CL
(306) 792-4466
+DF=B;G=89+$
+.
KKK
;G675AD
75
C::=79;G675AD
75
25)63)'7;28535-9%';
@@=B:CFA5H=CB 7C@@97H98=BH<=G5DD@=75H=CB=G:CF=89BH=:=75H=CBDFC79GG=B; C6H5=B=B;A98=75@=B:CFA5H=CB=B75G9C:5B=B>IFMCF=@@B9GG5B8GD=F=HI5@8=G7=D@9G<=D
"B:CFA5H=CBK=@@CB@M69
G<5F98K=H<H<9:C@@CK=B; 5ADGH5::5GF9EI=F98&98=75@ D9FGCBB9@=BH<975G9C:=B>IFMCF=@@B9GG CJ9FBA9BHCF;5B=N5H=CBG5GA5M69F9EI=F986M@5K
<IF7<9GH<5HCIF
75AD=GCKB986M
/9K=@@DFCH97HMCIF=B:CFA5H=CB6M9BGIF=B;H<5HDFCD9FG5:9;I5F8G5F9=BD@579
MG=;B=B;"5IH<CF=N9H<97C@@97H=CB5B8GD97=:=98IG9GC:H<=G=B:CFA5H=CB
":MCI<5J9
EI9GH=CBGCF7CB79FBGF9;5F8=B;CIFDC@=7=9GD@95G97CBH57HH<975AD8=F97HCF
/)%6),%9)%1%(8/7'203/)7)-1*8//
5AD9F'5A9
&5=@=B;88F9GG
A5=@88F9GG
*CCAA5H9<C=79
&5@9
9A5@9
)FCJ=B79
=HM
)<CB9'IA69F
Date of Birth
)CGH5@C89
9@@)<CB9
2017 Camp Sessions: 2<97? H<9 K99?G MCI KCI@8 @=?9 HC 5HH9B8, all prices include 5% GST3
Scamper Camp (ages 5-7) August 8-11 ..........................$136.50
Tween 1 (ages 11-13) July 16-21 .....................................$252
Junior Camp 1 (ages 8-10) July 23-28.............................$252
Tween 2 (ages 11-13)July 30-Aug 4.................................$252
Junior Camp 2 (ages 8-10) August 13-18........................$252
Young Teen (ages 13-15) August 20-25...........................$252
Senior High Camp (ages 15-Grade 12) July 9-14...........................$252
-567,2-')
)'21( ,2-')
)@95G9=B8=75H9MCIFDF9:9FF98 7<C=79G5GK9C::9F AI@H=D@9CDH=CBG:CFHKC75ADG5B8CH<9FG<5J95;9GH<5H CJ9F@5D
":H<9:=FGH7<C=7975ADG9GG=CB=G:I@@H<9BH<975AD9FK=@@69F9;=GH9F98=BH<9G97CB87<C=7975ADG9GG=CB
Horsemanship Skill Registration
If you would like to pariticpate in the horsemanship skill during
camp, please check the box below. Skill spots will be reserved based
on the order registrations are received. Once all spots are filled
for a camp session, a waiting list will be recorded.
Free T-Shirt
If we receive registration postmarked on or before
May 15, 2017 and registration fees are paid in full,
we will give your camper a free GSBC t-shirt
during registration on the first day of c amp.
*Excludes Scamper Camp registrations
Youth sizes: S
Adult sizes: S
M
M
:CFH<9H<=F8:CIFH<9H7
75AD9F=:ACF9H<5BHKC5F9G9BH
:FCA5:5A=@M
,<9G9AIGH69=B7@I898=BH<9G5A99BJ9@CD9
:CF55J=85B8#CB5H<5B75AD75F8
@=A=HC:75F8GA5M
69 IG98
'5A9CB75F8AIGHA5H7<F9;=GHF5H=CB:CFA
D@95G9BCH9H<5H+75AD9F5AD=GBCH9@=;=6@9:CF898I7H=CBGCH<9F
H<5BH<95J=85B8#CB5H<5B75F8G
Calculations
5AD 99G
L
L
Deductions 2)@95G9 7<97? H<9 5DDFCDF=5H9 6CL9G3
XL
XXL
98I7H=CBG
,CH5@(K=B;
2:(-(;28*-567 ,)%5%&287 86
/96G=H9/96+95F7<
+7<CC@ *9BH5@)FC;F5A
5A=@MF=9B8
Advertisement
(H<9F
Important Information
57<5AD9FK=@@F979=J95.<=;<@=;<HJ=89CC:H<9=FK99?5H75AD
Deadline for registrations is 1 week before the beginning of each camp.
