Camp Falling Spring 2012!July 8-13

Aaaahhh Yeeeeah! If you’re reading this, then you’re contemplating signing up for CFS ’12. If this contemplation leads to actually signing up, get ready for an AMAZING week! What’s more...if YOU sign up, there’s a good chance camp will be even more amazing because you are going to be there! Read on for the details...

Who can come to camp? Any student currently in grades 7-12 (2011-2012)

When is camp? Begins Sunday, July 8, at 5 p.m. and ends Friday, July 13, at 8 p.m. *Campers may not leave camp unless it's an emergency.  No early or midweek departures

for practices, vacations, appointments, etc... Please plan accordingly.

Where is camp? At the beautiful Horse Valley Acres in Upper Strasburg.

Can I invite my friends? Yes! (register early to guarantee spots)

How do I sign up? Complete the information on the next page and return it, with payment ($25 deposit or full), to the church by June 22. We can only register the first 115 campers for camp, so itʼs recommended to register early. Hereʼs the schedule...

We will begin accepting registrations on Wednesday, Feb. 22 with the following schedule:• 7 a.m. - 4 p.m. at the office (3 buildings North of the Family Life Center, back door)• 4 p.m. - 9 p.m. in the Family Life Center• Beginning Feb. 23, they can be taken or mailed to the church office, 9-4. If the office is

closed, put your registration in the mailbox by the back door.Please note: Registrations will be accepted in the order they are received at Falling Spring.

How much does it cost? On or before June 1: $175/person or $160/person for families sending more than 1 camper. After June 1: $200/person. Final payment due June 22.

Are scholarships available? Yes. Please indicate on your registration and weʼll send you a scholarship form.

Can I get involved before camp? Yes! Check out fallingspringyouth.org for details.

Confirmation Letter. Weʼll send you a confirmation letter and a herd of buffalo in June. The letter will give you the latest CFS info - times, directions, packing list, parent information and anything else we think youʼll need for a great week of camp.

Need more brochures? fallingspringyouth.org, the youth room, or the FLC lobby

We build RELATIONSHIPS and create a loving place where students and their families can KNOW Jesus, GROW close to Him, and SHOW His love to everyone.

THE PRESBYTERIAN CHURCH OF FALLING SPRING 221 N. MAIN STREET CHAMBERSBURG, PA 17201

Camp Falling Spring 2012 Registration *Last day to register is June 22

Name __________________________ Birth date ____/____/______ Phone _______________ Current Grade ______

Street_________________________________________ City _______________________ State ____ Zip __________

Parent E-mail ____________________________________________ (include if you would like to receive parent emails)

T-shirt size (adult sizes): XS S M L XL XXL

Payment info: ❍ Full pmt. enclosed ❍ $25 deposit enclosed ❍ Need scholarshipMake checks payable to “PCFS” Final payment due 6/22

Emergency contacts: Parent(s) ________________________________ Other _______________________________

MEDICAL INFORMATIONInsurance Co. ____________________________ Policy # _____________________ Ins. Phone # _________________

Will the camper bring any medications to camp? Yes NoIf yes, please list, with specific dosage and instructions for the camp nurses

Date of last Tetanus Booster: ____/____/______

Surgeries or serious injuries (dates)

Allergies (food, medications, plants, insects)

Other information regarding my childʼs health that a physician should know (seizures, diabetes, asthma, abnormal/severe reaction to insect stings, etc...)

AUTHORIZATION FOR TREATMENT, PARENTAL CONSENT AND RELEASE OF LIABILITY:" As the parent or guardian of the above named applicant, I hereby give my approval and consent for my child to participate in Camp Falling Spring, July 8-13, 2012. In addition, I hereby release The Presbyterian Church of Falling Spring (PCFS), its staff and volunteer leaders, and the members of Falling Spring Horse Valley Acres (FSHVA) from any and all liability for sickness, accidents, or injuries of any nature or cause whatsoever, including the negligence of PCFS and FSHVA, while participating and/or traveling to and from. I understand I am releasing PCFS, its staff and volunteer leaders, and FSHVA from any claims I may have individually and understand that I am also releasing PCFS, its staff and volunteer leaders, and FSHVA from any claims my child or anyone else may have as a result of any injuries suffered by my child while participating and/or traveling to or from." I further authorize the camp nurses and staff to administer such acts of first-aid as seem necessary. Authorization is also given for appropriate staff members to transport the applicant to a doctorʼs office or medical facility to secure the services of a physician. I further authorize the Camp Falling Spring staff to receive temporary physical custody of my child upon completion of any treatment. I further promise to utilize family insurance for any appropriate medical care and/or hospitalization. I understand attempts will be made to reach me in the event of a serious illness or injury." Permission is also granted to PCFS to use audio and/or visual recordings for website, bulletin boards, and promotional purposes.

___ (please initial) I understand that campers must arrive Sunday by 6 p.m. (at the latest) and remain at camp until (at least) Friday, 12 p.m.

____________________________ " ___________" " ______________________________________Parent or Guardian Signature" " Date " " " Parent or Guardian Name (Print)

If you do NOT want your child to receive any of the following, please write “no” next to item:

_____ Chloraseptic throat spray_____ Kaopectate_____ Debrox (ear) drops_____ Visine (eye)_____ Pepto Bismol_____ Imodium_____ Benadryl tablet_____ Ibuprofen_____ Acetaminophen_____ Milk of Magnesia_____ Hydrogen Peroxide_____ Rubbing Alcohol_____ Adhesive tape_____ Hydrocortisone cream/Cortaid_____ Neosporin/triple antibiotic_____ Calamine Lotion_____ Bactine Spray_____ Skeeter stick or Sting Kill_____ Icy Hot_____ Others: ___________________