chosen - a girls retreat at MCYC
Event Timing: April 21 - 23, 2017
Event Address: 820 North Lake George Road, Attica, MI 48412
Contact us at 810.664.8040 or programs@mcyc.org
Email address
First Name
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Last Name
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Cabin Requests - Because hey, camp is even better with friends!!
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Gender
Mailing Address
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City, State, Zip Code
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Attendee's Email
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Parents Email for Confirmation
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Birthday
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Mother's Name
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Mother's Cell Phone
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Mother's Email
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Father's Name
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Father's Cell Phone
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Father's Email
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Emergency Contact Name (if parent of Guardian is not available)
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Emergency Contact Phone Number
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Church you Attend
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Is camper free from infectious disease or conditions?
Are immunizations up to date?
Date of last tetanus shot?
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Any activity the camper should be restricted from?
Any physical, mental, or other condition that would require special attention or medication while at camp?
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List any allergies that your child may have.
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List any food allergies that your child may have
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Are there any special diets that we would need to know about (vegan, vegetarian, etc.)
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List all medications, both prescribed and over the counter. All medications will need to be turned into the camp office upon arrival. All medications MUST be in original containers.
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Method of Payment
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Camper Release (List anyone, including parents, to whom your camper can be released to so they can go home or if they have an emergency while at MCYC)
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The small stuff
A confirmation will be emailed to you with a health form and our release of liability statement. Please make sure to bring these with you on Friday night when you drop your camper off. It will speed along the drop off times.

In signing this document, I hereby certify that this information is accurate and give permission for the use of photographs and videos including myself to be used in camp publicity. I agree to release from liability and hold harmless Michigan Christian Youth Camp, its staff, agents and officers from or for any claims, liability, or damages that may occur as a result of an accident, injury or death during the Michigan Christian Youth Camp experience. This release includes theft, destruction of property, or result in injury to or death.

I agree to all the terms and conditions listed above.

To make payment through paypal please go to http://www.mcyc.org/make-a-payment.html and put 'Girls Retreat' as the event name with your child's name. This will help us keep payment with camper if last names are different.

Thanks for signing your camper up for our Girl's Retreat. We are excited to help her in her walk with Jesus!

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A copy of your responses will be emailed to the address you provided.
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