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Welcome campers and parents to the 2014 camping season! We in the Pacific NW are ready and excited for you to visit our camps! Our theme this year is “All Things New�. Together we will explore the life-transforming experience of being follower of Jesus. Our camp programs at Indianola, Lazy F, Ocean Park, and Twinlow offer something for everyone. All this in a safe environment guided by our carefully selected and trained staff. As ministries of The United Methodist Church, all of our camp programs happen in the context of Christian reflection and values where core life values are taught and lived out. We know that camp provides formative and powerful experiences that can last a lifetime. Come be a part of this!

Alan Rogstad Executive Director of Camping and Retreat Ministries

Remember that more information about each camp session as well as online registration can be found at www.pnwcamps.org.


Twinlow

Twinlow is located on beautiful Lower Twin Lake in northern Idaho. The camp is situated on a wooded hillside with a beautiful lakefront setting. Among other activities, Twinlow offers an active Watersports program with swimming, water-skiing, wake boarding, tubing, paddleboards, canoes, kayaks, and sailing.

Ocean Park

Ocean Park sits on 80 acres of forest and dunes right on the Pacific Ocean. Here, campers will find hiking, a challenge/ropes course, beach play, and the SCREAMER, a huge zip-line over the dunes. Located on the Long Beach Peninsula, the camp is close to lighthouses, forts, museums, shops, oystering, and fishing.

Lazy F

Lazy F is located on 110 acres of fir and pine forest in the Manastash Canyon, just west of Ellensburg. It features a babbling creek and fantastic hiking trails. Ride a horse at wrangler camp, stay in a teepee, go for a hike, or ride the river. Campers will also find fishing, archery, inner tubing, and more.

Indianola

Located on the Puget Sound, in the shadow of the Olympic rain forest, Indianola offers a unique experience to kids and adults alike. Hike through lush forest trails, discover marine life on the beach, and swing on the giant rope swing. Campers will also find kayaking, swimming, and many other activities.

Our Sacred Sites


Twinlow

At Twinlow, we could talk about our beautiful Twin Lakes location and our green open spaces on a diverse forested hillside. Or we could talk about our endless activities such as swimming, waterskiing, wakeboarding, canoeing, kayaking, fishing, sailing, archery, waterslide and trampoline jumping. But what we really believe is that camp is about people, and we know we have some of the best here at Twinlow. We invite you to join our community while at Twinlow. With our trained and professional counseling staff, our passionate volunteers, our pastors and skilled leaders, we strive to provide embracing hospitality and a Christ centered experience where everyone has a place. We exist to serve and to provide meaningful faith community by using God’s outdoor gifts and through God’s people here. What people are saying: • I really felt God’s presence when I was singing at campfire • Twinlow really brought about my personal relationship with God • Everyone just jumped into being my friend here • Love that [my camper] came home from church camp with a whole new attitude and love for God!

High School Options Pacific Northwest Cross Connection (PNCC) Open to High School and Jr. High Youth Groups register through www.twinlowcamp.org

Music, Arts, Dance, and Drama Camp (MADD) Grades 8-13

1. 2. 3. 4.

MADD Camp is a chance to explore your creativity and learn about your faith.

June 22-27, 2014 (Sun-Fri) July 20-25, 2014 (Sun-Fri) July 27-Aug 1, 2014 (Sun-Fri) August 3-8, 2014 (Sun-Fri)

PNCC is an opportunity to spend a week coming together as a group and helping people. Cost: $275

June 22-27, 2014 (Sun-Fri) Cost: $350/$400


High School Options

Jr. High Options

Junior Camp Options

Primary Camp options

Counselors in Training Open to High School students interested in becoming Leaders at camp.

MADD Camp (see above)

Junior Camp Grades 4-6

Primary Camp Come have fun outside while learning new things and exploring the Bible Grades 1-3

Come learn about what it takes to be a leader at camp, then put it into practice. June 29-July 11, 2014 (Sun-Fri) Cost: $375/$425 High School Crossfire Grades 9-13 Join us for a week of fun, make friends, learn new things, and explore your faith.