DD@=75H=CBG5F9DFC79GG98 :=FGH7CA9:=FGHG9FJ98 65G98CBH<9
postmark of the envelope.
To be eligible for the free T-shirt, registration fees must be paid in full and
envelopes must be postmarked on or before May 15 , 2017 .
DD@=75H=CBGK=@@BCH69DFC79GG98K=H<CIHH<9:C@@CK=B;
BCBF9:IB856@989DCG=H or full registration fees
+=;B98K5=J9FG
Medical"B:CFA5H=CB
Please include a non-refundable deposit of $30 or full registration
fees (only one is required to process the application). Any
remaining balance will be due on the first (%;2* 7,)6)/)'7)('%mp.
Please make all cheques 3%;%&/)72 22(3-5-7-&/)%03
$30 Deposit Included
Fees Paid in Full
OR
If you are unable to cover the entire registration fee,
check this box for financial assistance.
%03725)
(IFGHCF9=G CD9B 85=@M5B8C::9FG75AD9FG5 J5F=9HMC:GB57?G5Bd
+A9F7<5B8=G9H<9M75BDIF7<5G9
+HCF9@=A=H=G/85M,ID to a
maximum of $20 for 6 day camps and $12 for Scamper. Please bring
or enclose store mCB9MCB5 6)3%5%7)',)48) K=H<MCIFF9;=GHF5H=CB.
+HCF9ACB9M =B7@I898
Office use only
Amount Included
Camp Store
Balance Remaining
Financial Assistance
)(-'%/1*250%7-21
Camper Name: _______________________________ Health Services #: ____________________________
Family Doctor: _______________________________ Phone #: ______________________
A9F;9B7MCBH57H)9FGCB4444444444444444444444444444444444 *9@5H=CBG<=DHC5AD9F444444444444444444444444444444444
Home Phone: _________________________ Work Phone: ___________________________ Cell Phone: _______________________
)F9G7F=698&98=75H=CBG0+ '(@=GH=:M9G4444444444444444444444444444444444444444444444444444444444444444444444444444444
)*+*"&","('+&-+,"',!(*" "'%(,,%
%%* "+ '('$'(/'0+
"0+
((
&","('
'."*('&',%
%"+,%%* "+44444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444
*,"('44444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444
+.*",0,CH5@F9GHF=7H=CB 0+ '(
+)"%",0+ '(=:M9G D@95G9 7CBH57H75ADG97F9H5FMGCH<5H8=9H5FM58>IGHA9BHG:CFMCIF7<=@875B69=AD@9A9BH98 DF=CFHCF9;=GHF5H=CB
CAA9BHG444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444
"GH<975AD9F :I@@M56@9HCD5FH=7=D5H9=B5B57H=J9DFC;F5AK=H<CIH@=A=H5H=CBG0+ '( ":noD@95G99LD@5=B 444444444444444_4444444444444
444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444
)"%)+0(*!"+,(*0( +"1-*0+'(=B7@I89:96F=@9G9=NIF9=:M9GD@95G99LD@5=B 444444444444444444444444444444444444444
**0')")'0+ '(
$'(/+!(/,(-+",0+ '(
%%"&&-'"1,"('+0+ '(
" *,((&)%0/",!%"!$)*"(*,(&)* "+,*,"('0+ '(
)@95G97=F7@9 69@CKH<9A98=75H=CBG H<5H 75B69DFCJ=898HCMCIF7<=@8G<CI@8H<9M<5J9B9985B8H<5HMCI;=J9D9FA=GG=CB
:CF575AD GH5:: 89G=;B5H9*'CF:=FGH5=8DFCJ=89Fto58A=B=GH9F577CF8=B;HC +75ADA98=75H=CBDFCHC7C@G
9A9F;9B7M5B5D<M@5L=G
$ 5BH=<=GH5A=B9
$! C=BHA9BH5B8+HCD=H7<
$ CF !5B5@;9G=7
:CF8=5FF<95
"" B5IG95
!$! <CB9M65G9B5HIF5@7CI;<F9@=9:
"%5-286'5)%06*25-7',5)/-)*086'/)%',) %1(681&8515)/-)*
)@95G9@=GH 5BMCJ9FH<97CIBH9FA98=75H=CBGH<5HMCI8C BCHK5BHDFCJ=898:CFMCIF7<=@8444444444444444444444444444444444444444444444
444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444444
%032/-'-)6%1(21(-7-2162*152/0)17
+<5G=BD@579H<9:C@@CK=B;DC@=7=9G5B87CB8=H=CBGC:9BFC@A9BH=BCF89FHC7F95H9H<969GH9LD9F=9B79:CF957<75AD9F
/95G?H<5HBC BCB
9A9F;9B7M J=G=HGCFD<CB975@@G69A5896M D5F9BHGCFF9@5H=J9GC:H<975AD9F8IF=B;H<975ADK99?
