IMPACTING HEARTS of Young Life

www.ImpactingHearts.org
UNITED STATES OF AMERICA

2012 IMPACTING HEARTS OF YOUNG LIFE CAMP APPLICATION

This form must be completed by any and all students qualified for the 2012 Impacting
Hearts of Young Life High School Camp at Oakbridge Young Life Camp, by Escondido, on
the weekend of Friday, December 14th to Sunday, December 16th. Only High School
students enrolled in high school that are attendees of one of our 5 area YCNs (Youth Club
Nights) are eligible to attend as campers.
CHECKLIST: You must have all the following to attend the camp [ ] Parental/guardian AND social worker/caregiver approval (if applicable)
[ ] CONSENT/RELEASE FOR YOUNG LIFE ACTIVITY completed by parent/guardian/social
worker
[ ] CAMPING HEALTH, CONSENT AND RELEASE FORM completed by
parent/guardian/social worker
[ ] Impacting Hearts of Young Life waiver completed by parent/guardian/social worker
[ ] Impacting Hearts of Young Life Camp Application (this form) completed in full with a
volunteer from your YCN

NAME:_________________________
BIRTHDATE:__/__/____

AGE:______

SEX:_____

HOME
ADDRESS:________________________________________________________
CITY:_________________________
PHONE:____________________

ZIP:___________

YOUR
CELL
PHONE
EMAIL:________________________

#:_______________________

Which
YCN
do
you
attend,
_________________________________

and

for

how

long?

Do
you
believe
in
God?
____________________________________

Why

or

why

not?

___________________________________________________________________
Which
volunteers
do
_______________________________________

you

know

best?

____________________________________________________________________
Do you have a Bible? _____ Do you like to pray? _____ Do you believe in
Jesus? ______

PAGE 2 OF 2 - THURSDAY, NOVEMBER 29, 2012

What
are
your
__________________________________________

favorite

hobbies?

___________________________________________________________________
What
hurts
you
_______________________________________________

the

most?

What
makes
you
_____________________________________________

feel

loved?

By signing and agreeing to come, you are agreeing to obey the rules of the camp for the
entire weekend in regards to all things. Modest dress, one piece swimsuits for girls, no
cursing, being respectful at all times and obeying all volunteers. Failure to comply will
result in sending you home early. Do you agree? _____

SIGN HERE:________________________________________