Application Forms
Request for Information
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Step
1. Parent Info
Mother Info
Father Info
Mother Information
First/Last Name
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Zip
Home Phone
Children live with
Both Mom and Dad?
Yes
Father Information
First/Last Name
Work Phone
Cell Phone
Email
Address
City
State
Select One
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Zip
Home Phone
2. Camper Info
Camper 1
Camper 2
Camper 3
Camper 4
Camper 5
Camper 1
Camp
-- Select --
Brookwood for Boys
Deer Run for Girls
Exodus
Moose River Outpost
Session
- Select Camp -
First/Last Name
Date of Birth
Grade in School
as of Sept 08
E-mail
IM Address
Gender
M
F
Returning Camper?
Yes
Camper 2
Camp
-- Select --
Brookwood for Boys
Deer Run for Girls
Exodus
Moose River Outpost
Session
- Select Camp -
First/Last Name
Date of Birth
Grade in School
as of Sept 08
E-mail
IM Address
Gender
M
F
Returning Camper?
Yes
Camper 3
Camp
-- Select --
Brookwood for Boys
Deer Run for Girls
Exodus
Moose River Outpost
Session
- Select Camp -
First/Last Name
Date of Birth
Grade in School
as of Sept 08
E-mail
IM Address
Gender
M
F
Returning Camper?
Yes
Camper 4
Camp
-- Select --
Brookwood for Boys
Deer Run for Girls
Exodus
Moose River Outpost
Session
- Select Camp -
First/Last Name
Date of Birth
Grade in School
as of Sept 08
E-mail
IM Address
Gender
M
F
Returning Camper?
Yes
Camper 5
Camp
-- Select --
Brookwood for Boys
Deer Run for Girls
Exodus
Moose River Outpost
Session
- Select Camp -
First/Last Name
Date of Birth
Grade in School
as of Sept 08
E-mail
IM Address
Gender
M
F
Returning Camper?
Yes
3. Read Release
By Making Application: I agree to have my child examined by a physician, have immunizations current before entering camp, and complete a Health History and Examination Form before entering camp. Christian Camps and Conferences, Inc. will endeavor to conduct safe programs, and to inform our families of inherent risks. We believe that young people seek adventure and that camp provides an ideal environment for exploring new activities in a prescribed and safe manner. However, some of the activities may involve risks that young people do not encounter every day. Examples in our camps include activities in and on the water such as swimming, sailing, skin diving, white water rafting, blobbing, and water skiing. Land activities may include rappelling, rock climbing, riflery, skeet shooting, archery, paintballing, horseback riding, and activities in the facilities or on the trail where inclement weather may be involved, bicycling on public roads, travel in camp vans, and ropes or obstacle courses. Camp participants must also assume the infrequent but inescapable risks with such activities. Safety is an essential element of the activities we offer, and we observe standard precautions. We conduct our programs according to practices and procedures recommended by the American Camping Association. While we are aware that it is not possible to foresee every contingency nor to eliminate all risk, our risk management program includes specific criteria for staff selection, training and supervision, written safety policies and procedures, reporting and review of accidents and supervision will provide reasonable precautions for the safety and well-being of each participant. Although our medical staff is trained and equipped to handle most routine medical conditions, we can not care for campers with special conditions, for example those requiring insulin. Parents should contact the Executive Director for further clarification on this issue if necessary. I give my permission for my child to participate in the entire camp program including traveling in camp vehicles, and give permission for the camp to secure treatment for him/her in case of sickness or other emergency. I have read the 2008 General Information sheet and understand the expectations provided by the camp. I give my permission to use pictures in which my child as a camper may appear in camp brochures, flyers or other promotional literature both electronic or published and used by the camp. I approve this application and agree to the terms stated. MY NON-REFUNDABLE REGISTRATION FEE (AFTER FEBRUARY 29, 2008) OF $200.00 FOR 2-WEEK CAMP, OR $400.00 FOR 4 WEEK CAMP, IS ENCLOSED. I understand that Christian Camps and Conferences, Inc. may not be able to accommodate changes in session attendance after February 29th due to space allocations for two-week and four week campers, and that tuition paid after April 15th is refundable only if the vacated space at camp is filled through the waiting list or newly registered campers. I acknowledge that I understand there are risks involved in the activities as described and I accept this risk as part of my child's participation.
I agree to the terms and conditions.
34 Camp Brookwoods Road, Alton, NH 03809
Tel: 603.875.3600 Fax: 603.875.4606 info@christiancamps.net