Camp Christigan

July 28, - August 3, 2013

Dear Parents, Camp Christigan Directors, Support Staff and Counselors are delighted that you are allowing your young person to attend camp, and we trust this will be a positive experience for both you and your child. This year our camp venue has changed and Camp Christigan will be held at the Camp Whitley campgrounds on Troy Cedar Lake in Columbia City, Indiana. Attached is a three page registration package that will help us know how to better help your camper. Please complete the forms in full and along with a copy of your health insurance card and a signed Conduct Code and mail to: Camp Christigan Business Director 910 East Clark Street Warsaw, IN 46580

Below is some very important information for you:

Camp Cost: $150 if forms and full payment are in by June 16th. After June 16th the cost is $200.00 and registration forms will be accepted on a first come first serve basis, due to the limited amount of beds. Age: Young people entering 4th grade through 12th grade. Those entering 7th grade may choose which camp they would like to join, Jr. Camp or Sr. Camp. Discounts: If your child brings a first time camper they receive a $5.00 discount for each child they bring. This discount only applies to the camper who does the inviting. Also, this year we are able to provide a discount for multiple siblings attending camp who are living in the same household. The discounts are as follows; $150 for the 1st child (if registration is sent in before June 16th) $100 for the 2nd child living in the same household as first sibling. $75 for the 3rd child living in the same household as the first two siblings. Free for the 4th child living in the same household as the first three siblings. Checks should be made payable to: MIDWEST FELLOWSHIP YOUTH

Camp Store: During the week of camp, all young people are allowed to visit the camp store twice a day, with a $2.00 limit per visit. All items in the store are sold at cost (not for profit) and help provide a little extra snack. All money sent with your camper is put into the camp bank and what they dont spend is returned to the youth on the last day of camp. Mail Call is always an exciting time for the campers. Notes should be mailed by Wednesday of the week of camp, to help ensure you camper receive their mail. c/o Camp Christigan
4305 W. Camp Whitley Road Columbia City, IN 46725

Friday Talent Night: Parents are invited to join us on Friday evening after dinner for the Talent Night Show. You can check with your Grace Brethren Pastor for more information. Missionary Offering: Campers will have an opportunity on the last day of camp to give a donation to our Missionary Offering Project. Return Home: Campers will be released to go home on Saturday, August 4th, at 10:00 AM. We truly appreciate parents arriving on time. Check out is a fast process and campers can become unnecessarily worried when parents arrive late.

Things to Bring:
Please be sure to mark items with campers name Sleeping bag or bedding Pillow 2-3 towels (at least one for showers and one for swimming) Wash cloth Soap Toothbrush & toothpaste Toiletries, including comb brush Bug Repellant very important because we are by the water Sunscreen we dont want the campers to burn Flash light Walking/Sports shoes and socks (directors require all campers to wear some type of tennis shoe during game time to help prevent blisters) Shower shoes or flip flops Bible Money for camp store Raingear Sweater or sweat shirt Pen or Pencil Self addressed, stamped envelopes for home Enough clothes, under garments and socks for 6-7 days of camp Ball cap for protection from sun If your camper brings a camera, please be sure to write their name on the camera. Cell phones as cameras are problematic and NOT acceptable. Things NOT to Bring: NO Cell phones! Any camper bringing a cell phone will have to turn it into the Director for safe keeping until the end of camp. (We cant be responsible for any broken or stolen cell phones or any other electronic devices.) NO IPODs, MP3s, CD players, radios or any other electronic device! NO electronic games! NO lighters or matches! NO knives, fireworks or firearms! NO magazines! NO collectibles, i.e. cards Conduct Code All campers are required to follow directions for the sake of their safety. Each cabin will have adult leaders if for any reason you have a questions or problems you may approach them to assist. Understanding that they will encourage you to follow the rules. Understanding that the adults at Camp Christigan are there for your safety and will following their directions. All campers are asked to adhere to the above dress code and pack accordingly. If for any reason a campers behavior is unbecoming to the overall welfare of his/her safety or the safety of those around them, they will be removed from camp. If for any reason the campers behavior requires the General Directors intervention the course of action will only be resolved by a call to campers parent/guardian for removal from camp Dress Code We request that all clothing worn be modest and give evidence of good taste and not call attention to it. Also, proper under garments should be worn. The following are items that we are asking your camper NOT to bring: NO short shorts (must be at least finger tip length) NO hip huggers or low riders NO outfits or tops that expose the midriffs No Halter tops NO spaghetti strap tops NO tank tops (any exposed shoulders causes excessive sunburns) NO bikini swimsuits ( a tankini bathing suit is acceptable, if the midriff is covered. A tee shirt is worn over all swim wear. NO indecent pictures or questionable words imprinted on tee shirts NO tight fitting clothes

