MIDDLE SCHOOL CAMP

Student Life @ Louisiana Tech University May 28 - Jun 01

WHO: Students who have completed grades 6-7 WHEN: May 28 - Jun 01
(Drop-off: 11:30am at Student Building; Pick-up: 10:45am at Student Building)

WHERE: Louisiana Tech University, Ruston, LA COST: $250 before May 1st; $275 after May 1st $100 non refundable deposit due at Sign-up May 13 Deadline to sign-up for camp Mandatory Parents Meeting 12:30pm 1:30pm Student Building Worship Room

May 27

WHAT TO BRING: A fantastic attitude and a desire to draw near to God Casual clothing for three days (shorts that meet our standards and pants are acceptable for all meetings including worship) $10 key deposit Sheets, a blanket, a pillow, sleeping bag, etc. (unless told otherwise) Towels and washcloths Beach towels for Water Day Personal hygiene items Spending money for snacks, T-shirts, CDs, etc. Alarm Clock Watch Bible, pen, notebook, etc. Stuff NOT to Bring: Spaghetti strap tops or small tank tops Tight clothes
"Short" shorts or skirts. (Stand with your arms by your side. If your fingertips are touching your skin, your shorts or skirt should be longer for camp.)

Bikinis or two-piece bathing suits (unless covered with a dark T-shirt) Speedos Cell phones, iPods, mp3 players or video games Tobacco, drugs, alcohol or weapons Fireworks Water balloons Clothing with questionable sayings, slogans, etc.

Emergency Contacts: Girl Campers: Brandi Howard ~ 318-243-1708 Guy Campers: Logan Dugard ~ 318-218-0592 Michael Wood~ 318-372-0223 Cody Keys ~ 318-680-8329

Daily Schedule
First Day, May 28 11:30 3:00 4:30 6:15 7:45 10:00 11:30 Meet at Student Building Orientation Dinner Family Group Bible Study Corporate Worship Church Group Time Lights Out Other Days, May 29 31 6:45-8:00 8:15 9:00 10:15 11:30 12:00 1:15 3:30 4:30-6:00 6:00-6:45 7:00 9:00 10:30 11:30 Breakfast Quiet Time with Church Group Celebration Recreation / Family Group Bible Study Family Groups to Lunch Recreation to Lunch Recreation / Family Group Bible Study Free Time Dinner Family Group Prayer Gathering Corporate Worship Church Group Time Late Nite Lights Out Last Day, June 1 6:45-8:00 8:00-8:45 9:00 10:00 10:45 Breakfast Quiet Time with Church Group Celebration Dismiss Arrive at Student Building

Camp Registration Name: __________________________________________________________ Address: _________________________________________________________ City: ______________________________Phone: ________________________ Birthdate: ______________________ Male or Female: ____________________ School: _________________________ Grade Completed: _________________ First West Member: ________ If not, where do you attend? ________________ T-Shirt Size: _____________________________________________________ My choice for a roommate is: ________________________________________
I certify that, to my knowledge, my son/daughter has not been exposed to any contagious disease within the past 30 days. I give my consent to medical and surgical treatment as needed in the judgment of the treating physician chosen by representatives of First Baptist Church of West Monroe. I, also, give First Baptist Church of West Monroe and its representatives permission to transport my child at their discretion in case of emergency. I hereby hold First Baptist Church of West Monroe, their agents and employees harmless of any and all liability, actions, causes of actions, claims, expenses and damages on account of injury to my child, property, even injury resulting in death, which I now have or which may arise in the future connected with this activity or participation in any other associated activities. I also give permission for my child to be transported by the agents and employees of First Baptist Church of West Monroe. Lack of cooperation with Middle School Camp policies/rules will result in a student returning home. I understand and will allow photos and videos of my child to be taken while at Middle School Camp to be used in any First Baptist Church of West Monroe publication. I also understand that publication of these photographs may be accomplished electronically via the Internet/Worldwide Web and that after publication, the church will be unable to prevent persons from gaining access the Internet/Worldwide Web, copying my photographs and videos therefor, and subsequently using, altering, or republishing them without my consent. I waive any claim for damages against the church from unconsented use, alteration, or republication of my photographs and video by third parties accessing the Internet/Worldwide Web. *** All payments are NONREFUNDABLE***

________________________________________ Signature of Parent or Guardian

_____________________ Date

The following items are required for attendance of Middle School Camp 2011: - Signed First West Waiver Form Form - Medical Information

First West Student Ministry

MEDICAL INFORMATION AND HISTORY FORM After competing form, please sign and date at the bottom.
NAME: ADDRESS:
Street ZIP City State

AGE:

DOB:

GRADE:

HOME PHONE: EMERGENCY CONTACT: List date of last immunization: DPT: MMR:

Please Circle: PHONE#

Male or

Female

Tetanus: Polio:

Check if you have had:

___ Chicken Pox ___ Measles ___ Mumps

Foods Medicines

___ Whooping Cough ___ Other

Insects

Please list any allergies:

Previous Serious Illnesses: Current medications and dosages:

Special Dietary Issues: Other:

SIGNATURE OF PARENT or Legal Guardian: Printed Name of PARENT or Legal Guardian: Printed Legal Name of STUDENT:

Date: