Page 1

be exceptional, be amazing, be astonishing, be astounding, be sensational, be stunning, be incredible, be unbelievable, be phenomenal;

p m a C r R e E m ! E N m E u G S S A D 1 1 N 20 P W E A M M O C A

C


WELCOME! Did you know that we are accredited by the Amercain Camp Association and have been named one of the most improved camps by the Adventist Association of Camp Professionals? Our certified and trained staff along with a balanced program makes Camp Wagner the place to be this summer. I invite you to fill out a camp registration form and/or support a child from your home, church, or community, with transportation and/or camp accommodation fees so the can experience this lifechanging event. Your investment will pay HUGE dividends in the Kingdom. Remain “Forever Faithful,� until He comes... See you soon! Ralph

2011 SUMMER CAMP DATES 1st Week of Camp

July 10-16

2nd Week of Camp

July 17-23

3rd Week of Camp

July 24-30


OUR COMMITMENT TO YOU We are dedicated to providing an enjoyable balanced program involving physical, mental, and spiritual activities. Each camper will be cared for by our exemplary staff that will insure their safety and spiritual well being. This positive experience will enable each camper to make new friends through positive relationships while enjoying a well designed spiritual program. Enjoying God through nature is what we expect each camper will experience WE LOOK FORWARD TO SHARING OUR SUMMER WITH YOU!


ARCHERY - Keep a steady hand as you practice hitting the bull’s eye! Our trained and certified Instructors will show you the proper techniques to hit the mark every time

FIELD TRIPS - Have you ever been face to face with a cow? Can you fly a plane across the sky? Come and enjoy a game of bowling or a few hours of skating. These activities and more are planned with you in mind!

SWIMMING - Come and practice yoru backstroke! Our lifeguards are ready to teach new swimmers how to swim and to improve the skills of the advanced ones. How long canyou hold your breath under water?

CAMP COUNCIL - Bring your bibles as we teach you tot he love of God. Wonderful stories and illustrations from Gods Word will be presented daily by our Lake Region Pastors and/or Pastor Shelton, our Camp Director


GO CARTS - Our one of a kind driving course is waiting for you. Buckle up! Don’t forget to strap on your helmet as you cruise the course. Each camper gets to drive the go-cart for themselves!

BASKETBALL - We can play a pick up game, or 3 on 3, or even a full court game. You can even earn a Pathfinder honor while having fun in just one week, WOW! How cool is that!

GO CARTS - Our one of a kind driving course is waiting for you. Buckle up! Don’t forget to strap on your helmet as you cruise the course. Each camper gets to drive the go-cart for themselves!

CRAFTS - Express your creativity through Arts and Crafts! There are many gifts you can make, maybe you can bring something home for someone special or keep them all for your self.


2011 CAMPER APPLICATION Last Name:____________________ Birth Date: ____/____/____

First Name:__________________

Sex: ____M ____F

MI:______ Age:_____

Which week are you registering for? ________

Address: ______________________________________________________________________________ City: _________________________

State: _________

Father’s Name: ________________

Home Phone: ________________

Work/Cell: _____________

Mother’s Name: ________________

Home Phone: ________________

Work/Cell: _____________

Religious Denomination: ______________________

Zip Code: _______________

Home Church: ____________________

Referred by: ________________________________ The following activities listed below will be offered at Camp Wagner this season. Every Activity will not be offered each week as to add variety and uniqueness to the Camp Wagner experience. Week two (2) is specifically designed for evangelism while week four (4) specifically designed for drum corps.

Boating

Hoarse back riding

Crafts

Swimming

Archery

Canoeing

Skating

Basketball

Bowling

Field Trips

Go Karts

Nature Parks

All payments are to be made to the Lake Region Conference Youth Ministries. We will only accept money orders, cashier’s checks, church checks, and cash payments.


ACKNOWLEDGMENT OF FINANCIAL RESPONSIBILITY INSURANCE INFORMATION

Is your child covered by health insurance?

_______ Yes

If no, please fill out the section on the next page.

_______ No

For Insurance Policy Holders ONLY!

Insurance Carrier: ______________________________

Policy No. _____________________

Name/phone number of participant’s personal physician: _________________________________

Parent/Guardian Authorization (if camper is a minor): ____________________________________

I fully acknowledge that there are some inherent risks associated with camp activities that may result in bodily injury. I also acknowledge that my primary insurance will be utilized to cover the costs that exceeds the camper’s accidental insurance policy and that in the event of illness that is not related to camp activity, I assume all financial responsibility for any treatment given to my child. I certify that this information is true to the best of my knowledge.