,<=G=B7@I89GD5F9BHG=BCIF75ADG=H9G5B85H
H<9DFCJ=B7=5@D5F?
)5F9BHGCF;I5F8=5BGA5M@95J9@9HH9FG:CFH<9=F75AD9FG5HF9;=GHF5H=CB
+=GGAC?98FI;5B85@7C<C@:F99
,<95AD
=F97HCF F9G9FJ9GH<9F=;<HHC8=GA=GG575AD9F=:5BMC:H<956CJ9DC@=7=9G5F956IG98CF=:=H=G<=G<9FCD=B=CBH<5H575AD9F=G 5<5N5F8HCH<9G5:9HM
C:5BCH<9F75AD9FDIFDCG9@MA5?9G5BCH<9F75AD9FG9LD9F=9B79 =BGI::9F56@9 CF5DD95FGHC<5J9F9>97H98H<9F95GCB56@97CBHFC@GC:H<975AD
'C
F9:IB8K=@@695J5=@56@9:CF575AD9F@95J=B;95F@M9L79DH=BH<975G9C:=@@B9GGCF:5A=@M9A9F;9B7M
)(-'%/#%-9)5
I, the parent or guardian of _____________________________, authorize Good Spirit Bible Camp staff to obtain and approve any and all medical
attention and medical staff in the case of a medical emergency, with the understanding that all reasonable attempts have been made to consult with
myself beforehand except in the case of minor illness and/or first aid where deemed appropriate; with the understanding that I will take responsibility
for any additional expenses that may result from such services. I understand that there is a designated staff member responsible for first aid and
administering approved medication. I hereby release Good Spirit Bible Camp and the Saskatchewan Baptist Association from any claim for any
harmful effects resulting from the dispensing of the approved medication as aforementioned, and I hereby agree to release Good Spirit Bible Camp
and the Saskatchewan Baptist Association (including Camp Board, Director, staff, and volunteers) from all claims that may be made as a result thereof.
+=;B5HIF9C:)5F9BHCF I5F8=5B
5H9
#%-9)5
I understand the risks involved with the activities associated with the camp program and give permission for _____________________________ to
participate fully in all program activities and to use all program equipment available at the camp. I accept and assume all risks, dangers and hazards
including risk of personal injury, illness, loss of life or damage of any sort to the camper or the camper's property. I hereby release Good Spirit
Bible Camp and the Saskatchewan Baptist Association (including the Camp Board, Director, staff and volunteers) of any and all liability. I consent
to the collection and specified uses of the personal information on this form. I support the DC@=7=9G5B87CB8=H=CBGC:9BFC@A9BHC: CC8+D=F=H
=6@95AD5B85;F995@CB;K=H<H<975AD9FHC56=896M them.
Printed NameC:)5F9BHCF I5Fdian
+=;B5HIF9C:)5F9BHCF I5F8=5B
5H9
I give permission for GSBC to IG95BMD<CHC;F5D<GCFJ=89CC:AM75AD9F :CFDFCACH=CB5@5B858J9FH=G=B;DIFDCG9G
+=;B5HIF9C:)5F9BHCF I5F8=5B
5H9