Jr. High Camp Grades 6-9 Enjoy a week of learning and fun for Junior High students. There will be Bible study, games, and new challenges. 1. June 22-27, 2014 (Sun-Fri) Cost: $325/$375

Bible study, games and challenges will fill this week with lots of fun. 1. June 22-27, 2014 (Sun-Fri) Cost: $325/$375 2. July 6-11, 2014 (Sun–Fri) Cost: $330/$380

2.July 27-Aug 1, 2014 (Sun-Fri) Cost: $330/$380

High School Explorers Grades 9-13

Junior Explorers Grades 4-6

Come learn new skills in the out-of-doors, while we explore the Bible and our faith.

Get outside and learn something new about the outdoors. Dive into the Bible and explore your faith.

High School Watersports Grades 9-13 THE LAKE IS CALLING. Come play in the lake, learn about the Bible and your faith and try something new July 27- Aug 1, 2014 (Sun-Fri) Cost: $375/$425

Jr. High Watersports Grades 6-9 Water skiing, wakeboarding, knee boarding, canoeing, kayaking, and are just some of the things we’ll learn this week. 1. July 20-25, 2014 (Sun-Fri) Cost : $375/$425 2. Aug. 3-8, 2014 (Sun-Fri) Cost: $380/$430

2. August 3-8, 2014 (Sun-Wed) Cost: $180/$230

All Ages

July 6-11, 2014 (Sun-Fri) Cost: $330/$380

July 20-25, 2014 (Sun-Fri) Cost: $375/$425

1. June 29-July 2, 2014 (Sun-Wed) (optional Primary Plus July 2-3 until family camp begins, $25) Cost: $175/$225

Great American Family Camp All Ages Celebrate the 4th at Twin Lakes with our guest speakers for the older campers and camp counselor-lead activities for the younger campers. July 3-5, 2014 Cost: $50

July 27-Aug 1, 2014 (Sun-Fri) Cost: $375/$425 Junior Fish n Sail Grades 4-6 Aug 3-8, 2014 (Sun-Fri) Leader: Jay Gerbino Learn to fish and sail on Lower Twin Lake while exploring the stories in the Bible. Cost: $355/$405

p: 208-352-2671 e: office@twinlowcamp.org w: www.twinlowcamp.org 22787 N Twinlow Rd. Rathdrum, ID 83858

All Things New


Ocean Park

Why come to camp at Ocean Park? Here are some of the reasons why a week of camp at Ocean Park just may be the best week of your whole summer. The Site Ocean Park sits on 80 acres of flat, grassy spaces, with huge evergreen forests, low, rolling sand dunes, and a wide sand beach that invites all kinds of fun activities. And, of course, the beautiful Pacific Ocean dominates all. Your Neighbors While you are here, you will share the home of some very special neighbors. Deer roam the grassy fields, cute raccoons may steal your heart, and, if you look closely, you can see brown bunnies scurrying around. Look to the sky and beach for eagles, Canada geese, seagulls, sandpipers, and countless other birds. Fun The goal of our camp leaders is for you to have fun, fun, fun! Archery, kayaking, and endless games on our three acre sports field are waiting for you. The SCREAMER, our 550 foot- long zip line invites you to a thrilling ride. Forest trails bring out the explorer in you and the beach says bring your kite and sand-castle-building skills. Our newest fun feature, the low ropes challenge course, will test your communication, team-building, and leadership skills as you have fun with your friends. What You Learn Many of our campers tell us what they learn at camp is priceless. In skits, songs, stories, and conversations, you learn about yourself and your relationship with others and with God. Special times shared around a campfire with old and new friends help you understand that God is with you always and that you are truly a unique and special child of God. So come to a beautiful place, enjoy special neighbors, have loads of fun, and learn a lot about yourself and God. See you at Ocean Park!


