2015 Summer Camp
Camper Registration Form

CAMPER INFORMATION
Last Name / First Name / Middle Initial
Address / Home Phone
City / State / Zip / Grade Fall 2015
Date of Birth / Gender: / MALE / FEMALE / T-Shirt Size (circle one)
YS, YM, YL, AS, AM, AL, AXL
Preferred Name / Swims well? / YES / NO / Return camper? / YES / NO
Church / Church Phone:
Church Pastor/Children or Youth Leader
Roommate Request / Roommate Concerns
Dietary Restrictions
Specials Needs/Concerns

Our summer camps at Sumatanga will be priced in a three tier pricing structure.

·  Tier One is a basic fee with the remainder of the cost absorbed by Sumatanga.

·  Tier Two is a slightly higher fee which more fully covers the cost of camp, but also requires the remainder be absorbed by Sumatanga.

·  Tier Three reflects the actual cost of camp - choosing to pay at the Tier Three level means that Sumatanga does not need to absorb any of the cost.

· 

Which Tier do I choose?

The choice of which Tier is financially possible for you is entirely yours.When you register your camper you simply indicate which Tier you are selecting and include that amount.There is absolutely no difference in the camping experience for the campers; campers at all levels will receive the same experience.This is simply an invitation for you to evaluate your resources and determine how you are best able to be supportive of the Sumatanga camping ministry.We are hopeful that many will be able to move to Tier Two or Tier Three, but fully understand that the choice is a personal one that you will make prayerfully as you consider the stewardship of your resources.

Scholarships - Be assured that even as this new pricing structure comes into practice that we recognize that there is still great financial need in many areas of our Conference and that scholarships will continue to be available as they have in the past. Financial hardship will not be an obstacle that keeps anyone from camp.Also, we hope that whenever possible our local congregations will continue to help defray costs of camp for participants from their churches. Scholarships are not available for Tier 3 pricing. To request a scholarship, please download, complete and mail in a Happy Camper Scholarship form along with your registration. Camp staff will contact you with your application status.

A $50 non-refundable deposit is DUE AT TIME OF REGISTRATION.

REGISTRATIONS mailed WITHOUT a DEPOSIT will be RETURNED.

FAMILY INFORMATION
Parent/Guardian / Parent/Guardian
Last Name / First Name / Last Name / First Name
Address / Address
City / State / Zip / City / State / Zip
Email (required for confirmation) / Email
Cell Phone / Work Phone / Cell Phone / Work Phone
Relationship to camper / Relationship to camper
Camper Lives with… / Both Parents / Mother / Father / Other (specify)
EMERGENCY CONTACT
Last Name / First Name / Home Phone
Address / Cell Phone
City / State / Zip / Work Phone
WAIVER AND CONSENT
Photos of camper groups and activities may be posted on the Sumatanga website (www.sumatanga.org), and/or the North Alabama Conference website (www.northalabamaumc.org), and used in publicity brochures, video and other media for either organization. No children will be named if images are used. By signing this application, I indicate my approval to have my child’s photo used in the above mentioned ways.
I recognize the inherent risk of injury there can be in camping and camping-related activities. I understand that each participant must assume the risk of injury or damage that could result from these activities. I hereby agree to release Sumatanga Camp and Conference Center and its directors, staff, and volunteers from any liability, claims, demands, legal suits, or causes of action, arising out of, or in any way connected with my/my child’s participation in the camping and camping-related activities, and I further agree to indemnify any and all of them for any losses (including costs, expenses and attorneys’ fees) resulting from any suit brought in my name or on my behalf.
I understand that Sumatanga is a drug-free, alcohol-free, and firearm-free facility. I further understand that, specifically with regard to the summer camping program, alcoholic beverages, tobacco products, illegal drugs, fireworks, guns, knives, and any other type of weaponry are not allowed at Sumatanga. I agree that my child will comply with these restrictions.
I understand that Sumatanga is a Christian camp and retreat ministry and as such sets standards for behavior and dress that are designed to promote Christian integrity and respect. I have reviewed the camper conduct and dress code policies at www.sumatanga.org, and I agree to hold myself and my child to these standards.
I understand I am financially responsible for all property damage caused by my/my child’s behavior while at Camp Sumatanga.
Signature Date
(If applicant is under the age of 19, a parent/guardian must sign)
Make Checks Payable to: Camp Sumatanga ~ Credit Card payments, call (256)538-9860.
MAIL COMPLETED APPLICATIONS & PAYMENT to:
Summer Camp, 3616 Sumatanga Road, Gallant, AL 35972
FULL PAYMENT IS DUE 14 DAYS PRIOR TO YOUR CAMPER ARRIVING AT CAMP.

