. This is a legally binding agreement which I have read and understand.

What to Bring to Camp

 Bedding for bunks (Twin size fitted sheet, pillow and blanket)

 Washcloths and Towels for everyday

 Hygiene Products (We love campers that smell good!) Shampoo, deodorant, toothbrush and toothpaste, hairbrush, hair supplies etc.

 Flip flops for the shower

 Clothes for play or during the day (Typically 3-4 outfits)

 Clothes for church (Typically 3 dress services)

 Church shoes and Play shoes

 Pajamas with a bath robe

 Clothes for water day! (Not White)

 Sweatshirt for the evenings

 Money for Concession Stand (Most items a $1.00 or more. Campers are fed before church but an after church meal is not provided but can be purchased at the Concession Stand.)

 Bible

 Camera

 Mosquito Spray

***Keep in mind camp often has very hot days and so clothes become unable to be worn again***