CAMP ATTENDING:

Middle School Fall Camp, October 21-23

Senior High Fall Camp, November 18-20

Name _________________________________________ ( M / F ) ___

Parent Cell _______________________________________________

Church (if attending with a youth group) _____________________

School __________________________________________________

Roommate Request (2 max) ________________________________

Emergency Contact _______________________________________

Phone ___________________________________________________

Relationship to Student ____________________________________

Allergies _________________________________________________

Daily Med ________________________________________________In case of emergency, I give my authorization to provide whatever emergency care is necessary for my child’s safety, and assume primary responsibility for payment

Date ____________________________________________________

Parent/Guardian Signature _________________________________

Insurance _____________________________ Group # ___________

Policy # _________________________________________________

If attending with a church youth group, give this registration form to your youth leader. You’ll room with friends from youth group & your youth leader.

If you are NOT attending with a youth group, mail completed form, along with a check for $95 (made out to Camp Spalding) to: Camp Spalding, 8513 Hwy 211, Newport, WA 99156. Forms must be postmarked by Oct. 13th for Middle School Camp and Nov. 4th for Sr. High Camp.

REGISTRATION FORM:

Sleeping Bag • Pillow, Really Warm Clothes Bible, Pen, Notebook • Toiletries • Daily Meds

Jammies • Clothes (that will get really dirty) Large Garbage Bag (for your dirty stuff) • Towel

Spending money for Trading Post

COST:

www.campspalding.org

FALL CAMP

WHAT TO BRING:

DAVIS LAKE, WA

2016

Middle School Fall CampOCTOBER 21-23

Senior High Fall CampNOVEMBER 18-20