2009 Summer Camp Registration Form
To ensure that your child will have the best camp experience possible, please fill out this form. The information you provide will be used for your child’s safety and well-being while at Winkler Bible Camp. Also note that this is NOT AN LDP APPLICATION. Please note: Upon completion of this application Winkler Bible Camp will contact you by phone regarding payment options. Payment must be made by Mastercard or Visa for ALL applications.
CAMPER INFORMATION Has your child attended a WBC camp before?
Yes No
Camper's Last Name: First Name:
Sex:
Male Female
Mailing Address: Town:
Province: Postal Code: Home Phone: () Age on July 1/2009:
Camper's Email Address (if applicable):
Date of Birth: (eg. Jan/01/1997) Grade in Fall 2009:
Father's/Guardian's Name: Cell Phone: () Work Phone: ()
Mother's/Guardian's Name: Cell Phone: () Work Phone: ()
Parent/Guardian's Email Address:
Parents Are:
Married    Common-law    Separated    Divorced    Single Parent    Foster Parent    Guardian
Church camper attends (if applicable): Town:
Please list two people OTHER THAN PARENTS in case of accident or illness (parents will be notified first).
1. Name: Home Phone: () Work Phone: ()
2. Name: Home Phone: () Work Phone: ()
CAMP SESSION INFORMATION
Please indicate two camp session choices. If your first choice camp is full, we will enroll your child in the second choice you provide.
1st Choice - Session: Site: Date:
2nd Choice - Session: Site: Date:
Cabin mate request:
*Every effort is made to honour ONE cabin mate request per camper when they are WITHIN ONE YEAR OF EACH OTHER.
MEDICAL INFORMATION
In order for your child to have the best week at camp possible, please answer the questions below as in depth as possible.
Manitoba Health Registration: (top of purple card)
Personal Health ID: (purple card)      Other Health Number:
Name of Family doctor: Clinic: Phone: ()
Does your child have any:
     Medical conditions or physical disabilities:   Asthma    Bed Wetting    Diabetes    Other:
     Emotional issues:
     Behavioral issues:   ADD    ADHD    FAS    Requires one-on-one    Other:
Please indicate any allergies your child has and the severity of the reaction:
Does your child carry an epi-pen?
Yes No
Is your child on any medication/puffers/injections that will be brought to camp (ie Ritalin, etc.)?
Yes No
   If so, please explain:
Has the camper been hospitalized or had a communicable disease within the last six months?
Yes No
   If so, please explain:
Additional Comments:
HOCKEY CAMP INFORMATION - this section must be filled out by those attending Hockey Camp
Hockey Division in 08/09 Season:
Atom Pee Wee Bantam
Position:
Forward Defense Goalie
Jersey Size:
   Youth Large Youth Extra Large Adult Small Adult Medium Adult Large Adult XL
MISSION POINT TRANSPORTATION
I would like Mission Point Transportation ($40.00)
      Drop-off (if using Mission Point Transportation)
            
      Pick-up (if using Mission Point Transportation)
            