Primary Adventure 1st – 3rd grade July 6 - 11 (Sun- Fri) Deans: Carrie Bland, Lacey Jones, Kaitlin Davies Cost: $400/$475 Intermediate Explorers 4th – 6th grade July 6 - 11 (Sun-Fri) Deans: Carrie Bland, Lacey Jones, Kaitlin Davies Cost: $400/$475 Jr. High Jive 7th – 9th grade July 13 - 18 (Sun-Fri) Deans: Blaine Hanson, Tammy Hanson Cost: $400/475 Sr. High Celebration 10th – 13th grade July 20 - 25 (Sun-Fri) Deans: Corinne Anderson, Betsy Clayton Cost: $400/475

Kite Camp Intergenerational Aug. 21 - 24 (Thur. – Sun) Deans: Chris Natland, Tim Kelly Cost: Adults in rooms $225/$275 Children & youth (4 thru 17) staying in same room as parents: $112/$162 Adults in tents: $155/$205 Children & youth in tents: $112/$162 Adults in RVs: $185/$235 Children & youth in RVs: $112/$162 For Wednesday arrival, add $33/person for lodging. No meals served until Thursday dinner. Children under 4 are free. p: 360-297-2223 e: fun@opretreat.org w: www.opretreat.org PO Box C 25811 Vernon Ave. Ocean Park, WA 98640

All Things New


Lazy F

All of the programs at Lazy F Camp are led by carefully chosen, Jesus-centered staff who aim to make the camp experience meaningful for each camper who comes through the Lazy F ranch entrance. We are located in the beautiful, sunny Manastash Canyon, tucked away from the hustle and bustle of everyday life.  At camp, children and youth become a part of a small-group team and choose from a range of activities.  Events like archery, innertubing, fishing, hiking, dancing, sports, arts and crafts, campfires, Bible Encounters, and larger, evening-time programs like talent shows and capturethe-flag all contribute to an experience designed to invite campers to experience God’s gigantic, unconditional, tailor-made love through Jesus Christ both by word and by example. Check out our website for more info about specific camp programs—and to learn more about specialty programs like our horseback riding (“Wranglers Camp”) and tee-pee camping (“Backwoods”)!

Lazy Daze Retired Adults A camp opportunity for retired adults to experience a wonderful low key camp program that is specifically designed for them! September 9-11, 2014 Cost: $130/$155, add $10 for Skyline Grand Camp K-6 and Grandparents An incredible opportunity for grandparents and grandchildren to share quality time together having fun and walking in faith. June 22-25, 2014 Cost: $220/$260 Primary Camp Grades 1-3 For younger campers to have new, fun experiences 1. June 29- July 2 (Sun-Wed) Cost: $220/$261 2. July 27- July 30 (Sun-Wed) Cost: $220/$261


The Call Grades 10-13

Backwoods Challenge Grades 7-9

Junior Backwoods Grades 4-6

For high-schoolers wanting to know the God who calls us in special ways.

Camping in tee pees, cooking over the fire, and adventure in the woods! July 20 – July 25 (Sun-Fri)

Camping in tee pees, campfire cooking, adventuring in the woods!

June 29 –July 3 (Sun-Thurs)

1. June 29 –July 3 (Sun-Thurs) Cost: $220/$261

Cost: $312 / $368.

Cost: $312/$368

Night Owl Grades 8-12

Wranglers Grades 4-6

Junior High Grades 6-8

Epic group games, hiking, and summer camp fun—nocturnal style!

Look after your own horse for a week, go riding, go swimming, and have lots of camp fun! July 20 – July 25 (Sun-Fri)

An action-packed week with tons of special stuff—including river rafting! August 3- August 8 (Sun-Fri)

Cost: $499/$586

Cost: $367/$433

LIT’s (Leaders-in-Training) Grades 9-13

Explorers Grades 4-6

Youth Service Grades 6-13

Senior High Grades 9-13

A full week in 2014! Leadership / Counselor development for teens.  Be trained as a Junior Counselor!

Go on a day-long trail hike, go stargazing, and have tons of Lazy F Camp fun!