Camper Information Sheet Camp Christigan

Midwest Conservative Grace Brethren Churches

Staff Only Jr. Camp_____ Sr. Camp_____ Cabin #_______ Counselor__________________ __________________

July 28th-August 3rd, 2013

Please Print

Campers Last Name: ________________________________ Campers First Name:___________________________________

Please Print

Male: ___ Female: ___ Shirt Size___________ Date of Birth: __________________ Age: _______ Going into Grade: ____________ Desired Camp Jr.______ Sr.______ (Campers entering the 7th grade can opt to remain in the Jr. Camp or go into Sr. Camp.) Sponsoring Grace Brethren Church: ________________________________________________________
(Please list the Grace Brethren Church who is hosting your camper) Shirt Size Please Circle One Youth S M L Sponsoring Grace Brethren Pastor: _________________________________________________________ (Please list the Pastor of your hosting Grace Brethren Church) Adult - S M L XL XXL XXXL

Special Needs of camper: ______________________________________________________________________________________

(Please feel free to use the back of this page if more room is needed)

Siblings attending camp: ____________________________________________________________ Siblings attending camp: ____________________________________________________________

(Please feel free to use the back of this page if more room is needed)

Jr. Camp Jr. Camp

Sr. Camp Sr. Camp

*Number of 1st time invited campers for $5.00 discount______ If your camper is eligible for a 1st Camper discount, please list the names of 1st time invited campers on the back of this page. *Sibling Discount Applies: Yes____ No____ If yes, please circle which discount applies to this camper 1st 2nd 3rd 4th
*Please see cover letter for details on discounts. Will parent be a Camp Counselor for Camp Christigan? Yes________ No________

Parent or Guardian: _________________________________________________________________

Please Print first and last name

Address: ______________________________________________ City: ________________________State: ____ Zip:___________ Home Phone: ____________________________________________Cell Phone:__________________________________________ E-Mail____________________________________ Employer: ______________________ Work Phone: _______________________

Persons other than parent or guardian to be notified in case of emergency: 1. Name: _________________________________________________________ Relationship: ______________________________
Please Print first and last name

Address: _________________________________________ City:_____________________________ State: ____ Zip:___________ Home Phone: __________________________________________ Cell Phone:____________________________________________ Employer: _________________________________________________ Work Phone: _____________________________________ 2. Name: _________________________________________________________ Relationship: ______________________________
Please Print first and last name

Address: _________________________________________ City:_____________________________ State: ____ Zip:___________ Home Phone: __________________________________________ Cell Phone:____________________________________________ Employer: _________________________________________________ Work Phone: _____________________________________ Person or group, whom your child will ride home with on Saturday, close of camp: ____________________________________
________________________________________________________________________________________________________________________

( Print name of person or GBC group) ____________________________________________________________________ (Signature of Parent or Guardian) _____________________________ (Date)

Consent for Emergency Medical Treatment of a Minor Child

Camp Christigan
Midwest Conservative Grace Brethren Churches

Providing proper medical care for your children when they are away from home is very important. Camp Christigan needs this medical release properly filled out and signed so that we can provide prompt medical treatment and care in the event that your child is injured or becomes ill.

Important Notice: Unless a childs injuries are life threatening, physicians and hospital staff
cannot treat them without parental or guardian consent. As a result your child could suffer unnecessary discomfort while waiting for you to be contacted to approve usual and customary medical treatment. This form will give you the opportunity to consent to such treatment ahead of time. Simply complete this form, being sure to provide pertinent health insurance coverage. In the event that we have to take your child to the hospital there will not be any problems or delays in treatment while they obtain proper authorization.

As the parent or guardian of _________________________________________________________,

Please Print Campers Name

I authorize any medical officer, counselor, or staff member of Camp Christigan to seek immediate medical or surgical care my child may require if they are a victim of an accident, injury, or illness requiring such attention. I also give my permission for the medical officer of Camp Christigan to administer over the counter medications or prescription medications that the camper may bring to camp as the situation dictates. Family physician is: ___________________________________ Phone: ____________________ Health Insurance Co.: _____________________________________________________________
Please Print

Policy number: __________________________________________________________________ Signed: ______________________________________________ Date: ____________________

Be sure and include a photocopy of your insurance card, front and back side.

