Jul 8, 2013 ... ______ I give permission to use pictures that include my child in the promotion of
Solid Rock Bible Camp and. InFaith. ______ I do not want ...
I understand that every effort will be made to protect and safeguard all campers. I agree not to hold SOLID ROCK BIBLE CAMP liable for any illness or mishap from any cause whatsoever which may be sustained. I also give the camp full authority in dealing with problems of discipline. I agree that any camper disregarding camp rules is subject to being sent home with no refund of camp fees. Likewise any camper who willfully destroys or defaces property will be held responsible and charged accordingly.
PARENT/GUARDIAN SIGNATURE: _________________________________ As a camper at SOLID ROCK BIBLE CAMP I promise to obey the rules and fully participate in the camp program.
CAMPER SIGNATURE: _________________________________ If possible, I would like to be in the same dorm with: 1. ____________________________________ 2. ____________________________________ 3. ____________________________________
PHOTO RELEASE FORM ______ I give permission to use pictures that include my child in the promotion of Solid Rock Bible Camp and InFaith. ______ I do not want any pictures of my child to be used for the promotion of Solid Rock Bible Camp and InFaith.
Solid Rock Bible Camp
Parent / Guardian _____________________________________ Date _____________________
Psalm 62:2 He alone is my rock and my salvation; he is my fortress, I will never be shaken.
2013 Registration & Medical Form
CAMPER AGREEMENT
Please send registration form to Roland Broeder, 320 NE 20th Ave, Great Bend, KS 67530
REGISTRATION FORM
We have an exciting summer planned... just for you!!!
or register online at solidrockbiblecamp.yolasite.com
Name _________________________________________________ Age ______ Birth Date_______________ Grade Completed___________ Sex: M F Home Church _______________________________________ Address ______________________________City _________________ State ______ Zip Code ____________ Home Phone # (_____)_____________ Work Phone # (____) ____-______ E-Mail ______________________ Parent/Guardian Name _______________________________________________________________________ Camp fee is $135 per camper.
At Solid Rock Bible Camp you can be a part of many exciting activities like water games, sand volleyball, team games, swimming, horseback riding, great food, Bible classes, singing, a fantastic speaker, a campfire, and making lots of new friends. Come, bring a friend and be part of a great camping experience!
CAMP DATES & COST July 22-26 Completed Grades 3-6 $135 July 29 -Aug 2 Completed Grades 5-8 $135
A $35 Registration fee will hold your spot at camp. The rest is due upon arrival at camp.
WHAT TO BRING TO CAMP Bible, Notebook, Pencils, Flashlight, Camera,
Envelopes with stamps. Bedding: Pillow, Sleeping Bag or Blanket. Personal items: Washcloth, Towels, Soap, Toothbrush & Paste, Comb, Pajamas, Robe, Bug Spray, Sunscreen, etc. Money: for offering and canteen ($7 recommended). Modest clothing: shorts, shirts, jeans (for horseback riding), jacket, shoes (more than one pair). Bring clothes for recreation, water games, and modest one piece swimwear for swimming. Shirts need to be long enough to cover belt line, no spaghetti string tank tops. Medications (in zip lock bag and labeled). Please Do Not Bring: I-Pods, I-Pads, tablets, electronic games, cell phones, pop, snacks or valuables.
THINGS TO KNOW 1. Camp registration will be on the first day of your camp from 2-3 p.m. on July 22 and on July 29. 2. Camp will end at 1 p.m. on July 26 and on August 2. Please call if you will be late so your child doesn’t worry. 3. Campers must be at least 10 years old to ride horses. 4. Campers are encouraged to write and they love getting mail.
Camper’s Name % Solid Rock Bible Camp 884 NE 110th Ave Claflin, KS 67525
5. Check out our website or register online at solidrockbiblecamp.yolasite.com
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6. In an emergency, call Roland’s cell phone at (620) 793-0765. 7. Solid Rock Bible Camp is an inter-denominational camp which welcomes all regardless of race, color, nationality, sex, age, or handicap.
LOCATION & DIRECTIONS Solid Rock Bible Camp rents the facilities of Camp Aldrich. It is located 4 miles southwest of Claflin on HWY 156 and 1.5 miles north, or 10 miles northeast of Great Bend on Hwy 156, and 1.5 miles north. Please cut on the center fold and keep this side for your information!!!!
8. Camp will be directed by Roland & Deanna Broeder, Field Directors to central Kansas with InFaith. You may contact them at: Roland & Deanna Broeder 320 NE 20th Ave Great Bend, Ks 67530 620-792-4899
[email protected]
Camp Attending July 22-26 Grade 3-6 July 29-Aug 2 Grade 5-8 Camp fee or $35 Registration fee $____________ Canteen Amount ($7 Recommended) $____________ Offering for Missions $____________ T-Shirt (Optional) $10 (Circle Size) $____________ Size YS YL AS AM AL XL Donation Enclosed $____________
TOTAL AMOUNT
Please make all checks payable to Solid Rock Bible Camp. $5 discount given if registered by July 8th. Please register early!!!!! No confirmation letters will be sent. Please mail this form to Roland Broeder at address below!!!!!!!!
$____________
MEDICAL INFORMATION
Name (First)_________________________ (Last)________________________________ In case of emergency, notify________________________________Relationship______________ Phone # _______________________ Work Phone #_________________________ Cell Phone # _________________________ Parent/Guardian Health Insurance: Company____________________________________ Employee#____________________________ Policy #_____________________________ I hereby request that in the event of an emergency, my child be taken to the nearest doctor or hospital for treatment and I be notified as soon as possible. I understand that I will be responsible for any medical expenses not covered by my insurance or camp insurance. Parent/Guardian’s Signature
Date
Is the camper able to participate in all activities? Yes___ No____ If no, please explain ___________________________ _____ ________________________________________________________________________________________________ HEALTH HISTORY Allergies (specify) ___________________________________ yes no ___________________________________________________ Able to sleep on a top bunk? Bedwetting history? Taking any medications? (please note name of medication, dosage, and All shots current? instructions) DPT Series - Date _______ ___________________________________________________ Surgery within last year? ___________________________________________________ Epilepsy/convulsions? ___________________________________________________ Diabetes? Digestive problems? Note: Medications brought by campers must be placed in a zip lock Asthma/Hay Fever? bag and clearly marked with camper’s name and instructions. All Ear trouble? medications must be turned in to camp nurse. Heart problems? Please send camp fee & registration form to: Roland & Deanna Broeder, 320 NE 20th Ave, Great Bend, KS 67530 If financial assistance is needed, please contact Roland Broeder at 620-792-4899 for scholarship information.