Perfect for whole youth groups, or individuals alike! How do we “work” for God in the world, serve God’s people, and then rest?  Field trips to serve the poor in Central Washington in addition to tons of on-site Lazy F fun!

The culminating Lazy F experience, packed with awesome events, including river rafting—just for senior highs! August 10 – August 15 (Sun-Fri)

July 6 – July 10 (Sun-Thurs) Cost: $312/$368

July 13 – July 18 (Sun-Fri) Cost: Year 1-$215, Year 2-$133, Year 3-156, Year 4-$0

July 27- August 1 (Sun-Fri) Cost: $312/$368

2. August 3- August 8 (Sun –Fri) Cost: $312/368

Cost: $367/$433

July 27- August 1 (Sun-Fri) Cost: $300/$350

p: 509-962-2780 e: office@lazyfcamp.org w: www.lazyfcamp.org 16170 Manastash Rd. Ellensburg, WA 98926

All Things New


Indianola

This summer at Camp Indianola, we will explore the new things God is doing in our lives. At camp, you will get a chance to adventure through the forest on the trails, discover sea creatures at low tide, play games with old and new friends, and be led by our positive, nurturing, energetic Camp staff to experience the wonders of creation and God’s love. At Camp Indianola, we boat, kayak, and swim in Puget Sound, build beach forts, create amazing works of art at the Craft Cabin, and gather around a roaring campfire for music, stories, laughter, fellowship, and s’mores. Challenge yourself to sing loudly, have fun, feel God’s presence, eat amazing food, create skits, try new things, make friends, fly high on the giant Rope Swing, and make memories! See you at camp!


Family Intergenerational Spend the 4th of July celebrating with your family on the beautiful shores of the Puget Sound. Ignite the faith of your family as your start your summer together! July 2-5, 2014 (Wed-Sat) Cost: Adults $160, Youth (ages 10-17) $130, Child (ages 5-9) $100

Older Elementary Grades 3-6 Awesome activities and fun new adventures that will have your camper burning for more! Games, songs, Rally, friends, beach, and laughter! July 20-24, 2014 (Sun-Thurs) Cost: $285/$335

Adventure Challenge Grades 9-12

Senior High Grades 9-13

This unique program will give you a taste of different outdoor adventures each day. Backpacking, hot springs, kayaking, waterfalls, geocaching, and time with friends around the campfire!

Spend the week connecting in ways you never imagined. Lifelong friendships, laughter, new experiences and challenges, and lighting your faith on fire!

July 13-18, 2014 (Sun-Fri) Cost: $370/$430

July 27-August 1st, 2014 (Sun-Fri) Cost: $365/$425

Younger Elementary Grades 1-3

MAD Camp Grades 4-9

Junior High Camp Grades 6-9th

This program is designed specifically with younger campers in mind. Come and be introduced to the joys of camp. Spark the love of camping at an early age!

Explore your creative side, be goofy, and have a blast putting together an entire production in just one week!

Don’t miss out on epic fun! Ignite your summer with team competitions, campfires, kayak adventures, and new friends.

July 27-August 1 2014 (Sun-Fri)

August 10-15, 2014 (Sun-Fri)

July 20-23, 2014 (Sun-Wed)

Cost: $380/$445

Cost: $365/$425

Cost: $240/$275

p: 360-297-2223 e: office@campindianola.org w: www.campindianola.org PO Box 1150 , 10635 NE Shore Dr. Indianola, WA 98342

All Things New


SUNDAY

1

MONDAY

JUNE 2014

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TUESDAY

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WEDNESDAY

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THURSDAY

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FRIDAY

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Twinlow: PNCC 1 (Youth Groups) Twinlow: Jr. High 1 (Grades 6-9)

Twinlow: MADD Camp (Grades 9-12)

Twinlow: Junior Camp 1 (Grades 4-6)

Lazy F: Grand Camp (Grades K-6, Grandparents)

29

30

Twinlow: Counselors in Training - Two Weeks Twinlow: Primary 1 (Grades 1-3)

Twinlow: Primary Plus - Stay Until Family Camp (All Ages)

