MCBA Children's Camp
For kids 8 years old before January 1, 2015 and must be no older than 12 during the week of camp. Like us on Facebook:
MCBA Children’s Camp For updates and camp information and pictures
@ Camp Daniel Morgan in Hard Labor Creek State Park, Rutledge, GA.
CAMP DATES: JULY 7th - 10th Check-In is 2pm Tuesday: Check-Out is 10am Friday.
Register early & receive a $10.00 discount! Early Bird Registration Deadline is JUNE 1st. & must include payment in full to reserve a space!
There are only ‘’72’ spaces available on a first come ~ first serve basis! All received after the ‘’72’ camper limit will be placed on a waiting list in the order received.
Submit completed application & registration fee to:
MCBA Children’s Camp c/o Rodney Allgood PO Box 1262, Madison GA 30650 Or Register Online @: https://kideventpro.lifeway.com/myChurch/?id=28114 For more info call: Rodney @ (706)474-8230 or Email @ [email protected]
REMEMBER...Early Bird Registration is $70.00. After JUNE 1st : $80.00 per Camper! Please make checks payable to: ‘MCBA Children’s Camp 2015
MORGAN COUNTY BAPTIST ASSOCIATION’S 2015 CHILDREN’S CAMP APPLICATION Church Name (Please Print):_______________________________ Age: ____
DOB: _____________
Camper’s Name: ______________________________________
Last Grade Completed: 3rd
Month / Day / Year
4th
5th
6th
Sex: Male
Female
**Must have turned ‘8 YRS OLD on or before Jan 1, 2015 & not turned 13 YRS OLD before week of Camp**
Parent(s) / Guardian(s) Name: _________________________________________________________________________________ Address: _______________________________________________________________________________________________ Email _____________________________________________________________ Home Phone: _______________________ Permission To Swim:
Yes
Work Phone: ________________________
Cell Phone: ______________________
Date of Last Tetanus Shot: ______________________________
No
Would like to be in the same cabin with: ________________________________________________________ Name of One Friend...Must be in same grade to bunk together.
Allergies or Medical Concerns: _________________________________________________________________________________ ________________________________________________________________________________________________________ Family Doctor: _________________________________________________________ Name
Address
Doctor’s Phone: ___________________
City
State
Zip
MEDICAL RELEASE: I, ____________________________________________, the parent/guardian of _____________________________________________ hereby give permission to the sponsors of the Associational Children’s Camp to authorize any needed medical aid including: Tylenol, Ibuprofen, & Benadryl. Any emergency cost will be the responsibility of myself or my insurance company. Signed: __________________________________________________________________
Date: _____________________________
**** PLEASE... Attach a Copy of Your INSURANCE CARD **** Morgan County Baptist Association’s insurance is with Church Mutual, with limits of $3,000.00 per person. Your insurance is primary & the Association’s is secondary. As a parent, I understand that if my child fights, bullies, smokes, uses tobacco, uses drugs without a Doctor’s prescription, or is found with alcohol, the Camp Director will suspend my son or daughter from the camp and I will be responsible to pick them up. Parent’s Signature: __________________________________________________________
Date: _________________________________
STAFF USE ONLY: PLEASE DO NOT WRITE IN THIS SPACE! ___MEDICAL/ALLERGIES
___MEDICATIONS IN INFIRMARY
___PAID
___BALANCE OWED
___CABIN MATE REQUEST
___SWIM
___GRADE
___GENDER
MCBA Children’s Camp For updates and camp information and pictures
@ Camp Daniel Morgan in Hard Labor Creek State Park, Rutledge, GA.
CAMP DATES: JULY 7th - 10th Check-In is 2pm Tuesday: Check-Out is 10am Friday.
Register early & receive a $10.00 discount! Early Bird Registration Deadline is JUNE 1st. & must include payment in full to reserve a space!
There are only ‘’72’ spaces available on a first come ~ first serve basis! All received after the ‘’72’ camper limit will be placed on a waiting list in the order received.
Submit completed application & registration fee to:
MCBA Children’s Camp c/o Rodney Allgood PO Box 1262, Madison GA 30650 Or Register Online @: https://kideventpro.lifeway.com/myChurch/?id=28114 For more info call: Rodney @ (706)474-8230 or Email @ [email protected]
REMEMBER...Early Bird Registration is $70.00. After JUNE 1st : $80.00 per Camper! Please make checks payable to: ‘MCBA Children’s Camp 2015
MORGAN COUNTY BAPTIST ASSOCIATION’S 2015 CHILDREN’S CAMP APPLICATION Church Name (Please Print):_______________________________ Age: ____
DOB: _____________
Camper’s Name: ______________________________________
Last Grade Completed: 3rd
Month / Day / Year
4th
5th
6th
Sex: Male
Female
**Must have turned ‘8 YRS OLD on or before Jan 1, 2015 & not turned 13 YRS OLD before week of Camp**
Parent(s) / Guardian(s) Name: _________________________________________________________________________________ Address: _______________________________________________________________________________________________ Email _____________________________________________________________ Home Phone: _______________________ Permission To Swim:
Yes
Work Phone: ________________________
Cell Phone: ______________________
Date of Last Tetanus Shot: ______________________________
No
Would like to be in the same cabin with: ________________________________________________________ Name of One Friend...Must be in same grade to bunk together.
Allergies or Medical Concerns: _________________________________________________________________________________ ________________________________________________________________________________________________________ Family Doctor: _________________________________________________________ Name
Address
Doctor’s Phone: ___________________
City
State
Zip
MEDICAL RELEASE: I, ____________________________________________, the parent/guardian of _____________________________________________ hereby give permission to the sponsors of the Associational Children’s Camp to authorize any needed medical aid including: Tylenol, Ibuprofen, & Benadryl. Any emergency cost will be the responsibility of myself or my insurance company. Signed: __________________________________________________________________
Date: _____________________________
**** PLEASE... Attach a Copy of Your INSURANCE CARD **** Morgan County Baptist Association’s insurance is with Church Mutual, with limits of $3,000.00 per person. Your insurance is primary & the Association’s is secondary. As a parent, I understand that if my child fights, bullies, smokes, uses tobacco, uses drugs without a Doctor’s prescription, or is found with alcohol, the Camp Director will suspend my son or daughter from the camp and I will be responsible to pick them up. Parent’s Signature: __________________________________________________________
Date: _________________________________
STAFF USE ONLY: PLEASE DO NOT WRITE IN THIS SPACE! ___MEDICAL/ALLERGIES
___MEDICATIONS IN INFIRMARY
___PAID
___BALANCE OWED
___CABIN MATE REQUEST
___SWIM
___GRADE
___GENDER
