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YC... s C T Camp BOU

EN

RO

A istian Youth at has T I B A in 1963, Chr ganisation th ng

r Started charitable o amps for you a s as” c ai ! Waihol nning “sweet years!!! 0 u 5 r r n o e f be people to hrough ll t s p m are a or ca ed juni camps - they for m e h t ur e ck From o lised teenag e coming ba a i b c ll our spe n and you wi . u f o r m re supe nt mpete o c r e d n un will s are ru ch day there at the e i t i v i t ted d ea All ac sion an ching presen i v r e p su tea of Bible pers level. e m i t be a cam

CAMP

UPCOMING CAMPS SCHOOL YEAR

Girls Horse Trek Boys Mountain Bike Boys Summer Camp Girls Summer Camp Hunting Camp Pony Camp D: Camp Southern Lads Camp Winter Girls Camp Winter Boys Camp Art Camp Techno Camp Motorbike Camp House Party Camp Cavalcade Camp Tramping Camp

Girls Yr 9 -13 Boys Yr 9 - 13 Boys Yr 5 - 8 Girls Yr 5 - 8 Boys Yr 9 - 12 Girls Yr 7 - 10 Co-Ed Yr 12+ Boys Yr 9 - 13 Girls Yr 5 - 8 Boys Yr 5 - 8 Girls Yr 9 -12 Boys Yr 8 - 11 Boys Yr 9 -12 Girls Yr 9 -12 Co-Ed Yr 9 - 13 Co-Ed Yr 9 - 13

DATE

7 - 11 Jan 14 - 18 Jan 14 - 18 Jan 21 - 25 Jan 22 - 26 Apr 22 - 26 Apr 31 May – 3 Jun 15 - 19 Jul 15 - 19 Jul 22 - 26 Jul 22 - 26 Jul 30 Sep - 4 Oct 2 - 5 Oct 7 - 11 Oct 12 - 14 Dec 14 - 17 Dec

$250 $190 $170 $170 $190 $250 $110 $190 $170 $170 $190 $190 $190 $190 $120 $160

LM

EN

13

TF OR M

S U T C A CONT S C

PRICE

20

P TH CAM U O Y N A OAD HRISTI

YSON R 70 FINLA 15061 P.O. BOX A 9243 WAIHOL 0 3) 417 712 PHONE: (0 ES: NQUIRI E S P M A .nz KIDS C waihola.org c y c @ s p m kidsca ES: NQUIRI E Y T I L z FACI aihola.org.n w c y c @ o f in

www.cycwaihola.org.nz W A I H O L A

Camp F

ees Assistance tow ards paying for camp fees may available - cont be act the CYC of fice for more in about available formation subsidies and sp onsorship

Celebrating our 50TH ANNIVERSARY

1963 - 2013


2013 W A I H O L A

ENROLMENT FORM

An enrolment form is required for each camp. Items marked with are required fields

CAR EGI VER DET AIL S Prima ry Care giver :

CAMPER DECLARATION I will behave myself while at camp and agree to abide by all camp rules. I will fully participate in the camp program.

Home Addr ess:

Camper Signature:

Camp Name:

Da y Phon e:

Nigh t Phon e:

Camp Dates:

Cell Phon e:

Emer genc y Cont act: Yes / No

Where did you hear abou t this camp?:

S econd ary Care giver : Home Addr ess:

CA MP ER DE TA IL S Cam per Nam e: Gen der :

Male / Female

Da y Phon e:

Nigh t Phon e:

Cell Phon e:

Emer genc y Cont act: Yes / No

S cho ol Yea r:

EM ER GE NC Y CO NT AC

T Please specify emergency con tact other than the contact s listed above

Dat e of Bir th:

Em erg enc y Con tac t:

Add res s:

Hom e Add res s: Da y Pho ne: Hom e Pho ne Num ber :

Cel l Pho ne:

Nig ht Pho ne: Rel atio n to cam per :

Em ail Add res s: M E D IC A L D oc to rs N am e:

a n d A D D IT IO N

A L D E T A IL S

D oc to rs A dd re ss : D oc to rs Ph on e N um be r: M ed ic al C on di ti on s / A dd it io Please list any na l I nf or m at io medical conditi n: ons you any cu

have, any medic stody issues we need to be aw ation you need should know ab are of, any sp to take, out you at camp ecial diets or . anything else we

EM EN TS TR AV EL AR RA NG ase specify) Private / Bus / Other (ple Ar riv al Tra nsp ort : Ar riv al Bu s Co mp any : Bu s Pho ne:

specify)

: De par tur e Bu s Co mp any Bu s Pho ne: De par tur e De sti nat ion :

the throughout camp presented at There will be Bible based talks Bible of showing the relevance of the campers level with the purpose said e Christian life. Prayers will be esom whol a lop deve to and y toda ls. mea re befo and camp t throughou named us I have ensured the camper As horses can be carriers of tetan tion. uniza imm their in nt on this form is curre

Car egiv er Sig nat ure : Dat e:

Bu s De par ts At :

cam p: t the cam per at end of Peo ple au tho ris ed to col lec

Last Update: 29 October 2012

erty will e of others or disrespect for prop Any disruptive behaviour, abus be not will Fees nse. expe my at e result in camper being sent hom refunded. in all camp named on this form to take part I give consent for the camper camper named on this form to the of ation port trans for activities, and photos/video and I agree to the use of any and from any off site activities publicity purposes without for form this on ed nam er containing the camp any remuneration.

ts must be paid with all enrolmen A $20 non-refundable deposit des those inclu this p cam the in lled before the camper is enro must be and/or sponsorship. Camp fees applying for OSCAR subsidies . camp to itted adm be will paid in full before the camper

Bu s ETA :

ate / Bus / Other (please De par tur e Tra nsp ort : Priv

NS EN T at CYC and I CA RE GI VE R COnam ed on this form to attend camp I give consent for the camper itions: cond and s term wing nt with the follo have read and am in agreeme knowledge lied is correct to the best of my all enrolment information supp tive to be used for the safe and effec enrolment form information is with the camper named act cont er furth ible poss for operation of camp and on this form. minor inister necessary medication and I authorise camp staff to adm h syrup, coug mol, ceta para (i.e. care th medical treatment for basic heal ical med nt urge seek to staff orise camp sticky plasters, etc). I also auth arise. need the ld shou cost my at t treatmen ss in an ed on this form during camp unle I will not phone the camper nam becomes unwell, disruptive form this on ed nam er camp emergency. If the on from home, we will phone you or is not coping with being away . supplied phone numbers

CAMP FEES Are you applying for OSCAR?:

NO / YES

I enclose pa y ment of:

$

$20 minimum deposit and completed enrolment form is required for all enrolments


2013 Enrolment Form