CAMP SANDY STONE BOYS & GIRLS CAMP PRE-REGISTRATION FORM

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Stone Association Boys & Girls Camp Pre-Registration Form

*Boys Camp Dates: June 2nd - June 6th

*Girls Camp Dates: June 9th - June 13th
*Camper Age: Completed Grades 1 - 6

*Counselor Age: Completed Grades 7-12
*Camper Cost: $150 Per Camper (1st - 6th Grade) ($175 AFTER 5/20/25)
*Camp Counselor Cost: $95 per Counselor (7th - 12th Grade) ($110 AFTER 5/20/25)
*YOU MUST FILL OUT A FORM FOR EACH CHILD

*YOU MUST FILL OUT A FORM IF YOU ARE A CAMP COUNSELOR AND/OR A VOLUNTEER

*ALL COUNSELORS AND VOLUNTEERS OVER THE AGE OF 18 MUST HAVE A BACKGROUND CHECK
*DEADLINE FOR PRE-REGISTRATION AND PAYMENT IS MAY 20TH, 2025.

Email *

Name: *

Address: *

Best Daytime Phone Number: *

Best Nighttime Phone Number: *

Church I attend: *

If your church is not on the above list, what church are you attending?

Child's Name / Adult Volunteer's Name *

Child's / Adult Volunteer's T-Shirt Size (Included) *

My Child Is: *

I am an adult volunteer attending: *

My Child has just completed: *

My Child has / I have the following allergies (food, environmental, etc.). TYPE N/A IF THERE ARE NO ALLERGY CONCERNS. *

Are there any special instructions, special needs, medications, etc., that the Camp Directors need to be aware of? *

Yes

If the above answer is "Yes", what is the best number and time that we can reach you to discuss? If the above answer is "No", simply type N/A. *

My child, whom I am registering on this form, has my permission to engage in all of the camp activities, including swimming. *

Yes

N/A: Adult Volunteer

If the above was answered "No", please list any and all exceptions. Type N/A if the above was answered "Yes" or "N/A: Adult Volunteer". *

By typing my name below, I certify that I will not hold the Camp Director, Camp Committee, Counselors, Stone Association of Southern Baptists, or any other person enrolled in camp, to be responsible in case of any accident that may bring injury to myself / my child. *

By typing my name below, I grant my permission for camp staff to seek, and for emergency medical personnel to administer emergency medical treatment to myself / my child if it should become necessary. *

By typing my name below, I am agreeing that I WILL NOT be able to volunteer at Camp Sandy Stone until my background check is completed. I also understand that the form will be emailed to me once this registration is received. (Type N/A if you are registering a child / camp counselor who is under the age of 18) *

In case of Emergency, Please Contact (Type the Emergency Contact Name and Phone Number): *

My Medical Insurance Carrier is: *

My Policy # is: *

My Family Physician name and phone # is: *

I am this registered child's: *

I give permission for my child to appear in photos taken during their week at camp for printed historical photos and release the photos for uploaded social media purposes (Facebook, Instagram, website, etc.) to document promote the different activities experienced at camp. *

Yes

CAMPER PAYMENT OPTONS:

I am sending my payment of $150 per camper (If Registered And Paid By 5/20/24), or $175 per camper (If Registered And Paid After 5/20/24) via:

Venmo (@StoneAssociation-ofSouthernBap) Please include child's name in your "For". Venmo Transfer must be available by the deadline above to receive the early registration discount.

Check (80 Pippin Rd, Cookeville TN 38501) Please include child's name and "Girls Camp" or "Boys Camp" in your "Memo". Make checks payable to Stone Association. Checks must be received by the deadline above to receive the early registration discount.

I am not sending any campers

Other:

COUNSELOR PAYMENT OPTONS:

I am sending my payment of $95 per counselor(If Registered And Paid By 5/20/24), or $110 per counselor (If Registered And Paid After 5/20/24) via:

Venmo (@StoneAssociation-ofSouthernBap) Please include child's name in your "For". Venmo Transfer must be available by the deadline above to receive the early registration discount.

I am not sending any counselors

Other:

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