Twinlow: Great American Family Camp (All Ages) Lazy F: Primary 1 (Grades 1-3)

Lazy F: Junior Backwoods 1 (Grades 4-6) Lazy F: The Call (Grades 10-12)


SUNDAY

29

MONDAY

Twinlow: Counselors in Training - Two Weeks

30

Twinlow: Primary 1 (Grades 1-3) Lazy F: Primary 1 (Grades 1-3) Lazy F: Junior Backwoods 1 (Grades 4-6) Lazy F: The Call (Grades 10-12)

TUESDAY

JULY 2014 1

WEDNESDAY

2

THURSDAY

3

FRIDAY

4

SATURDAY

5

Twinlow: Primary Plus - Stay Until Family Camp (All Ages)

Twinlow: Great American Family Camp (All Ages) Indianola: Family Camp Extravaganza (Intergenerational)

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Twinlow: Counselors in Training - Two Weeks Twinlow: High School Crossfire (Grades 9-12) Twinlow: Junior Camp 2 (Grades 9-12) Ocean Park: Primary Adventure (Grades 1-3) Ocean Park: Intermediate Explorers (Grades 4-6) Lazy F: Night Owl (Grades 8-12)

Ocean Park: Junior High Jive (Grades 7-9) Lazy F: Leaders In Training (Grades 9-13) Indianola: Adventure Challenge (9-12)

20

Twinlow: PNCC 2 (Youth Groups) Twinlow: Jr. High Watersports 1 (6-9) Twinlow: High School Explorers (9-12) Twinlow: Confirmation Camp (Confirmation Group) Ocean Park: Sr. High Celebration (Grades 10-13) Lazy F: Backwoods Challenge (Grades 7-9) Lazy F: Wranglers (Grades 4-6) Indianola: Younger Elementary (Grades 1-3) Indianola: Older Elementary (Grades 4-6)

27

28

Twinlow: Junior Explorers (Grades 4-6)

Twinlow: High School Watersports (Grades 9-12) Twinlow: PNCC 3

Twinlow: Jr. High Camp (Grades 6-9) Lazy F: Explorers (Grades 4-6)

Lazy F: Youth Service (Grades 6-13) Lazy F: Primary Camp (Grades 1-3) Indianola: MAD (Grades 4-9)

Indianola: Senior High (Grades 9-13)

All Things New


SUNDAY

29

WEDNESDAY 30

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MONDAY

AUGUST 2014

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Twinlow: Junior Explorers (Grades 4-6)

Twinlow: High School Watersports (Grades 9-12) Twinlow: PNCC 3

Twinlow: Jr. High Camp (Grades 6-9) Lazy F: Explorers (Grades 4-6)

Lazy F: Youth Service (Grades 6-13) Lazy F: Primary Camp (Grades 1-3)

Indianola: MAD (Grades 4-9)

Indianola: Senior High (Grades 9-13)

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Twinlow: PNCC 3 Twinlow: Jr. High Watersports Twinlow: Primary 2 (Grades 1-3) Twinlow: Junior Fish and Sail (Grades 4-6) Lazy F: Jr. High (Grades 6-8) Lazy F: Jr. Backwoods (Grades 4-68)

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Lazy F: Sr. High (Grades 9-13)

Indianola: Jr. High (Grades 6-9)

Ocean Park: Kite Camp (All Ages)

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Ocean Park: Kite Camp (All Ages)

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Visit us online!

www.pnwcamps.org Visit our website! Here you’ll find more info, such as: • Directions • Packing lists • Check-in times • Waiver forms • More about what goes on at each camp session

Greater Northwest Camps

www.fb.com/PnwCamps www.twitter.com/pnwcamps Join the conversation! Like us on Facebook and follow us on Twitter for year-round information and updates.@PNWCamps

The PNW Conference is a part of the Greater Northwest Episcopal Area, which also includes the OregonIdaho and Alaska Conferences. Make sure to visit http://pnwcamps. org/about-us/or-id-ak for more information about the fantastic camps offered in these Conferences, such as the Shakespeare Camp at Camp Latkawa near the Oregon Shakespeare Festival. www.alaskaumc.org www.gocamping.org

Register with our easy, secure online registration.

