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st Tru
in g
Jesu
s O u r Gu i d e
ry a n o i s s i M Inspiring Story
So ut
h Ho
s ch r u h pe Community C
rse e V Bible
g n i g n n a o i h t C a ife oriz
M em
July
22-26, 2013
Ages 6-12
Childs Name______________________
In the event I cannot be reached in an EMERGENCY, I hereby give permission to the physician or hospital selected by the Camp Director to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child as named above.
Proverbs 3:5-6
Notes to Parents:
Our Purpose South Hope Community Churchs Day Camp is dedicated to providing a well-rounded program to meet the spiritual, mental, and physical needs of boys and girls. We center everything we do on the Gospel of the Lord Jesus Christ. Our Staff Adults and competent young adults, who have been carefully screened by Child Evangelism Fellowship (CEF), will provide constant care of your children. Health and Safety A trained nurse will be present at all times. Children should bring A bag lunch, a Bible if they have one, sneakers or shoes, and a sweater on cool days marked with their name.
Contact: Day Camp Director Ethan Troester et5thbrother@gmail.com 691-0354 Or Pastor Jamie Bickel 790-0161 www.southhopechurch.com
Date______________
*Required for those under 18; to be signed by parent or guardian in ink. HEALTH HISTORY (giving approximate dates) 1. Please list all allergies and health concerns.
2. Is Your Child taking any medications? Yes No *If yes, please list.
4. Has your child been under a physicians care in the last 6 months? Yes No * If yes please explain