Junior Camp 1 (July 5-8)

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Newsletter Spring 2010

Junior Camp 1 (July 5-8)

New this summer: The Missoula Alliance Church is providing a bus to transport campers to and from each camp. To make arrangements to be part of this opportunity, contact the camp at 406 882-4572.

Note: Camper's family insurance plan is the primary source of coverage for accidents.

Camper Name:
Gender:
Age:
Birth Date:
Grade in the Fall:
Mailing Address:
Parent/Guardian Name:
Home Phone:
Father's Cell Phone:
Mother's Cell Phone:
Parent/Guardian Email:
Camper's Email:
Emergency Contact Name:
Emergency Contact Relation:
Emergency Contact Home Phone:
Emergency Contact Cell Phone:
Insurance Carrier:
Primary Insured:
Policy Number:
Family Physician:
Family Physician Phone:
Date of last Tetnus shot:
Current Medications and dosage:
Allergies:
Dietary or Special Concerns:
Activity Restrictions:
Camp Bunk Buddy:
Swim Skill Level:
Camp Attendance:
Please send me a camp newsletter:
Yes, my child's photo can be used in promotionals:

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