I will pick-up/drop-off camper at the dock (contact camp office for map if needed)
CAMP POLICIES
CAMPER PICKUP POLICY—In order to keep WBC a safe place for your child, campers must be signed out at their cabins AFTER the closing program. The name of the pickup person will be asked for during registration. If this changes during the week, please notify the camp office before the Closing Program.
CANCELLATION POLICY—Where cancellation is made three weeks prior to camp session, the fee less the deposit will be refunded. If less than three weeks prior to camp session, unless in case of medical emergency, there will be no refund.
REGISTRATION TIMES—Registration for all Main Site and Teepee Village camps begin at 9:00 am with the exception of the following: LB 2 and JR 2 will be at 3:00 pm; LB 3 and JR 6 will be at 7:00 pm. Hockey Camp registration will begin at 7:00 pm. Mission Point registration times will be at 8:00 am at WBC and 9:30 am in Winnipeg with the following exceptions: Canoe Camp and Teens camp registration times will be at 3:00 pm at WBC and 4:30 pm in Winnipeg at the designated location disclosed in your acceptance letter.
CLOSING PROGRAMS—All Main Site closing programs will begin at 7:00 pm, with the following exceptions: LB 1 and JR 1 will be at 10:00 am; INT 2 will be at 4:30 pm; LB 3 and JR 6 will be at 5:00 pm; Day Camp pickup time will be at 7:00 pm (no closing program). All Teepee Village pickup times will be at 8:00 pm in front of the WBC chapel. Pickup times for Mission Point camps will be at 8:30 pm at Winkler Bible Camp and 7:00 pm in Winnipeg at the designated locations disclosed in your acceptance letter.
DEPOSITS—A $25.00 deposit must accompany any two or three day camp registration, and a $50.00 deposit for any five or six day camp. Hockey Camp deposit is $100.00. Deposits are included in the listed Camp Fees.
FAMILY RATE—Deduct $30.00 per camper for third and each additional child registered (applies to immediate family only). Registrations must be mailed together and may include a LDP registration also. Please notify us if this is the case.
ATTENDANCE—A camper may register for more than one week; their first choice will be processed and additional requests will be placed on a waiting list. You will be notified one week prior to start of additional camp choice dates.
FUNDING OPTIONS—Funds are available from a variety of sources to enable children who cannot pay the entire camp fee. Financial aid can be requested from the Sunshine Fund by calling (204) 784-1130 or call the camp at (204) 325-9519.
MEDICATION—Due to the responsibility of the staff and Health Officer here at camp, all medication including vitamins, over the counter medication, and prescription medications MUST be in their original containers. Medication not in the original containers will not be dispensed. All medication, vitamins, etc. must be handed in to the Health Officer upon arrival.
CANTEEN—The cost for daily canteen is included in the registration fee. Please do not send money with your child.
PAYMENT FEES—Make cheques or money orders payable to Winkler Bible Camp. Postdated cheques will be accepted on the balance of fee only. Full payment is due three weeks prior to date of registered camp.
WAIVERS AND CONDITIONS OF ENROLLMENT

1. The acting Director reserves the right to dismiss a camper who, in his/her opinion, is a hazard to the safety and rights of others, or who appears to have rejected the reasonable controls of the camp. If this occurs, the fee is non-refundable. The parent/guardian certifies that the applicant is normal in condition and habits and is open to necessary discipline. Possession of and/or use of tobacco products, non-prescription drugs, and alcohol are strictly prohibited and grounds for dismissal.
2. The parent(s)/guardian(s) submitting the application are those having legal custody of the child. Conditions of custody if applicable, will be fully communicated in writing to the camp, including a photocopy of the session of any court order referring to visitation rights.
3. While every precaution is taken for the safety and good health of our campers, Winkler Bible Camp, its directors, staff members and other employees of facilities outside of the campgrounds are hereby released from any liability in the event of an illness, accident, or misfortune that may occur to the applicant camper. Each camper must be insured by Provincial Health or equivalent medical insurance.
4. The submission of this application shall (1) Give the acting Camp Director or Health Officer the right to arrange for any special services or medical attention necessary for the camper’s welfare and good health including injection, anesthesia, or surgery. In such situations the camp will attempt to notify the parent(s)/guardian(s) as soon as possible. The parent(s)/guardian(s) are responsible for any additional expenses that may result from such services; and (2) Give the acting Camp Health Officer the right to administer the use of any non-prescription drugs to the camper and relevant emergency treatment such as CPR, epi-pen, medication given to the medical officer upon instruction of the parent/guardian, etc.
5. The submission of this application shall give the camp permission to teach the camper through various means in accordance with our Statement of Faith. To see a copy of our Statement of Faith, please visit our website at www.winklerbiblecamp.com or call us at (204) 325-9519.
6. The submission of this application shall give the camp permission to use pictures or videos of the camper for promotional purposes.
7. The submission of this application shall give the camp permission to transport the camper as necessary for purposes of programming or emergencies.
In order to process this form, payment must be made by Visa or Mastercard. Winkler Bible Camp will contact you by phone during business hours (9:00-4:00 Monday-Friday) for the credit card information. A minimum deposit is required within five business days of submission.

Thank-you