Game Show Weekend Registration |

Name__________________________________ |
Age ______ Grade ______ Gender _________ |
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Shirt Size (Adult): XS S M L XL
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Address ________________________________ |
City ______________________Zip __________ |
Parent’s Names __________________________ |
Get

Phone # _______________________________ |

for...
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Email _________________________________
Ready
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Alternate Contact _________________________ |
Phone # _____________ Work # ___________ |
MEDICAL INFORMATION: |
Allergies: _______________________________ |
Medication Being Taken: ___________________ |
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_______________________________________
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Physical Handicaps or Limitations: ____________ |
_______________________________________ |
Medical Insurance Company: ________________ |
Policy Number: __________________________ |
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Member’s Name: _________________________
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Primary Physician: ________________________ |
Physician’s Phone# _______________________ |
Are you planning on skiing or snowboarding |
(chaperones will be provided) at Mission Ridge? |
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____ Yes _____ No ____Maybe |
____ Could I have more information? |
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If “yes” are you planning on renting equipment? |

____ Yes _____ No

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PLEASE COMPLETE OTHER SIDE! |
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Harbor Covenant Church,
5601 Gustafson Dr. NW |
Gig Harbor, WA 98335 |
253.851.8450 |

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 What you need to know for the
Welcome to Game Show Weekend !

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Everyone enjoys game shows!
There’s just something about watching someone
win something that can change their life in an
instant! That’s why we are putting on a weekend
of game show games with good old Camas
Meadows as our backdrop!
Get ready for a weekend of adventure and
relaxation! There will be plenty of opportunity
for getting away and taking a break from
everything that stresses you out. Or if you’d
rather break loose and go crazy, then we have
that too!
There will be plenty of ways to enjoy all the
snow: cross country skiing, world famous inner
tubing, our annual pick up game of Snow
Rugby, snow ball fights, or even snow-cave
building! Not to mention skiing/snowboarding
(costs extra and is chaperoned) at Mission Ridge!
This weekend will be full of fun, games, and
praise to our God. The Game Show Weekend
Winter Retreat at Camas Meadows has some-
thing for everyone. Get ready to play hard,
laugh until it hurts, and learn about a God that
wants nothing more then for us to know how
much He cares for each of us. If this sounds like
something you desire, then this winter retreat is
where you need to be.
Registration is now open!
The Game Show weekend:
When Does Registration close? January 31st
When is it? February 5-7th
Times: Depart at HCC at 3:15pm Friday, Feb. 5th
Return to HCC at 4pm Sunday, Feb. 7th
Cost: $165 .00
*Plenty of Scholarships are available!*
There is an early bird rate of $155 IF registration and
deposit are in BEFORE JANUARY 13th! No excep-
tions!
What should I bring:
A Sack Dinner for the trip there, Sleeping bag, pillow, a
few bucks for the snack bar (optional), Bible, warm/
snow clothes, toiletries, towel, journal, friends, cam-
era (optional), flashlight, Bible, pens, extra socks, two
pairs of shoes (or snow boots recommended).
What shouldn’t I bring:
Personal electronic devices like ipods (anti-social),
weapons, drugs, alcohol, pets, expensive personal
items, or Icaulanibokola’s.
How do I sign up:
Complete the registration form (keep your portion to
retain important information), attach a down pay-
ment ($40.00 non-refundable deposit) and then
place in the lock box outside the youth pod (room
106 in education building). Then skip around with
joy!
What if I have questions? Contact Director of Middle
School Ministries, Jen Easton @ 253-851-8450 or
email at jeaston@harborcovenant.org


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The undersigned gives permission to Harbor Covenant
activity. In the event of an emergency, I hereby author-

from this activity and transport them immediately back

to consent to any x-ray examination; medical, dental or
Show Weekend)” with Harbor Covenant Church (Gig

injury and illness that my child may sustain during this

ate) as listened to practice under the laws of the state/

province where the services are rendered, either at the

Church to photograph his or her son or daughter and

and sponsors, from responsibility and liability for any

ize an adult leader of this activity, as an agent for me,

explanation, please contact Jen Easton at the church.

themselves or others, or engages in any unacceptable
surgical diagnosis; treatment; and hospital care as ad-

Harbor Covenant Church deems proper. For further

I give permission for ______________________ to

vised by a physician, surgeon or dentist (as appropri-

doctors office or in any hospital. I expect to be con-

travel to The “Middle School Winter Retreat (Game

brings alcohol, drugs, weapons, causes any injury to

I hereby release Harbor Covenant Church, its staff

use the resulting photographs for any purpose that

behavior, I will be responsible to remove my child
I also understand that if my child is disruptive,

___________
Date
Medical Release

Email: jeaston@harborcovenant.org
Harbor, WA) February 5-7, 2010.

_____________________
Parent or Legal Guardian
tacted as soon as possible.

Jen Easton Contact Info:

Photography Release

Work: 253-851-8450
Cell: 253-241-3760
to Gig Harbor.