Day Camp

For children entering grades Kindergarten - 5th in the fall of 2012.

Arrival and Departure: Day Camp begins at 8:45 and ends at 4:45. The pavilion will be the location for check-in and check out for campers. We cannot accept campers before the check-in time or after the check-out time.

Cost: The fee for day camp is $20 per day. Campers will receive lunch and a small snack. All activities will be included in the price. Our Snack Shop and Outpost Store will be open in the afternoon, so we recommend that campers bring a few dollars for spending money.

Dress Code: Campers should be prepared for recreational activity. Modest shorts (to the top of the knee), long pants or jeans are permitted for recreational activities. Clothes should not be tight or revealing in any way.

Daily Schedule: Campers will participate in group games, free time activities, chapel, and crafts. For a list of free time activities, visit www.mtlousan.org/custom-camps.

What to bring: Bible, pencil or pen, swimsuit (one piece), towel.

Do not bring: Electronic devices, alcoholic beverages, drugs, tobacco

Non-discrimination policy: Rules for acceptance and participation in the program are the same for everyone without regard for race, color, religion, or national origin.

Registration

*Required Fields

Select Day(s) *

Wed, July 4

Thurs, July 5

Fri, July 6

Camper Information

Camper Name *

Grade in Fall of 2012 *

Gender *

Camper Address *

Camper City *

Camper State *

Camper Zip *

Email *

Camper Home Phone *

Must include area code (ex. 717-545-2599)

Camper Cell Phone *

Must include area code (ex. 717-545-2599)

Parent/Guardian Information

Parent/Guardian name *

Parent/Guardian Relationship *

Parent/Guardian Email

if different from camper

Parent/Guardian Emergency Contact: Primary *

Must include area code (ex. 717-545-2599)

Parent/Guardian Emergency Contact: Secondary

Must include area code (ex. 717-545-2599)

Signature Required

(typing your name below will qualify as your digital signature)

Parent/Guardian Signatures

I have read the general information above, and I agree to support Mt. Lou San in their dress and conduct regulations for my child. I also give permission to use photos and video including the camper in camp publicity. In case of medical emergency, I understand that every effort will be made to contact parents or guardian of campers. In the event I cannot be reached, I hereby give permission to the physician selected by the camp director to hospitalize and secure proper treatment for and order injection and anesthesia or surgery for my child. I agree to release any records necessary for treatment, referral or billing purposes.

Signature of parent/guardian *

Pay Online

After submitting this registration you will be taken to our online payment page. Please pay your $20, $40 or $60 amount by: 1) clicking the 'Give Now' button and 2) selecting 'Camper Payment' from the Categories and Funds drop down list.

SPECIAL NOTE FOR THOSE REGISTERING MULTIPLE CAMPERS:
For anyone registering multiple campers, please make ONE PAYMENT for the grand total (our merchant account does not allow identical payments from the same card on the same day).

Your Payment *

I paid $20 for 1 day online

I paid $40 for 2 days online

I paid $60 for 3 days online

Other (multiple campers, scholarship, etc.)