To Register For Camp

:
Registrations, medical forms, and a $50 nonrefundable deposit will be accepted IMMEDIATELY. ANYONE WHO REGISTERS FOR CAMP IS COMMITTING TO BE THERE FOR THE ENTIRE EVENT. No exceptions!

Monday, June 16 to Thursday, June 19, 2014. Cost is $235.00 Due to the limited number of camper spots available, registration will be on a first-come, first-serve basis and limited to families registered with Corpus Christi Church. Be sure to sign up early because the camp fills fast! We look forward to providing your camper with a wonderful camp experience that will bring them closer to Jesus and their Catholic faith. If you have any further questions, please contact the Youth Ministry Office.

CAMP WOW FRIDGE REMINDER:
 Registration Form & $50 deposit—First Come First Serve. SPACES FILL UP!!!  Medication Form—turn in with original Registration  $185 Final payment—due by April 1, 2014

(update as needed)

Questions? Contact: Mark Herwaldt at mark@corpuschristics.org or 630-483-4883

Join us for 4 days of:  SWIMMING  CANOEING  PRAYER  ARCHERY  TALKS  CAMPFIRE  INDOOR GYM  ROCK CLIMBING  LIVE BAND  HAYRIDE  SPORTS  WACKY OLYMPICS  SKITS  CRAFTS  AND SO MUCH MORE!

What IS CAMP WOW?
It’s a 4-day, 3-night summer camp for middle school students sponsored by several area parishes.

When IS WOW?
Monday, June 16—Thursday, June 19

Who CAN GO?
Any Corpus Christi youth currently in grades 6th, 7th, or 8th

Where IS IT HELD?
Dickson Valley Camp & Retreat Center in Newark, IL (Near Plano, IL)

How MUCH IS IT?
$235.00* (Includes the $50.00 deposit)
*NO ONE WILL BE DENIED PARTICIPATION BECAUSE OF AN INABILITY TO PAY.

SOUNDS FANTASTIC!! How CAN I Register?
Fill out the registration form and medication forms and return both with your $50.00 nonrefundable deposit (payable to Corpus Christi Church) to the Youth Ministry Office. The balance of $185.00 is due no later than April 1, 2014. QUESTIONS? CALL Mark Herwaldt at 630-483-4226

SPACES WILL BE FILLED ON A FIRST-COME, FIRST-SERVE BASIS.

SPACES FILL FAST—DON’T MISS OUT!

CAMP WOW 2014—REGISTRATION & PERMISSION FORM
GENERAL PERMISSION FORM
I request that my child ,______________________________, be allowed to participate in Camp WOW located at Dickson Valley Camp, Newark, IL on the following day(s): from June 16, 2014 to June 19, 2014. I hereby release and indemnify Corpus Christi Church, St Peter Church, Holy Cross Church, St. Katharine Drexel Church, and Christ the Teacher Parish, their staff, volunteers, and the Catholic Bishops of Dioceses of Joliet and Rockford from any and all liability arising from claims of any kind or nature whatsoever from my child's participation in this event. Campers are expected to stay during the entire camp session and if they must leave for any reason other than a family emergency they should not register for camp.

MEDICAL PERMISSION FORM
I grant permission for the administration of First Aid to my child, _____________________________________, by the people in charge of Camp WOW, and those transporting my child to and from the event as their judgment deems advisable, and to make the necessary referrals to qualified physicians for the treatment of illness or accidents of a more serious nature. I understand I will be promptly notified in the event of any serious illness or accident and prior to any major surgery, except when delay in such communication would endanger life. In the case of a medical emergency, I understand that every effort will be made to contact the parent/guardian of the participant. In the event that I cannot be reached, I hereby give permission to the physicians selected by the adult staff to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery if deemed necessary for my child.

Videotaping and Still Photographs
Video and still photographs may be taken during this event. This authorization form constitutes permission for my child's participation in the videotape and/or still photographs, which may be used for future promotional efforts, including the church website and ministry Facebook pages.

(PLEASE PRINT NEATLY) Camper’s Name:______________________________________ Address:____________________________________________ ___________________________________________________ School:_____________________________________________ Birth Date: __________________________________________ Grade as of Sept. 2013:________________________________ T-SHIRT SIZE: (ADULT SIZES) S M L XL XXL

Code of Behavior
You are representing Youth Ministry in our diocese during this event and we expect you will represent us well. We expect that you will display mature and responsible behavior, which for many years has been the trademark of Catholic youth and adults of our diocese.

Some Expectations:
1. 2. All participants are expected to arrive on time to all events. All participants are expected to demonstrate common courtesy and respect at all times. Inappropriate language/behavior will not be tolerated. Socializing should always be done in designated public areas. Dress should reflect the value of modesty. Writing on clothing should reflect Christian values. The possession or consumption of any alcoholic beverage and/or possession/use of any illegal drug is not permitted. Smoking is not permitted. Weapons and/or drug paraphernalia are not allowed. All medications, including over the counter (i.e. Tylenol, aspirin, Benadryl, etc.), are to be turned in to the camp nurse upon registration. Medication should be in its original container and clearly marked with the young person’s name. Please put the containers in a clear zip-lock bag along with instructions indicating dosage amounts and times. Infraction of these rules can mean immediate dismissal with no refund. Participants will be responsible to local authorities as well.

3. 4. 5. 6. 7. 8.

Parent Name(s): ____________________________________ Phone #: (_________) _____________________________ (circle) mother’s / father’s — (circle) home / work / mobile Phone #: (_________) _____________________________ (circle) mother’s / father’s — (circle) home / work / mobile EMAIL:_____________________________________________

Insurance Information Policy in the name of __________________________________ I understand and agree to this Code of Behavior. I also understand Insurance Company: __________________________________ and agree that at the time of an infraction requiring my dismissal, I Policy Number: ______________________________________ am responsible for my removal from the premises and any costs involved. Authorized Physician: _________________________________ Phone #: _______________________________________
9.

I also understand and agree that my parents or guardian will be notified at the time of an infraction requiring my dismissal. My parents or guardian will be responsible for my removal from the premises and any costs involved.

Camper Signature:_____________________________________ Date_______ Parent Signature: ______________________________________Date_______ *We are in need of additional funds to help give financial assistance to families who would like to

Office Use Only: $50 Deposit Pd.: ___________ Medication Form.:___________ $185 Balance Pd. __________ Scholarship Gift: $_________

send their kids to camp, but can’t afford the fee. If you would be able to help it would be greatly appreciated!
*Return this completed form, the medication form, & $50 deposit to the Corpus Christi Youth Ministry Office Space fills up quickly. Checks

can be made out to Corpus Christi Church. No one will be denied participation because of an inability to pay. If you anticipate any difficulties paying for camp, please call the Youth Ministry office.

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