Medical Information Sheet Camp Christigan

Midwest Conservative Grace Brethren Churches

Staff Only Jr. Camp_____ Sr. Camp_____ Cabin #_______ Counselor__________________

Campers Last Name: ________________________________ Campers First Name:___________________________________

Please Print Please Print

Male: ____ Female:_____ Date of Birth: _______________ Age: _______ Going into Grade: ______
Campers SSN:______________________ Patent or Gaurdian:_________________________________________________________

Address__________________________________________________City___________________________State______Zip________ Home Phone:______________________________________________ Cell Phone:________________________________________ Parents Employer: _________________________________________________Work Phone:________________________________ Sponsoring Grace Brethren Church: ______________________________________________________________________________
(Please list the Grace Brethren Church who is hosting your camper)

Sponsoring Grace Brethren Pastor: ______________________________________________________________________________

(Please list the Pastor of your hosting Grace Brethren Church)

Is your child having any of the problems listed below? ____ Hay fever, asthma, wheezing ____ Eczema, frequent skin rashes ____ Convulsions / seizures ____ Heart trouble ____ Diabetes ____ Difficulty passing urine ____ Difficult bowel movements ____ Shortness of breath ____ Speech problems ____ Menstrual problems ____ Frequent colds, sore throats ____ Dental problems ____ Ear aches ____ Other

Please Explain any problem areas indicated above: __________________________________________________________________ ___________________________________________________________________________________________________________ If a girl, has she been told about menstruation? Yes: ___ No: ____ Has she menstruated? Yes: ____ No: ____ Operations or Injuries: _________________________________________________________________________________________ ___________________________________________________________________________________________________________ History of Emotional or Behavioral Disturbances: ____________________________________________________________________ ___________________________________________________________________________________________________________ Medications Needed or Used (Including Psychiatric): Medication _____________________________________________ _____________________________________________ _____________________________________________ Frequency ________________ ________________ ________________ Dosage ________________ ________________ ________________ Yes: ____ Yes: ____ Yes: ____ No: ____ No: ____ No: ____

Special conditions to be watched for, such as ALLERGY (Reaction to foods, penicillin or other drugs) bedwetting, fainting, sleepwalking, etc. ___________________________________________________________________________________________ ______________________________________________________________________________________________________
Date of Immune Date of Booster Date of Immune Date of Booster Date of Immune Date of Booster

Polio:

____________ ___________

Pertussis:____________ ___________ Other: ____________ ___________

Diphtheria: _____________ ____________ ____________ ____________

Mumps: ____________ ____________ Tetanus: ____________ ____________

Measles: ____________ ___________ Rubella:

Should this campers activity be restricted due to illness or physical defect? Yes: ____ No: ____ You can use the back if more room is needed. If YES, explain the degree of restriction. __________________________________________________________________________ I certify that this information is true to the best of my knowledge. I also am attaching a photocopy of the health insurance card (front and back side) under which my child is covered. __________________________________________________________________________
Signature of Parent or Guardian

_______________________
Date

Things NOT to Bring: NO Cell phones! Any camper bringing a cell phone will have to turn it into the Director for safe keeping until the end of camp. (We cant be responsible for any broken or stolen cell phones or any other electronic devices.) NO IPODs, MP3s, CD players, radios or any other electronic device! NO electronic games! NO lighters or matches! NO knives, fireworks or firearms! NO magazines! NO collectibles, i.e. cards Dress Code We request that all clothing worn be modest and give evidence of good taste and not call attention to it. Also, proper under garments should be worn. The following are items that we are asking your camper NOT to bring: NO short shorts (must be at least finger tip length) NO hip huggers or low riders NO outfits or tops that expose the midriffs No Halter tops NO spaghetti strap tops NO indecent pictures or questionable words imprinted on tee shirts NO tight fitting clothes NO bikini swimsuits ( a tankini bathing suit is acceptable, if the midriff is covered. A tee shirt should be worn over all swim wear, to avoid sun burns and sun poisoning. NO tank tops (any exposed shoulders causes excessive sunburns) Conduct Code All campers are required to follow directions for the sake of their safety. Each cabin will have adult leaders if for any reason you have a questions or problems you may approach them to assist. Understanding that they will encourage you to follow the rules. Understanding that the adults at Camp Christigan are there for your safety and will following their directions. All campers are asked to adhere to the above dress code and pack accordingly. If for any reason a campers behavior is unbecoming to the overall welfare of his/her safety or the safety of those around them, they will be removed from camp. If for any reason the campers behavior requires the General Directors intervention the course of action will only be resolved by a call to campers parent/guardian for removal from camp.

Yes, I have read the Dress Code and Conduct Code with my camper __________________________________
Print Campers Name

And understand that if my camper does not follow the Conduct Code he/she will be sent home. ____________________________________________________________
Parents Signature

Yes, as a Camp Christigan camper, I have read the above rules and will do my best to abide by them, with the understanding that if I do not I will be sent home. ____________________________________________________________
Campers Signature