Summer 2016 Registration Form
www.campwestminster.org
Email: [email protected]
770-483-2225
Please complete both sides of this form.
Camper Name_____________________________________________________________
 Male Female
Mail the Registration Form to:
Camp Westminster
1438 Sheridan Rd., NE
Atlanta, GA 30324
Camp is located at:
Camp Westminster
2412 Lake Rockaway Rd.
Conyers, GA 30012
Birthdate_______________ T-shirt Size____________
Address___________________________________________________________ City______________________________________State_______ Zip___________
Parent's Email address_______________________________________________________________________________________ (For camp use only. Never shared or sold.)
Camper’s School____________________________________________________________________________________________ Grade Completed (by 6/1/16)________
Church you attend_____________________________________________________ City_______________________________________State________Zip___________
Parent’s and/or Guardian’s Name______________________________________________________ Home Phone_____________________________________________
Cell Phone (Father/Mother)________________________ /________________________ Work Phone_____________________________________________
In case there’s an emergency and parent/guardian cannot be reached, please notify:
Name________________________________________________ Work Phone____________________________ Home Phone________________________________
Has camper ever attended Camp Westminster? _____ When? _______________________________________________
New campers: How did you hear about Camp Westminster? Friend’s Referral (please list friend’s name) __________________________________
 Camp Fair (where?)_____________________ Internet Browsing (site?)________________________ Church/School Promotion (where?)__________________________
Brochure/Postcard Mailing Print Ad (publication?)_________________________ Other (explain)_________________________________________________________
Cabin Buddy1: __________________________Cabin Buddy2: __________________________ (Same age or grade preferred. Request will be honored if possible.)
Statement of Parent or Guardian: I do hereby grant permission for my son/daughter/ward to attend Camp Westminster during the camp session
indicated herein. I agree to assume the responsibility for the financial obligations to the camp.
Parent or Guardian Signature____________________________________________________________________ Date___________________________________
Camp Information
Tuition
Tuition includes room, all meals & activities, canteen, a camp t-shirt and group photo. At any time you may reserve a session with a non-refundable fee of $75 which applies to tuition. The remaining
tuition balance is due 2 weeks prior to your child's camp session.
Refund Policy
The $75 registration fee is built into the tuition and is non-refundable. Remaining tuition paid is fully refundable until two weeks prior to your registered session.
Confirmation
When we receive your registration, we’ll send you a confirmation of session, activity option and payment amount. At the same time you’ll receive release forms and information instructing you to pay
any remaining balance and return forms by a date two weeks prior to your session. Your information will include what to pack and when to come, etc. Please note—unless otherwise requested,
your confirmation will be emailed to you. All the forms you need will be attached to this email, so please do not disregard it.
Check-In Requirement
All families are requested to make payment and return the completed General Release and Health Form two weeks before arrival. You will get your cabin assignment when you check in at camp.
Scholarship Information
A limited number of scholarships are available according to need. To receive a scholarship application, check the box below and send it and a $75 registration fee to the camp office. The application
form may also be downloaded from our website. Scholarship application deadline is April 1, 2016. You will be notified of the status of your application by May 1, 2016. If your child is unable to attend
camp, we will return your $75 registration fee.
Please Send Me a Scholarship Application (Application deadline April 1, 2016). You may also download a Scholarship Application from our website's 'Forms' page at www.campwestminster.org.
Payment Information
PERSONAL CHECKS AND CREDIT CARDS ACCEPTED.
CIRCLE TYPE OF CREDIT CARD:
Pay in
full by
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SELECT SESSIONS ON REVERSE SIDE. A $75 REGISTRATION FEE IS
BUILT INTO THE TUITION AND IS NON-REFUNDABLE.
Total Tuition Fees (Full price of sessions selected on reverse side):$
Riding Class Fees (Total of riding class fees checked on reverse side):$
CARD NUMBER ____________________________________________________
Subtract any applicable Package Discount (Details on reverse side):-$
NAME AS IT APPEARS ON CARD _______________________________________
Subtract $20/$10 Early Bird Discount (If paying for 1 session IN FULL by 3/15/16):-$
EXPIRATION DATE ______________ VALIDATION CODE ____________________
Equal's Total Tuition Due:=$
SIGNATURE ________________________________________________________
I authorize Camp Westminster to charge my balance payment to
this credit card 2 weeks prior to camp session. Initials _______
Payment Amount (Minimum payment required is $75, which is non-refundable):-$
Total Balance Due (Balance due by 2 weeks prior to camp session):=$
Visit us in 2016 for Open House: March 12, 10 am­- 2 pm
CAMPER NAME:
CHOOSE YOUR CAMPER'S SESSION(S) BELOW. IF THERE ARE ACTIVITY OPTIONS FOR YOUR CAMPER'S SESSION, PLEASE CHECK
THESE AS WELL. AFTER SELECTING SESSIONS AND DISCOUNTS BELOW, YOU WILL TOTAL YOUR CHARGES AND PAYMENTS ON THE
REVERSE SIDE.
Session Selection
Adventure Weeks
Our most popular session since our inaugural summer in 1955! Adventure session offers the very best in outdoor camping experiences. Come prepared for a full week of incredible growth, new friendships,
and never-ending fun. Activity choices include our popular climbing wall and zip line, swimming, archery, sports, fishing, paintball, horseback riding, and much more! All programs, activities, and lessons are
led by a mature staff of counselors, committed to promoting the spiritual development of each camper.
