Summer 2008 Registration Form
Name _______________________ Cabin mate request _____________________________
City _________________________________ State _______ Zip _______________________
Grade (07-08) _________ Gender _____ Birthday __________ Phone __________________
Camper's email address ___________________________________________
Parent/Guardian _____________________________ Work Phone ________________________
Home Congregation ____________________________ Parent's Cell Phone __________________
Circle the camp you are registering for:
Camp Achieve June 5-6,9-11$15/day
Cottontail Day Camp June 12 $15
Chipmunk Day Camp June 13 $15
Third Grade June 16-18 $80
Fourth Grade June 18-21 $80
Fifth Grade June 23-28 $140
Sixth Grade July 7-12 $140
Sr. High July 14-19 $140
Jr. High July 27-Aug 1 $140
BWCA trip TBA $225
Swan Lake T-Shirts $10
Youth S (6-8)
Youth M (10-12)
Youth L (14-16)
Adult S (34-36)
Adult M (38-40)
Adult L (42-44)
Adult XL (44-46)
Adult XXL (50-52)
Camp Fee ______________
Church Scholarship - $ ____________
Bring a Friend who has NEVER been to SLCC - $ ______________
(applies only to 5th - Sr. high camps only) ($15 off)
Friend's Name ___________________________________
CD of Pictures from your week of Camp ($5) ___________
T-shirt (circle size) +$10 ______________
T-Shirt is FREE if registration is postmarked by June 1st.
(This applies to 3rd- Sr. high Camps only.)
Total Due ______________
Please include payment with your registration. Make Checks payable to:
Swan Lake Christian Camp
45474 288th St
Viborg, SD 57070
* * If your registration is postmarked by June 1st your SLCC t-shirt is FREE! (applies to 3rd. - Sr. High camps only)
* Bring a friend who has NEVER been to camp before and take $15 dollars off your registration fee.
*** Camp scholarships are available upon request. Call the camp for more info.
Since there are no required examinations, it is important that the parent/guardian fill this form out
carefully and completely.
Camper Name Health and Safety Provisions
A hospital and clinic are within 5 miles of the campgrounds. Registration fees include accident
insurance for all campers. Water activities are supervised by qualified water safety personnel.
Arrangements can be made for campers requiring medications during registration. In case of
emergency call the camp at (605) 326-5690)
Please indicate which of the following conditions the camper has/has had. Give approximate dates.
Allergies ________________________ Do you give permission for your childe to take over-
_______________________________ the counter medications if necessary? ________
Medical Conditions________________ (ie for headaches, upset stomach, cramps)
_______________________________ Swan Lake has basic First Aid supplies available.
_______________________________ Are there any activities which need to be monitored/
Special Dietary Needs _____________ avoided? _______________________________
_______________________________ Family Physician ________________________
Phone Number __________________________
Please list any prescription or non-prescription medications your child is bringing to camp.
Name of Medication Taken For When taken
Does the staff need to help/remind the camper of his/her treatment? ______________
If so, what kind of assistance is needed? _____________________________________________
Please note any other conditions the staff should be aware of: ______________________________
IMPORTANT: Please notify the camp if this camper has been exposed to any communicable disease
during the three weeks prior to camp attendance.
Parents/Guardians, please read, fill out and sign this form
I give permission for the camp nurse or designated In case of emergency, I hereby give permission
staff person to provide treatment if staff deem to the doctor selected by Swan Lake Christian
necessary from the camp's non-prescription First Camp to secure proper treatment (including
Aid supplies. hospitalization and surgery) for my child.
I realize that Swan Lake Christian Camp will
attempt to contact me if an accident or illness
occurs requiring medical treatment by a physician.