PWC Kids Camp 2023

PWC Kids Camp 2023 will take place June 11-14 at Bair Lake Bible Camp in Jones, MI.

Registration from May 1 thru May 28 is $275.
Discount for multi-child families of $25 per student.

Child's Infomation

Name

Birthdate

Gender

Male Female

Graded Entering

Shirt Size

Cabin Mate Preference

Prefered Afternoon Activites (pick top three)

Climbing Tower Zipline Lake (boat/swimming) Pool Archery BB Guns Archery Tag

Legal Gardian

Name

This address will receive a confirmation email

Phone

Address

If, in an emergency, I cannot be reached, call (Please include Phone Number)

Medical Information

InformationAs legal guardian, I do hereby certify that this child is in good health and able to participate in all activities of the group:

Yes No

If no, what are the limits of his/her participation?

Current Medications

Any other allergies/medical issues to be aware of

Medical Insurance Company

Insurance Policy Number

As legal guardian of the herein named child, I hereby give my permission for him/her to participate in PWC activities and to travel to and from the location. I am familiar with and approve of the mode of transportation, leadership, departure, and return times and other circumstances of the trip.

Yes No

Whenever it may be necessary, I authorize the calling of a doctor and/or the providing of other necessary medical services and, unless covered by insurance, agree to pay for same. I understand that reasonable measures will be taken to safegaurd the health and safety of the child and that I will be notified as soon as possible in case of emergency. However, I do agree by my signature on this document to indemnify and hold harmless Plymouth Wesleyan Church, their employees, representatives, or group leaders from all liability, be it injury or illness, arising from this child’s participation in or attendance of PWC functions, no matter how caused.

Yes No

Note: There is also a Bair Lake Covid-19 Waiver and Release form that must be filled out. This can be found here.

Payment

An initial deposit of $50 is due at registration to reserve a spot. Please select '$50 Deposit' for the initial payment or '$250 (Full Registration)' to pay the full payment now.

Early registration was through April 30, 2023. As of May 1, the cost is now $275. Final registration is May 28, 2023

Discounts are available for multiple kids registered.

If you are registering multiple children from the same household, a $25 discount per child is given. (ex. 2 children registered, the total cost will be $500)

With a discount, a $50 deposit is due in order to secure a spot.

Note: All money is due by June 1, 2022

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

PWC Kids Camp 2023

Description

Please Fix the Following