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Microsoft word - creative arts camp application 2004.doc
$135.00 per camper (including $10.00 for canteen) Please include fees
with application. Campers will not be allowed to stay at camp if fee has not been
received. A $20.00 late charge will apply for applications received two weeks or
less before camp. Fees are non-refundable except with a doctor's note.
Camp Mountainview is
Campers should try to
them immediately to see if this is available.
2:00pm-3:00pm on the first day of camp. The camp cannot be
responsible for campers arriving before 2:00pm.
• What to bring to camp:
*** SLEEPING BAG / BLANKET / PILLOW ***
PLEASE NOTE: The Salvation Army cannot accept responsibility for lost, stolen or broken articles.
: Campers may be picked up following camp between 2:00pm-2:30pm on
the last day of camp. There will be a Creative Arts Program on Sat. Aug. 21th @
1:00 pm. All parents/drivers are invited to attend.
• Alcoholic beverages, illegal drugs, cigarettes or weapons of any kind including knives and
• Campers are not to be in the cabins/washrooms/shower facilities of campers of the opposite sex.
• Foul language, coarse jokes and conversation, questionable reading material &
inappropriate clothing will not be permitted.
• Roughhousing and fighting will not be tolerated.
A camper who is consistently uncooperative or otherwise disruptive to the camp or
who consistently breaks any of the camp rules, may be returned home via
Greyhound Bus Lines at the expense of the Parent / Guardian whose signature
The Salvation Army is offering a six day/
five night Creative Arts Camp for ages
is available at an additional cost. T-Shirts: $15.00. Other items
7 to adult…
are also available. Any extra cash for canteen must be kept by the camp and
Come take this opportunity to learn
handed in at registration. Remaining cash will be returned at the end of camp.
more about your instrument, voice,
Return ALL applications to your local Salvation Army
or artistic talent!
Please phone/email the BC Division Northern Regional Office if you need contact
information for your local Salvation Army Church. (250)562-4555
CREATIVE ARTS CAMP APPLICATION
Please check the activity you are applying for:
Level: Beginner Intermediate Advanced
House/Apt # Street
The following electives may be offered. Sign up lists will be
available at registration. If you intend to take Guitar, Brass or Timbrels
Has the child been to camp before? Yes No
CAMPER MEDICAL INFORMATION
Creative Movement Drums
Declaration of Custodial Parent and or Legal Guardian:
To the best of my
knowledge the information on this application is correct, the camper mentioned is
in good health and is able to participate in the full activities of the camp program. I
hereby give permission for the Camp Director to hospitalize and provide the
Health & Safety are emphasized at all times at Camp Mountainview. Basic health
necessary care for my child in the event of an emergency.
care is given at the camp. (please note: we are NOT a peanut free site)
I am the legal guardian of the applicant with full authority to make decisions with
If yes to any of these questions, attach a separate sheet with full details.
respect to the care, upbringing and education of the applicant.
I confirm that only the following people, and myself, have my full authority to
pick up the applicant during the camp session, and I hereby authorize you to
Note: For the safety of all campers, all medicines which the camper must use during the camp
release the applicant into the custody of any of these people:
must be clearly marked and placed in the custody of the Camp Director on arrival at Camp.
I understand that if I have not inserted the name of anyone in the space provided
above, and if I have not provided the camp with authority over the telephone, the
applicant will not be released into the custody of anyone who attends the camp to
May the following be administered if necessary?
visit the applicant, even if the visitor is a relative.
Yes No Ibuprofen (Advil/Motrin)
I herby authorize The Salvation Army to use photographs of my child for
Yes No Diphenhydramie (benadryl)
Medicated throat lozenges
I understand, and am in agreement with the camp rules and information outlined
on the information sheet attached to this application.
Any medical problems? Yes No Any emotional/social problems? Yes No
Signature of Custodial Parent or Other Legal Guardian Date
Applications will be processed only if all information is completed on this
IN CASE OF EMERGENCY PLEASE CONTACT
form at time received.
Return ALL applications to your local Salvation Army
Please phone/email the BC Division Northern Regional Office if you need
contact information for your local Salvation Army Church.
Compositions Aceclofenac 200 mg (SR) + Rabeprazole 20 mgDiclofenac Sodium 50 mg + Thiocolchicoside 4 mg Diclofenac Sodium 50 mg + Thiocolchicoside 8 mg Lycopene 6% 5000mcg + Vitamin A 2500 I.U. + Thiamine Mononitrate 2mg + Riboflovin 3mg + Pyridoxine HCL 1mg + Niacinamide 20mg + Folic Acid 0.3mg + Cynocobalamin 5mcg + Ascorbic Acid 50mg + Calcium Pantothenate 5mg + Vitamin E 10mg + V
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