WHITEWATER CHRISTIAN SERVICE CAMP
THE GREATEST CAMP ON EARTH
2017 CAMP REGISTRATION FORM
9181 Whitewater Camp Rd. Vevay, In 47043 Phone: 812-534-3020
Email Website: www.whitewatercamp.org
PLEASE READ THE ENTIRE REGISTRATION INFORMATION SHEET BEFORE YOU COMPLETE THIS FORM.
CAMPER INFORMATION:
Name: (Last)______(First)______(Mi)______Phone______
Address______(City)______(State)______(Zip)______
Email address______Age______Date of Birth______Grade Just Completed______
Immersed Christian [ ] Yes [ ] No Gender [ ] Male [ ] Female Home Church______
CAMP WEEK: (The 2nd money figure is for the late Registration & Walk-ins) check your camper’s week: All GRADE designations refer to the grade just completed. Registrations are ON-TIME if received 2 WEEKS prior to your camper’s week. This saves you $25
[ ] Work Study Week (7th- 12th) June 11-16 $70/$95 Dean: Darin Ayler 812-273-4458
[ ] Wilderness Week (7th-12th) June 18-13 $150/$175 Dean: Doug Hutson 812-623-0200
[ ] 3rd & 4th Grade Week June 25-30 $150/$175 Dean: Brian Schultz
[ ] Junior High Week July 2-7 $150/$175 Dean: Matt Loper 513-304-9387
[ ] 1st Chance Camp July 9-11 $80/$105 Dean: Matt & Angie Wagner 513-470-9231
[ ] Day Camp (Kindergarten) July 12 $30/$40 Dean: Shawna Tiemeyer 812-432-5271
[ ] Senior High Week July 16-21 $150/$175 Dean: Kevin Smith 812-637-3388
[ ] 5th & 6th Grade Week July 23-28 $150/$175 Dean: Joe Van Wye 812-599-4570
[ ] Status Conference 18 & up 7:00 pm Aug 4-6 $35 Dean: Micah Stephen
CABIN CHOICE (Circle) BOYS 4 3 2 1 Upper Lower 2nd Choice
GIRLS 9 8 7 6 5 Upper Lower 2nd Choice
SHIRT SIZE: CIRCLE ONE CHILDS S M L ADULTS S M L XL 2XL 3XL
CHURCH TUITION HELP: (If your church will pay any or all of your tuition, you MUST fill out this portion)
The ______congregation agrees to pay$______toward tuition to Whitewater Christian Service
Camp. Signed (Elder or Minister)______-
Office use: Advance Received:______Reg______Due______
MEDICAL INFORMATION: This information may be needed by the Camp Nurse, Hospital or Physician
Emergency Contact: Name______Home Phone______Cell Phone______Work Phone______
Physician:______Important Medical Information______
Allergies______Last Tetanus Shot______(more space on back if needed)
Medications______
(If camper needs alternate diet for medical reasons, Please notify the Cook or the Nurse during check-in. All medications MUST be given to the Nurse, along with schedule and dosage information. All medications MUST be in ORGINAL containers.
PARENT’S PERMISSION: Please Read Carefully!
[ ] I hereby give my permission for the above named camper to attend camp and participate in all its activities.
[ ] I affirm that my child has read with me the rules for conduct on the back of this form and has agreed to abide by them.
[ ] I consent to providing of medical care and/or transportation by the Whitewater Christian Service Camp Nurse or other
staff.
[ ] I give permission for my child’s photo or video likeness to be used in camp promotional materials.
Parent Print______Sign______Date______
(Please inform the Dean during check-in if; visitors are anticipated during the week, or if the camper must leave during the week or someone other than the above signed parent will be picking up the camper.)
THIS PAGE IS FOR PARENTS TO ADD ANY OTHER INFORMATION THEY MAY THINK CAMP STAFF SHOULD KNOW.
WHITEWATER CHRISTIAN SERVICE CAMP
THE GREATEST CAMP ON EARTH
CAMP INFORMATION
WHAT TO BRING TO CAMP:
1 Bedding: sheets/blanket or sleeping bag and a pillow
2 Class materials: Bible, notebook, pencil/pen
3 Toiletries: comb/brush, toothbrush, toothpaste, soap, wash cloth and towels
4 Spending money: Each week, campers will contribute to the missionary offering. Snaq Shak uses a ‘prepaid debit card’
System ($10 or $15 per card) for campers and faculty. Unused value of the Snaq Shak card will go to the camp.
5 Clothing: Clothes suitable for study, worship and play, NO 2 Piece Swim suits allowed, no short shorts/skirts & no string tank tops. Shorts are to be NO shorter than finger tip high. NO EXCEPTIONS.
ADDITIONAL INFORMATION:
1 CHECK-IN & CHECK-OUT: Camp weeks officially begin with the Sunday evening meal. Check-in time is from 3:00 to 5:00PM.
Campers will be dismissed to go home Friday evening (1st Chance on Tuesday) at 3:00PM, Unless dismissed earlier by the Dean.
Please pick up campers promptly.
2 HEALTH AND SAFETY: A nurse will be on duty each week. During check-in please inform the nurse of medical matters which may
need attention. Give the nurse ALL medications in their ORIGINAL containers.