All Things New


FULL PAYMENT IS DUE 14 DAYS BEFORE CAMP STARTS.

PNW Camping Registrar Sarah Robinson P. O. Box 13650 Des Moines, WA 98198

CANCELLATIONS: • Cancellations occurring 14 days or more prior to event will be refunded fee paid minus non-refundable deposit. • The full amount is still due for cancellations occurring less than 14 days before camp starts. At that point, preparations have been made to host your camper. Policy exceptions due to unforeseen tragedy or serious circumstances will be considered on an individual basis. • In the event the camp is canceled, you will receive a full refund including the deposit. • “No-Shows” will not receive a refund.

CHECKING IN AT CAMP SITE: 1. For security reasons, first you must check in with the site staff to ensure we have all required forms. 2. We ask that you pay any balance due that is your responsibility at this time unless you have made other arrangements with the Camping Registrar. 3. The camp Health Care Provider will review your camper’s health and medication forms with you when checking in their medications. Any concerns you have can be addressed at this time.

4. Register online or mail before May 1st to qualify for your EARLY BIRD DISCOUNT of $20. Deposit must be included. 5. All payments are due 14 days prior to the start of camp.

Mail to:

3. DEPOSIT IS REQUIRED WITH REGISTRATION Registering online: You can pay the non-refundable deposit with a VISA or MasterCard credit card. Registering by mail: include check for payment. Make check payable to ‘PNW Treasurer’.

2. COMPLETE REGISTRATION FORMS Register online at www.pnwcamps.org. If you are not registering online, fill out all three pages: (Registration, Health History and Administration of Meds) completely, including signatures.

HOW TO REGISTER: 1. SELECT A CAMP Make a first and second choice. Some events are very popular and fill up quickly.

If your church is paying a campership, you still need to mail your remittance balance 14 days prior to event or, at the latest, pay balance due at registration. Send to: PNW Camping Registrar • P.O. Box 13650 • Des Moines, WA 98198 Phone: 800-755-7710 • 206-870-6805 Register online: at www.pnwcamps.org or complete these forms and mail to the address above.

REGISTRATION INFORMATION: • All registrations are processed “first come, first served”. • Early Bird Discount: Registrations must be postmarked by May 1st and deposit included to receive the $20 discount. • Online registering is part of our ministry to be caring and good stewards of God’s forests. We attempt to use e-mail for all possible correspondence to reduce the amount of paper consumed in our camping registration process. • Please add “camping@pnwumc.org” to your address book. • Download forms at www.pnwcamps.org. DEPOSIT: • A non-refundable deposit of $50 for UMC Youth camps or $25 per person for family or senior adult camps is required to secure your reservation. • If you register online, you will pay the deposit with a VISA or MasterCard credit card. (NOTE: The system will not allow you to register without deposit payment.) • All deposits are non-refundable/non-transferable unless the event is canceled. • You are encouraged to pay the full amount when registering.

Description of Fees Based on feedback, we have simplified our pricing to one Standard fee for each program. There is also a Supportive level. This higher price provides for related needs not included in the standard fee, such as maintenance and ongoing expenses. If your family is able to choose this level, please do so. Price options for multi-camper families are also available through the Registrar, and camperships are also available. Please see below for information on camperships.

SCHOLARSHIP INFORMATION: Scholarships and financial assistance are available to families in need. • First stop: Speak to your pastor to see if your church has scholarship money available. Your pastor can also contact the Camping Registrar to request Conference assistance. • Conference scholarship requests should be postmarked by Friday, June 20, 2014.

Remember -- our practice is that no one is turned away for lack of funds. For assistance, please contact your pastor or the PNW Camping Registrar at (800) 755-7710 ext. 305 or e-mail camping@pnwumc.org.