Signature of Parent/Guardian: ____________________________________

Date:___/___/_____

Address:_______________________________________________________________________________ Home Phone: __________________

Business Phone: _________________ Cell:__________________

E-mail Address___________________________________________


ACKNOWLEDGEMENT OF FINANCIAL RESPONSIBILITY Non-Insured Insured Camper

I fully acknowledge that there are some inherent risks associated with camp activities that may result in bodily injury. I also acknowledge that I do not possess health insurance and that I assume all financial responsibility that exceeds accidental insurance provided by the camp and that in the event of illness that is not related to camp activity, I assume all financial responsibility for any treatment given to my child. Signature of Parent/Guardian: ____________________________________

Date:___/___/_____

Address:_______________________________________________________________________________ Home Phone: __________________

Business Phone: _________________ Cell:__________________

E-mail Address___________________________________________ ***Please submit a copy of your Health Immunizations with this form***

Parent/Guardian Consent for Treatment (if camper is a minor): I hereby give permission to the physician selected by the camp director to provide routine and emergency health care including taking a history, doing a physical examination, ordering tests as required and providing treatment as required. In the event of emergency hospitalization is required, I consent to the evaluation and treatment deemed appropriate to the circumstances by the Emergency Physician at the hospital. I understand that I will be contacted as soon as possible regarding any of these medical necessities.

Signature of Parent/Guardian: ____________________________________

Date:___/___/_____

Address:_______________________________________________________________________________ Home Phone: __________________

Business Phone: _________________ Cell:__________________

E-mail Address___________________________________________


CAMP WAGNER CAMPER HEALTH HISTORY FORM The following health history must be filled out by the parent/guardian if the participant is a minor. A copy of both sides of parents’ health insurance card must be also attached. Thank you! Signature of Parent/Guardian: ____________________________________

Date:___/___/_____

Address:_______________________________________________________________________________ HEALTH HISTORY Allergies: _____________________________________________________________________________________ ______________________________________________________________________________________________ Date of last Tetanus Shot: ___/___/_____ Medications (Please list ALL medications being taken routinely - Including alternative medications such as herbal, etc.) ___ I take NO medications routinely ___ I take the following medications: Med #1 ______________________________ Med #2 ______________________________ Med #3 ______________________________

Frequency:____________________________________ Frequency:____________________________________ Frequency:____________________________________

General Questions Do you have any currently known communicable disease? Yes / No Do you have diabetes Yes / No Do you have a chronic or recurring illness or condition? Yes / No Have you ever had seizures Yes / No Do you have any physical restrictions? Yes / No Do you have asthma? Yes / No Note: If you need more space to further explain any “yes” answers from any of the above questions and to provide any additional information you think the camp medical staff should know, please add another sheet of paper with explanations.


MISSION POSSIBLE The emphasis of our second week of camp will give practical training in the areas of creative evangelism focusing in puppetry, face paininting balloon tying, storytelling, and prayer ministries. In addition to learning these skills, campers will practice what they have learned by going into the community as an outreach project under the supervision of our trained staff.

DRUM CORPS CAMP Come and join us in our final week of camp as we will have experienced drum instructors for an entire week of drumming. Each camper will be given a pair of drumsticks and received quality instructions. Throughout the week we will be joined by special guest or drumlines that will demonstrate drumming for us. We wil strap up and play throughout the week preparing fora final performance as a drum line.


ABOUT US Camp Wagner strives to provide a high quality camp experience at a very affordable price. To register for a week of camp, you will need to fill out a camp application and mail all funds to the Lake Region Conference, Attn.: Camp Wagner, 8517 South State St. Chicago, IL 60619. Please plan to have enough clothes for a second week or pay an additional laundry fee of $20.00. FINANCES Weekly Rates* $235.00 per week FEES $ 50 - per camper for a no show (if funds are refunded) $ 100 - Cancellation fee within one week prior to camp $ 20 - Laundry (optional for stay-over camper only!) DISCOUNTS $ 35 for early bird discount when you pay your entire bill prior to May 15 $ 25 if you pay your entire bill when you stay for two weeks $15 Discount for each additional immediate family member (that comes for a week) Some camp scholarships are available. You can contact the Office of Youthministries to see if there is one available for you. Scholarships are liited.


mp a r C ER ! e m N EE m S GD Su A 1 AN 1 W 0 E 2 P OM M A C

C

Camp Wagner Attn: Youth Ministries 8517 South State St. Chicago, IL 60619

“I will instruct you in the way you should go. I will counsel you and watch over you.” Psalm 32:8

Camp Wagner  

Camp Brochure

Read more
Read more
Similar to
Popular now
Just for you