Kids Camp Registration 2021
Camp Wannahockalugie: June 21 -25, 2021
M-F 9AM-4PM
Email address *
Awaken - June 21-25, 2021, 9am-4pm
One registration per camper NOT per family.
CAMP INFO:
CAMPER INFORMATION
Child's First Name *
Child's Last Name *
Birthday (Change year to birth year) *
MM
/
DD
/
YYYY
Current Age *
Grade attended during 2020/2021 school year *
Gender *
What T-shirt size does your child wear? *
Would you like to be in the same group as someone else attending? Let us know who and we will try to make that happen, but no promises.
We will be going off site for some of the activities and will be transporting all campers to and from locations by bus. Can your child participate? *
For monitored pool events, is your child allowed to visit the deep end? *
If camper is to be picked up early, parent/guardian must notify camper's chaperone prior to leaving camp. *
HOUSEHOLD INFORMATION
Address *
City *
State *
Zip Code *
Home Phone (Indicate if none) *
Cell Phone (Indicate if none) *
Parent's Name *
Parent's Email *
Emergency Contact Person *
Emergency Contact Number *
Emergency Contact's Relation to child *
MEDICAL INFORMATION
Please include any Behavior/physical problems/handicaps/diets/headaches/anger/etc.
Allergies (food or medication)
My child will bring the following (Please know that ALL prescription medications must come in its original container, with doctor's label. They will be turned in at the registration and administered by the Healthcare staff for the week. Children who are sick or too weak will be sent home.)
IN CASE OF EMERGENCY
I, being the parent or legal guardian of this child, give Hilltop Christian Fellowship permission to act in my behalf in giving informed consent for medical treatment for my child when I am unavailable to give such consent on June 21 through June 25, 2021. I also agree to pay for the performance of such treatment as deemed necessary in the opinion of the attending physician.
Name of parent or legal guardian of camper *
Do you have health insurance coverage? *
Name of Insurance Company / Policy Number *
Emergency Treatment Permission
Digital Signature of Parent/Guardian *
For security reasons who will be the primary person to pick up camper each day? (Name/Relationship to camper/Date(s) *
WAYS TO PAY REGISTRATION FEE
$70 MUST be RECEIVED by MAY 30th before registration is accepted and spot is reserved for camper.
Choose your method of payment *
ADDITIONAL INFORMATION
For additional information, contact Kelly Edwards at 724-422-5261 or Denise Higgins at 301-992-4581.
NEW THINGS THIS YEAR:
**Camp start time is 9AM this year(in previous years we have had an earlier start time)
**We will not be offering breakfast this year, campers need to eat before coming to camp
**We will be providing a bagged lunch daily along with an afternoon snack-Menu upon request
(feel free to pack your child a lunch also)
**Deadline to register is May 30th, please ensure payment is received by this date or registration can't be processed

**Masks & Social Distancing may be required this year, we will have to follow any current health and safety guidelines that are in place**
How did you find out about camp? *
A copy of your responses will be emailed to the address you provided.
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