Day Camp – Rising 1st-3rd grade $125

June 8-12 / Day Camp I
June 15-19 / Day Camp II
June 22-26 / Day Camp III

Adult and Child Camp – ages 4-9

$200 per adult, $100 per camper, $350 max per family.

June 28-30 / Adult and Child I
July 1-3 / Adult and Child II

Dad and Me Camp – ages 4-9

$200 per adult, $100 per camper, $350 max per family.

June 21-23 / Dad and Me Camp I
June 24-26 / Dad and Me Camp II
July 19-21 / Dad and Me Camp III

Grand Camp – ages 4-9

$200 per adult, $100 per camper, $350 max per family.

June 7-9 / Grand Camp I
June 10-12 / Grand Camp II
June 14-16 / Grand Camp III
June 17-19 / Grand Camp IV
July 5-7 / Grand Camp V
July 8-10 / Grand Camp VI
July 19-21 / Grand Camp VII

Mom and Me Outdoor Campout – ages 4-9 $100

June 5-7 (2 Day) / Mom and Me Campout I
June 12-14 (2 Day) / Mom and Me Campout II
July 7-9 (WK Day) / Mom and Me Campout III

Mother and Child Camp – ages 4-9

$200 per adult, $100 per camper, $350 max per family.

June 21-23 / Mother and Child I
June 24-26 / Mother and Child II
July 12-14 / Mother and Child III
July 15-17 / Mother and Child IV

Taste of Camp – rising 4th-6th grade

Tier 1 $155, Tier 2 $170, Tier 3 $185

June 7-9 / Taste of Camp I
June 10-12 / Taste of Camp II
June 28-30 / Taste of Camp III
July 1-3 / Taste of Camp IV

Elementary Camp – rising 4th-6th grade

Tier 1 $360, Tier 2 $400, Tier 3 $440

June 7-12 / Elementary Camp I
June 14-19 / Elementary Camp II
June 21-26 / Elementary Camp III
July 12-17 / Elementary Camp IV
July 19-24 / Elementary Camp V

Elementary Horse Camp – rising 4th-6th grade $475

June 7-12 / Elementary Horse Camp I
June 28-July 3 / Elementary Horse Camp II

Elementary Sports Camp – rising 4th-6th grade

Tier I $360, Tier 2 $400, Tier 3 $440

June 28-July 3 / Elementary Sports Camp

Mid-High Camp – rising 6th-8th grade

Tier I $360, Tier 2 $400, Tier 3 $440

June 7-12 / Mid-High Camp I
June 21-26 / Mid-High Camp II
July 12-17 / Mid-High Camp III

Mid-High Extreme Camp – rising 6th-8th grade

June 28-July 3 / Mid-High Extreme Camp

Mid-High Horse Camp – rising 6th-8th grade

$475,

June 14-19 / Mid-High Horse Camp I
July 5-10 / Mid-High Horse Camp II

Mid-High Princess Camp for Girls – rising 6th-8th grade

Tier I $360, Tier 2 $400, Tier 3 $440

July 5-10 / Mid-High Princess Camp

Music and Arts Week – rising 3rd – 2015 seniors

Tier I $375, Tier 2 $415, Tier 3 $455

July 5-10 / Music and Arts Week

Senior High Camp – rising 9th-12th grade & 2015 seniors

Tier I $360, Tier 2 $400, Tier 3 $440

June 14-19 / Senior High Camp I
July 5-10 / Senior High Camp II

Senior High Horse Camp – rising 9th-12th grade & 2015 seniors, $475

June 21-26 / Senior High Horse Camp I
June 12-17 / Senior High Horse Camp II

Senior High Leadership – rising 9th-12th grade & 2015 seniors

Tier I $360, Tier 2 $400, Tier 3 $440

June 7-12 / Senior High Leadership Camp

Senior High Remix – rising 9th-12th grade & 2015 seniors

Tier I $360, Tier 2 $400, Tier 3 $440

June 28-July 3 / Senior High Sports Camp

Theatre Camp – rising 9th-12th grade & 2015 seniors

Tier I $360, Tier 2 $400, Tier 3 $440

June 28-July 3 / Theatre Camp

Senior High Backpacking Camp – rising 9th-12th grade & 2015 seniors

Tier I $360, Tier 2 $400, Tier 3 $440

June 28-July 3 / Senior High Backpacking Camp

** Youth Special Camp will be held June 22-27

Contact Deborah Wyatt at (256) 307-5082 or for registration information.

** Adult Special Camp will be held July 20-25

Contact Joy Davis at (256) 658-8359 or for registration information.