Woodcrest Retreat - Christian Summer Camp and Retreat in Ephrata PA

Winter Blast III - Sat. Feb. 9, 2008 - ages 10-12 Register Here

Winter Blast I & II were a great success! Check out the photo gallery! There's still room for more in Winter Blast III for ages 10-12 - Sat. Feb. 9.

Winter Blast III - Sat. Feb. 9, 2008 - ages 10-12

Winter Blast III - Registration Form:


Child First Name
Child Last Name
Date of Birth ex. (03-09-1998)
Age at time of camp
Current Grade
Gender	Male Female
Parents Names
Address
City
State
Zip
Phone 1
Phone 2 (emergency, work, cell, other)
Email Address
Church (if any)	None
School
Has this child been to a summer camp at Woodcrest before?	Yes No
Optional: Name of friend (for "Bring a new friend" discount described above.)	A registration form for this child must also be submitted, if not already.
Optional: Name of friend as a groupmate (Must be mutual)	A registration form for this child must also be submitted, if not already.
Any significant health concerns or allergies that we should be aware of.
I/We hereby acknowledge that I am/we are the parent(s)/legal guardian(s) of the camper registered above, and as such parent(s)/legal guardian(s), I/we hereby authorize my/our child to participate in the camping program at Woodcrest Retreat ("Camping Program"). I/We also authorize Woodcrest Retreat to use photographs and/or video of my/our child in camp publicity. I/We acknowledge and understand that the Camping Program involves a wide variety of formal and informal indoor and outdoor recreational and learning activities and that participation in the Camping Program is an activity which could result in personal injury or illness to my/our child. With full knowledge of the risks associated with my/our child's participation in the Camping Program, I/we, on behalf of myself/ourselves, and my/our child, hereby absolve, release and discharge Woodcrest Retreat, its officers, directors, members, employees and agents, and any individual directly or indirectly involved with the Camping Program from any liability for injury or illness suffered by my/our child while participating in or as a result of the Camping Program. In the event my/our child should suffer an injury or illness while participating in or as a result of the Camping Program, I/we hereby authorize and consent to any and all medical treatment which may be determined by a physician, other qualified medical personnel or the officials of the Camping Program to be necessary or desirable for my/our child and hereby authorize the officials of the Camping Program to use their discretion to have my/our child transported to a medical facility for such treatment. Authorize Consent here: Please type your full name: