Teen CAMP 2019
Registration Form
Email address *
First Name *
Your answer
Last Name *
Your answer
Grade Completed *
Gender *
Age *
Your answer
Street Address *
Your answer
CITY *
Your answer
STATE *
Your answer
ZIP CODE *
Your answer
NAME OF PARENT/GUARDIAN *
Your answer
Home Phone
Your answer
Cell Phone *
Your answer
Work Phone
Your answer
Church Affiliation *
Your answer
Requested Roommate(s)
Your answer
TEEN CAMP T-SHIRTS
We give every student who preregisters a Teen Camp T-Shirt. To help us prepare though we need to know what size T-shirt your child wears. PLEASE CHOOSE WHAT SIZE FITS YOUR CHILD BEST
What Size T-Shirt does your child wear? *
TEEN CAMP IS JULY 8 - 13
Pricing is $300.00 if postmarked by Saturday, June 8th, 2019, $325.00 if received after.
This camp is for teens entering 7th grade - completing 12th grade
Make Checks payable to: Chambers Camp and Retreat
Send checks to: Teen Camp Registrar, Pastor Josiah Roloson
6034 County Route 69, Canisteo, NY 14823

WHAT TO BRING
Every student needs to bring a sleeping bag or bedding, pillow, toiletries, Bible, flash light, MODEST swimming attire, clothes for varying weather conditions and activities. Sunhats/baseball caps, sunscreen and bug spray can be brought at your own discretion.
WHAT NOT TO BRING
* No weapons, laser pointers, water devices or prank items.
* All inappropriate items will be confiscated with no return.
* There is a ZERO-TOLERANCE policy prohibiting any alcohol, tobacco, drugs
CONDUCT AND DRESS CODE
*Campers are expected to treat everyone and their property with respect and consideration
* Campers will demonstrate Christian values in language, behavior, and dress.
* There is a zero tolerance policy regarding public displays of affection, sexual contact, alcohol, tobacco, illicit drugs, weapons, gambling and pranks.
*Modesty in dress is expected. All clothing will cover the abdomen and all under clothing. No two piece bathing suits, string tops or short shorts.
* No clothing that references tobacco, alcohol, drugs, immoral behavior or rude comments, including related insignias or advertisements are permitted.
* Campers and their parents/guardians will be financially responsible for any and all property damage directly resulting from inappropriate behavior.
* Everyone will be open to the incredible things God has in store for this week! The lasting effects of what is learned at camp are life changing.
HEALTH FORM INFORMATION
* All campers are required to submit a Health Form BEFORE camp begins.
* It must be filled out completely and signed by their parents, and a doctor or nurse must verify the camper's immunizations.
* No one will be permitted at camp without a COMPLETE Health Form.
* DO NOT COPY THE HEALTH FORM ON THE BACK OF ANY OTHER FORMS.
* Campers will also be checked for head lice at registration.

Please go to

http://www.chamberswesleyancamp.org/uploads/2/2/2/0/22208628/chambers_health_form170317.pdf

To download the necessary health form

REGISTRATION AND PICK-UP INFORMATION
Registration is at 1:00 PM on Monday, July 8 2019. Pick-up is at 1:00 PM on Saturday, July 13, 2019.
PARENTAL/GUARDIAN PERMISSIONS
* I hereby agree to allow my son/daughter to attend Chambers Teen Camp and participate in all activities other than medically necessary exceptions. *
Required
* I understand and agree to all rules regarding conduct and that inappropriate behavior may require my child's immediate removal from the grounds. *
Required
Photography
* I grant Chambers Camp and Retreat Center the right to take, print, and/or electronically use photographs/videos of me and/or my child in connection with camp activities for such lawful purposes as publicity, illustration, advertising and web content.
By Checking the designated box I am signing that I will adhere to all policies and regulations set forth in this Teen Camp registration form.
A copy of your responses will be emailed to the address you provided.
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