Mail registration to our Camping Registrar at PO Box 13650, Des Moines, WA 98198, or register online at www.pnwcamps.org

About My Camper Camper Name:

Camper Registration Camper Name:

Adult-S

Youth-S Adult-2X

Adult-M

Youth-M Adult-3X

Adult-L

Youth-L

Energetic

Cries easily

Compassionate

Cooperative

Chatty

Cautious

Bossy

Ambitious

Likable

Leader

Intellectual

Competitive

Hides emotions

Has a Temper

Easily Frustrated

Excitable

Follower

Quiet

Procrastinator

Outgoing

Nervous

Nerdy

Moody

Meticulous

Messy

Loner

Whiny

Touchy

Territorial

Stubborn

Shy

Sensitive

Sense of humor

Rowdy

Responsible

Behavior Concerns (Please describe, if applicable) 1. Has your camper been on, or just recently taken off, any behavior assisting drugs (ex. Ritalin, Prozac) that may affect, alter or disturb their behavior, mood or attention span while at camp? (Circle one)

2. Does your camper have any particular sensitivity or emotional issues? Has there been any recent adjustment (death, divorce, separation, etc.) that may affect their behavior at camp? (Circle one)

3. Has your camper had any pattern of behavior at school or another event in the last three years that could create problems?

4. Additional comments:

No

Yes

No

Yes

No

Yes

Even Tempered

Camper Personality

Dear Parents, For your camper to have a quality experience, please answer this questionnaire. This information is helpful as we minister to your camper. Thank you for allowing us to help your child experience God’s love in our special camp community. In Christ, Your Camp Directors and Leaders

About my Camper (for children and youth only, to be filled out by parent/guardian of youth campers)

Event Name: Site: Event Name: Site:

Zip:

Grade entering Fall 2014:

Age:

Event Choices First Choice

Second Choice

State:

Female

Housing with/small group (no guarantee): Camper Information Camper Name:

E-mail:

Cell #:

Home #:

Male

Birthdate (M/D/YYYY): Gender: Street Address: City: Camper e-mail: Parent/ Guardian Info

Adult-XL

Note: Parent e-mail address will be used for confirmation, Dean’s letter, packing list, directions, etc. If no e-mail is listed, correspondence will be mailed to above address. Please add camping@pnwumc.org to your address book.

Local church:

T-shirt Size Payment Information (Make checks payable to “PNW Treasurer)

Supportive Rate

A non-refundable minimum of $50.00/person for UMC youth camps or $25.00/each for family/senior adult camps must accompany registration.

$

Standard Rate

I am including a Donation to Camping Ministry of:

$

Check one: I am paying the

Amount Enclosed:

$

Visa

Our church will pay a campership amount of: MasterCard

$

to my

Date:

Balance Due 14 days prior to camp start date: Charge $________ Enter Card #: Expiration Date: Name on Card: Signature:


Camp Date:

Mail registration to our Camping Registrar at PO Box 13650, Des Moines, WA 98198, or register online at www.pnwcamps.org

Birthdate (M/D/YYY):

Camp Attending:

Health History Form

Camper Name: Male

Street Address: Zip: Female

Phone: (

)

Gender:

State:

)

City:

Day/Work Phone: (

Emergency Contact #2: if parent/guardian unavailable, for all campers:

)

Emergency Parent Contact #1: parent/guardian name for youth only:

Phone: (

Name(s): ) )

Eyeglasses or contacts

Self-mutilation

Nightmares

State:

Headaches

No

Zip:

Name(s): Day/Work Phone: ( Cell Phone: (

Yes

Bed-wetting

Blood type:

Broken Bones

Sleepwalking

Date of last tetanus shot:

Alcohol/drug addiction

Hearing aids

Sore throats - frequent

No

Do you carry an Epipen?

