Summer Camp Registration Info

              Camp Mardela Registration Form              

Registration Instructions

PLEASE read before filling out the registration form.

  1. Fill out camper information first.
  2. If desired, indicate the name of ONE friend your child would like to bunk with. No trio or groups. Because cabin assignments have already been prepared, requests for cabin-mates made at on-site registration may not be granted.
  3. Make certain that the parent/ guardian agrees to the policies and terms before submitting this form. Submission of the form is intention to follow the policies.
  4. Mail your payment within five days of this online registration, OR...
  5. Use Paypal for online payment of the $55 nonrefundable fee (applicable to camper’s fee). There is a $5.00 fee for this service.
  6. You may also choose to pay your full registration fee at this time via Paypal. There is a $10.00 fee for this service.
Name
Birthdate
Age
Sex  F    M
Grade Completed this year
Mailing Address
City
State       Zip: 
Daytime Phone
Evening Phone
Parent’s Name (s)
Home Church
Denomination
Email Address
Camp Registering for

June 20th to 25th

 5th, 6th, 7th Grade Camp
  June 27th to July 3rd Youth Camp (9th to 12th grades)
  July 11th to July 13th Mini Camp (2nd and 3rd Grades)
  July 11th to July 16th Horse
  July 11th to July 16th Performing Arts
  July 11th to July 16th Outdoor Adventures
  July 16th to July 17th Me and You Camp (Pre K to 1)
  July 25th to July 30th Jr. Camp (3rd and 4th Grades)
  August 1st to August 7th   Jr. High Camp (6th 7th and 8th Grades)
  August 7th to August 14th  Camp Agape

In submitting this application my child agrees to abide by all policies governing personal conduct and use of camp property as outlined on the policy page of the summer camp link.  The camper is aware that he/she is expected to cooperate and participate in all camp activities.  The camper agrees to do his/her best to fulfill these expectations.

Additional Information

Is this the camper's first time away from home for a week?  Yes    No
Is the camper under regular medication? Yes    No
If yes, please list  
Reason for medication  
   

Please indicate any emotional or health problems, dietary restrictions, traumatic events in the camper’s life or other information that we should be aware of:

 
     

 

Cabin mate request (one only)  

Congregational or Agency support:

Name of person who has approved this support:  
Amount of support the church or agency offers:  
Name of the church (or agency providing this support):

 

  

 

A Note About Fees:

The first fee listed is for Mid-Atlantic District, Church of the Brethren families. All other campers pay the second fee listed. To qualify for a session, the campers must have completed the grade indicated for the camp to be attended.

 

Scholarships

Some scholarship assistance is available through the camps. Requests for these scholarships should be in writing and should accompany the registration form.

 

Personal Conduct Policies

In order to provide an atmosphere where people can live together in an intentional Christian community, the following guidelines are provided for personal conduct. These guidelines include but may not be limited to:

1.     Each camper is expected to participate and cooperate in all activities.

2.     Any type of abusive behavior toward other persons is unacceptable.

3.     Any type of abusive behavior toward camp property, including the natural setting, is unacceptable.

4.     Profane language is unacceptable.

5.     The possession or use of tobacco, alcohol, and illegal drugs are strictly prohibited and are cause for immediate dismissal from camp.

6.     Established “off-limits” places are to be honored.

7.     Clothing, including swimsuits, needs to be modest. T-shirt design and writing on t-shirts should not be suggestive, in poor taste, or offensive to other persons.

8.     Campers must not behave in such a way as to require constant one-on-one adult supervision and care.

 

If a camper is unable to function within these guidelines, actions will be taken by the camp staff, keeping in mind the best interest of the individual, all other campers, and camp staff. A camper may be sent home after consultation with parent/ guardian if it is determined that the camper’s behavior is disruptive to the program.

 

Consent Statement

In submitting this application, I certify that all information is correct and my child/ward is in good health and may participate in camping activities.

I give consent for camp officials to act in any emergency in the best interest of the health and welfare of my child/ward. Should it become necessary for him/her to return home during the week because of illness, accident, homesickness, or conduct, I will abide by the camp’s decision in this matter and provide transportation.

I recognize that certain hazards and dangers are inherent in camp events and programs. I understand that adventure activities may expose my child to psychologically and physically stressful and challenging situations. I understand, also, that although the camp has taken precautions to provide proper supervision, instruction, training, and equipment for each activity, it is impossible for the camp to guarantee absolute safety.

I further understand that my child/ward shares responsibility for his/her safety and I have instructed my child/ward in the importance of knowing and abiding by camp rules, regulations, and procedures for the safety of camp participants.

Further, I waive any claim that may arise against the camp and/or its employees as a result of participation in the program, except for those which are the direct result of gross negligence of the camp or its employees.

I give permission to use pictures including my child in camp publicity.

I give permission for my child to travel in camp-provided vehicles and to participate in off-site trips.

Payment will be made through the U.S. Mail within five days       

Payment will be made now using Paypal (remember to submit this form)