Timber-Lee Signup Form

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January 11th-February 10th: $220

February 11th-February 17th: We cannot guarantee a spot

This form is also available for download Here: https://wsbc.link/Timber-Lee

Parent Name: *

Student Name: *

Grade: *

Birthdate: *

Sex: *

Male

Female

Required

Health History *

None of These Apply

Frequent Ear Infections

Bleeding/Clotting Disorder

Frequent Sore Throats/Strep

Hand, Foot, Mouth Disease

Chicken Pox

Measles

Mumps

German Measles

Diabetes

Asthma

Seizures

Heart Defect/Disease

Mononucleosis

Meningitis

Autoimmune Disease

Tuberculosis

Required

Allergies (please specify) *

Chronic or recurring illness or medical condition (not noted above) *

Any treatment to be continued at camp? *

Any medically prescribed meal plan or dietary restrictions (please notify camp staff two weeks prior to arrival) *

Activities to be discouraged or limited *

Additional health information for camp personnel *

Describe any physical condition, medications or allergies that require special consideration *

Current medications (Send with instructions in original container) *

Have you filled out the Church's Medical Release Form? *

Yes

No, go Here: wsbc.link/Permission

Required

Technology Policy

At Western Springs Baptist Church we seek to be intentional and fully present in our time together. This means that we will be looking to disconnect from electronic devices during this trip. Disconnecting from technology encourages students to be quiet before God and creates room for them to be more intentional with their faith.

We would prefer and encourage technology to stay at home for the weekend, and we will collect any cellphone or other technology students choose to bring with them. These devices will be stored in a padded case, and will be returned to them on the ride home. Western Springs Baptist Church is not responsible for consequential loss, damage, or misplacement of said devices.

If for whatever reason a student needs to call home, they can always use a leader’s phone. For parents, the fastest way to reach your student is to call Timber-Lee at 262-642-7345. Timber-Lee will then be able to radio me (Aaron Hoesli). You can also try calling my number (630-291-1105), but once again, service is not the best at the camp so I might not receive every call.

If I choose to bring technology on this trip, I will not hold Western Springs Baptist Church responsible for any damages.

I Agree

Required

I give my child my full support and permission to attend and participate in any and all trips, activities and events sponsored by Western Springs Baptist Church.

I Agree

Required

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