Relationship to camper:

City:

Address:

) Zip: No

Cell Phone: ( State: Yes

Yes

Address (if different); City: Does camper have any known allergies: SEVERE allergies to: Medication Allergies: Food Allergies or Dietary Restrictions: Other Allergies: Is the camper current on all immunizations needed for school

Allergic reaction - severe Diabetes Heart disease/surgery

Tobacco Usage

Health History - within the last 3 years. Check any that apply:

Anxiety/Depression Ear Infections - frequent Infections

Type 2

Asthma Eating disorders

Other:

Type 1

Attention deficient/ hyperactivity

Menstrual problems

Nurse-Notes:

Yes:______

Epilepsy or Seizures

No

)

Consent

Date:

I give permission for: • Transportation for scheduled off-site events • Photos/videos to be used in future publicity • Camper’s name or e-mail address to be included in address list

I, the undersigned parent/guardian, give permission for the above named camper to participate in the camp indicated above. I recognize and acknowledge that camping activities can involve certain hazards, including, but not limited to illness, injury, and accidents, and release The United Methodist Church from liability.

No

Back pain/strain Pertinent Past Medical treatment

Yes

Phone: (

Policy#:

Does the camper have a health issue (e.g. allergies, chronic conditions) or special circumstances which may affect program participation, special housing needs, or anything we need to know prior to emergency treatment?

Group #:

Family Medical Insurance Name of Insured: Name of Family Physician:

Carrier:

• My child/I have permission to partake in all supervised camp activities unless limitations are noted. • I hereby give permission to the camp to provide routine health care, administer prescribed medications, and seek emergency medical treatment. • I agree to the release of any records necessary for insurance purposes. • I give permission to the camp to arrange necessary related transportation for my child/myself. • This completed health form may be photocopied for trips out of camp. • I have either appropriate insurance or agree to pay for all the medical service costs as may be incurred by my camper/self. • In an emergency, I hereby give permission to the physician selected by the camp to secure and administer treatment, including hospitalization, for the above named person. Parent/Guardian/Self Signature:


Mail registration to our Camping Registrar at PO Box 13650, Des Moines, WA 98198, or register online at www.pnwcamps.org

Permission to Administer Medications

Camp Date:

Birth date:

Site

ALL PNW Campers are required to fill out this form

Camp/Event Name:

Camper Name: I give my permission to the Camp Health Care Provider or his/her designate to administer medications (or their generic equivalents) to my child or me, in accordance with recommended package dosing for the specific indications below. These medications are available at camps and need not be brought by participants, and may include Tylenol (mild fever or discomforts), Benadryl (allergy symptoms), ibuprofen (mild fever or discomforts), Sudafed (allergy symptoms), throat lozenges (coughing/sore throat), antacid (upset stomach), topical creams (itching, sunburn or insect bites), or anti-diarrheal (for diarrhea) (circle one): Yes No

No If Yes, list below

Permission to follow recommendations by Washington Poison Center or Idaho Poison Control (circle one): Yes No

Yes

Identify medications that camper has recently stopped taking:

Is the camper presently taking or using any type of medication(s)?

Name:

Time to give:

Name:

Time to give:

Name:

Reason:

Dosage:

Reason:

Dosage:

Reason:

Dosage:

Keep all medications (Prescriptions and Over-the-Counter) IN THE ORIGINAL CONTAINERS that identify: prescribing physician, medication name, dosage and frequency. Bring enough medication to last for the entire time of the event. All medications for age-level campers must be checked in to camp health care provider at registration.

Time to give:

Date:

I authorize the PNW Camp Health Provider to administer the above listed medications to my child/dependent during camp. I have given the Health Care Provider dosage and administrative instructions. (signature needed for all

campers) Parent/Guardian signature:

Administration of Meds updated:

Health History Form verified:

Date

Date:

By: (initial)

By: (initial)

Note: Camp personnel will notify you if your child displays the following symptoms: • Any illness that persists longer than 24 hours, including: fever, cough, excess expulsion of bodily fluids, allergic reactions, severe tiredness • Any injury that causes severe prolonged pain, discoloration and/or swelling • Any condition that cannot be sufficiently treated by camp Health Care Provider • Any condition requiring transport to other medical service Upon Camper Check-in


2014 pnw camp catalog