Westhill Winter Retreat

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Email *

SPECTACLE

Name of Camper *

Date of Birth *

YYYY

Home Address: *

Primary Parent/Guardian Cell# *

Emergency Contact (other than parents) *

Emergency Contact Cell # *

Shirts -$10 - Shirt Size (Shirts size might run small, so you might get 1 size larger) Staff Shirts - No Cost *

XXL

List Any Allergies: (if none write "NA" *

List any MEDICATON camper is currently taking (If none, write "NA") (All Medicaton must be in original prescription bottle & turned in at retreat). *

By cheking the box below, we (the guardian of the camper and the camper) agree to the following policies and procedures of Westhill Church of Christ. By checking the box we acknowledge that we have read, understand, and will adhere to the policies that will be upheld at Retreat.

1. Dress code consists of all tops must have sleeves with no low cuts, or midriffs showing. Shorts should cover (A dollar bill) above the knee. No see through/ lace/ mesh shirts.

2. Phone use will be restricted

3. You are not permitted the use of tobacco, e-cigarettes, drugs, alcohol, fireworks or weapons.

4. Campers and staff are to respect each other.

Failure to comply with these policies may result in disciplinary action. If a camper is sent home, Westhill CoC is free of any monetary reimbursement. Parent/Guardian must come pick up their child at their own expense.

I have read and agree to the policies for the Winter Retreat

Required

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