Riding Class There is an additional $20 charge for horseback riding, and space is limited. If your child is interested in riding, check 'Yes' next to the 'Riding Class' option for your session. Space may not
be available at check-in. AGE GROUP: 7-12
COST: $495/wk
If you wish to attend an Adventure Session, check the desired week below. You may register for more than one week.
Adventure 1 June 5-11
Adventure 3 July 10-16
Riding Class ($20): Yes
No
Riding Class ($20): Yes
No
Adventure 2
Adventure 4
June 19-25
July 24-30
Riding Class ($20): Yes
No
Riding Class ($20): Yes
No
Trailblazer Weeks
Designed especially for Middle School students, our Trailblazer weeks offer the opportunity to learn advanced skills in some of our most popular activities. Trailblazer campers can select one of several
2-hour activity blocks— 2-hour horses (Horsemanship), 2-hour challenge course (Challenge), or 2-hour combo of both horses AND challenge course (H/C Combo). Alternatively, you may choose the Classic
option of five one-hour activity periods chosen by the camper on registration day. (Campers who choose one of the 2-hour options will also select 3 additional activities on registration day.)
Riding Fees There are additional fees for horseback riding—$40 for 2-hour Horsemanship, and $20 for H/C Combo. The $20 fee also applies if your child does the riding class in the Classic schedule.
If you wish to attend a Trailblazer Session, check the desired week below. You may register for more than one week.
Choose ONE activity option below
Trailblazer 1 June 12-18
Horsemanship ($40)
H/C Combo ($20)
Classic
COST: $495/wk
Choose ONE activity option below
Trailblazer 2 July 17-23
Challenge
AGE GROUP: 10-13
Horsemanship ($40)
H/C Combo ($20)
Challenge
Classic
Senior Blast
A session designed exclusively for teens! Senior Blast offers our widest selection of activities—including paintball, giant swing, high ropes, team-building, basketball, dance, and more. Guest speakers and
special programs help provide an ideal environment for students to experience the relevance of Jesus in their lives. Come ready for a week you'll never forget!
Riding Class There is an additional $20 charge for horseback riding, and space is limited. If your child is interested in riding, check 'Yes' next to the 'Riding Class' option for your session. Space may not
be available at check-in. AGE GROUP: 13-17
COST: $550/wk
If you wish to attend the Senior Blast Session, check the box below.
Senior Blast
June 26-July 2
Riding Class ($20): Yes
No
First Timers
Our First Timers sessions offer a unique opportunity for campers not quite ready for a full week away. Three days and three nights designed to introduce you to all the fun of Camp Westminster. Enjoy
swimming, fishing, art, sports, Bible studies—even horseback riding and the climbing wall. Extra supervision, outstanding activities, and a low camper-to-counselor ratio make this the perfect first-time
camp experience!
AGE GROUP: 6-9
COST: $270/wk
If you wish to attend a First Timers Session, check the desired week below.
First Timers 1 June 5-8
First Timers 2 June 8-11
First Timers 3 July 10-13
First Timers 4 July 13-16
Day Trek
Now bringing more than 50 years of camping excellence to the day camp experience! Camp Westminster offers a positive outdoor environment that will instill confidence and encourage personal growth.
Campers will encounter new activities each day, including horseback riding, nature exploration, creative arts, soccer, swimming lessons, and our climbing wall. Our experienced staff, low camper-tocounselor ratio, and attractive programming all reflect our dedication to quality Christian camping. Program runs from 8:30am-5pm. Monday – Friday.
AGE GROUP: 6-10
COST: $240/wk
If you wish to attend a Day Trek Session, check the desired week below. You may register for more than one week.
Day Trek 1
Day Trek 3
June 13-17
July 18-22
Day Trek 2
Day Trek 4
June 20-24
July 25-29
* Day Trek Pickup Policy
Day Trek campers must be picked up promptly at 5pm each day. A late fee of $15 will be
assessed for each 15 minutes after 5pm. Late fees are due on the day they are incurred.
I have read the Day Trek Pickup Policy, and understand I will be charged if I am late for pickup.
Discounts / Camper Packages
*_ Please note—only one type of Package Discount may be applied to a camper.
There are four ways to save on camp tuition with our Package Discounts:
Early Bird Discount Pay in full for one session by March 15, 2016 and receive $20 off your total balance ($10 for Day Trek and First Timers sessions). This discount may be combined with the
following Packs if paid by March 15th.
Family Package First child's session is full-price. Each additional child receives $50 off ($25 for Day Trek and First Timers sessions).
Multi-Session Package Come for more than one session and your additional sessions are $25 off the regular price ($15 for Day Trek and First Timers sessions).
New Friend Referral Refer a new camper and receive a $50 discount ($25 for Day Trek and First Timers sessions). Your friend's name must be listed below to be eligible for the discount. Your discount
is applied when we receive the friend's registration. Maximum of 3 New Friend discounts applied per camper.
Name of Friend(s)________________________________________________
Check discount type if applicable:
Multi-Session Package
$25/$15 off additional sessions
Family Package
$50/$25 off each additional child
New Friend Referral
$50/$25 off when friend registers