3 ACTUAL COST: Actual cost per camper is approximately $260. Contributions to cover the balance are appreciated.
4 JUNIOR STAFF: Deans of 1st Chance, 3rd & 4th, and 5th &6th Grade Weeks may appoint Junior Staff for their weeks. Staff & Junior
Staff must complete Staff Application/Contract. There is no charge for Junior Staff. In order to be Junior Staff you must either attend
Work Study or the week that corresponds with your grade. This is for ALL Junior Staff NO EXCEPTIONS
5 BUNK ASSIGNMENTS: Cabin and bunk assignments will be confirmed during check-in. Please mark your choice on the
registration, otherwise, you will be assigned a bunk. DO NOT PUT ANYTHING IN THE CABINS UNTIL YOU GET YOUR
BUNK ASSIGNMENT AT CHECK-IN.
THE WHITEWATER WAY: FOR A QUALITY CAMP EXPERIENCE:
1 PARTICIPATION: All campers, faculty and staff are expected to conform to the Dean’s schedule for the week, including wakeup
call, mess-call, and lights out, unless specifically excused by the Dean. CAMPERS, FACULTY, AND STAFF ARE EXPECTED TO
STAYS AT CAMP UNTIL THE CLOSING ASSEMBLY ON FRIDAY. UNLESS APPROVED BY THE DEAN AND CAMP
COORDINATOR. NO EXCEPTATIONS!
2 MEDICAL: All illnesses and accidents are to be reported to the dean and the nurse as soon as possible.
3 DRESS: Everyone is expected to dress modestly at all times.
a. Your attire must include shirt and shoes (except when swimming).
b. NO SHORT SHORTS/SKIRTS, BARE MIDRIFFS, LOW CUT OR TORN JEANS, SHORTS ARE TO BE NO SHORTER
THAN FINGER TIP HIGH. NO EXCEPTIONS!
c. Swim wear, Boxer swim suits for guys, and modest 1 piece suits for girls are acceptable swim wear.
d. No clothing which bears offensive imprints such as drugs, tobacco, alcohol, sexual content, bad language, nudity,
secular music, etc.
e. Attire for the evening meal and Vespers should be the best of the day.
4 SWIMMING: You may only swim in or use the swim-pond during assigned times when the lifeguard is present.
5 FORBIDDEN: the following items are forbidden: DRUGS, TOBACCO, ALCOHOL, CELL PHONES, OR ANY OTHER
ELECTRONIC DEVICES. (ALL MEDICATION MUST BE TURNED INTO THE NURSE AT CHECK-IN)
6 LEAVE AT HOME: Campers should not bring GUNS, (real or toy), HUNTING KNIVES, FIREWORKS, LIGHTERS, TV’S,
CD PLAYERS, I PODS, RADIOS, CELL PHONES, PALM GAMES, COMIC BOOKS, MAGAZINES, SKATES, SKATE BOARDS,
OR OTHER DISTRACTIONS.
7 CARS: CAMPERS WHO DRIVE TO CAMP ARE NOT PERMITTED TO USE CARS DURING CAMP.
8 CLEAN-UP: Campers are expected to participate in clean-up activities daily and on the last day of the week.
9 DISMISSAL: The coordinator & Dean have the authority to dismiss anyone who disregards the rules or disrupts the program.
10 NO GRAFFITI: Campers/staff who deface or damage property will be responsible for rectifying the damage.
11 CANTEEN/SNAQ SHAK: Campers may buy a $10 or $15 Snaq Shak debit type card. Unused money left on the card will be
donated to the camp. Missionary offering is separate.
12 VISITORS: Visitors should leave before campfire or earlier at the Dean’s request. All visitors is at the Dean’s discretion. The
camp has a gate that is LOCKED at 11PM every night and reopens at 6AM. Note: All visitors must check in with the coordinator or dean, NO EXCEPTIONS! No overnight visitors are permitted, unless approved by the Dean AND Coordinator.
WHITEWATER CHRISTIAN SERVICE CAMP 9181 WHITEWATER CAMP RD VEVAY, IN 47043 812-534-3020
WWW.WHITEWATERCAMP.ORG EMAIL:
WHITEWATER CHRISTIAN SERVICE CAMP
THE GREATEST CAMP ON EARTH
2017 CAMP REGISTRATION INFORMATION
PLEASE NOTE CHANGES HAVE BEEN MADE TO DATE OF PRE-REGISTRATION:
Check in begins at 3:00 PM First day and camp ends at 3:00 PM the last day
You can save $25 if you pre-register 2 weeks prior to your week
THIS INCLUDES ALL CAMPS.
All “grade” designations refer to the grade just completed
I Wanna Go! What do I Gotta do?
Use the attached registration or download from
www.whitewatercamp.org
Please remember to register 2 weeks prior to your camp week to save $25
Read the entire form, front and back
Fill in all blanks carefully
Parents MUST read and sign
Send in $25 pre-registration fee or the complete amount
Come to camp at your appointed time REGISTRATION BEGINS
AT 3:00 PM, NO EARLIER, Bring the rest of your registration fee,
Canteen money, mission offering
HAVE A GREAT CAMP EXPERIENCE.
WHITEWATER CHRISTIAN SERVICE CAMP, THE GREATEST CAMP ON EARTH!!!!!!!!
Contact Information:
Whitewater Christian Service Camp
9181 Whitewater Camp Rd.
Vevay, In 47043
Phone: 812-534-3020
Email:
Website: www.whitewatercamp.org
Joel Smith, Camp Manager/Coordinator/Caretaker
812-621-2844
Email:
General Information & Costs: (Register 2 weeks prior to your week to avoid the $25 late fee or $10 for Day Camp)
If you register 2 weeks prior to your week $150/week, $80 for 1st Chance, $70 Work Study Week & $30 for Day Camp. Send the completed registration with $25 non-refundable advance fee, or the whole amount, to the camp at the address above. Bring the balance to camp when you come. Advance registration is advised to secure a bunk on your desired camp week. The first 8- registrations for each week will be assured acceptance.