2010 LANDMARK YOUTH-CAMPMEETING
RESERVATION - REGISTRATION FORM
mail, phone-in or fax to ...: Landmark Church ~ 1802 Lois St ~ Cleveland, TN 37311
(church: 423-478-1545 ~ fax: 423-339-1883 ~ home: 423-4728847 ~ cell:423-596-8183 ~ 423-584-0922)
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name:__________________________________________age:(9+)____MorF__ address:_________________________________________________________ city/state/zip:_____________________________________________________ phone #'s:________________________________________________________ email:____________________________________________________________ church:___________________________________________________________ pastor:___________________________________________________________ |
Work Assignments
All Adults
& Campers are given work assignments at Registration.
Adult Volunteers are needed. Required Personal Items
-KJV BIBLE
-Sleeping Bag-Sheets-Pillow -Towels-Soap-Deodorant -Bag for Damp Clothes |
BASIC CAMP RULES
Attend All Activities & Services No Cell-Phones, MP3's, Players, etc. No Shaving Cream
No leaving of camp grounds No Smoking, Matches, Firecrackers No Squirt Guns, etc
Girls & Women DRESS CODE: I agree to wear dresses or skirts which cover my knees during all activities and tops which cover my stomach. I also agree to leave at home all jewelry, body-piercing rings-pins, shorts, pants, culottes, gauchos, sleeve-less & low-cut blouses.
Boys & Men DRESS CODE: I agree to wear pants and shirts which cover my stomach and under-garments during all activities. I agree to leave at home all tank-tops, shorts, and saggin pants.
In an attitude of cooperation and modesty,.. I agree to comply with the above Camp Dress Code while at Liberty Retreat without complaining. Camper Signature: _________________________________________________
PERMISSION FOR MEDICAL TREATMENT
On any medication? If Yes, name it: ______________________________________________________________
Any allergies?, medical? If Yes, name it: __________________________________________________________
Contact #’s In Case of An Emergency: ____________________________________________________________
As parent or guardian of the above camper I grant my child permission to receive necessary medical attention which the camp nurse or camp management deems needed for his/her well-being and agree to assume the responsiblity for any medical expenses not covered by camp insurance. Signature: __________________________________________________________
PERMISSION TO PARTICIPATE IN AFTERNOON ACTIVITIES
As Parent / Guardian of the above camper I grant my child permission to participate in afternoon outdoor games & activites: YES - NO I grant my child permission to participate in afternoon zip-line and paint-ball. YES - NO
Signature : ____________________________________________________
ORDER T-SHIRT ($10) ~circle size~ Youth: XS S M L Adult: S M L XL XXL XXXL XXXXL
....Include $10.00 with this Application-Registration to guarantee your shirt to be waiting for you.
I would like to register for this years Landmark Youth Camp at Liberty Retreat in Athens, TN. I have read the above Camp Rules and Dress Code and agree to follow them and cooperate with all camp counselors, leaders, and supervisers. I understand that by breaking these rules and/or infringing on the rights of others, I may be moved from my bunk or sent home, ... even in the middle of the night.
Camper :_____________________________________ Parent : ______________________________________