Camp Quarterman
Our mission is to provide an
opportunity for young people to live in a Christ-centered community that
teaches life tools, builds
strong friendships and exercises creativity in a safe and structured manner.
This page of the
application must be completed, front and back, and returned with $100 deposit
or payment in
full to the address below. Please fill
out separate forms for each camper.
Camp Quarterman
232 East
Cottonwood Street
Amarillo, Texas
79108
Please check the session you are applying for:
_____Primary
Camp (6/25-7/1) (Completed
grades 2-4)
_____Junior
High Camp (7/2-7/8) (Completed
grades 5-8)
_____Senior
High Camp (6/18-6/24) (Completed grades
9-12)
All sessions are coeducational. We welcome all people without regard to race, creed, national origin or religion. Campers are expected to attend the full camp session. Each camp session runs Sunday through Saturday. This ensures a full camp experience for all campers and staff.
Cost: A minimum of $100 deposit is required with all registration
forms. Registrations paid in full and
postmarked by May 15, 2006 are eligible for the early registration fee of $225
for each camp session. The registration
fee for forms postmarked after May 15, 2006 is $250. All registration forms must be postmarked seven (7) days prior to
the start of the camp session. A late
fee of $25 will be added to any registration forms postmarked after the
seven-day cut off.
Multiple Children Attending Camp: Families with more than one child attending camp will receive a $25 discount. This will be applied to each tuition after one full tuition is paid. This applies to only immediate family members.
This discount does not apply
to families taking advantage of the early registration option.
Please make checks payable
to BQCC or fill out the VISA/MasterCard credit card information below.
Credit
card information: Name (as it appears on the
card)
_________________________________________________
Amount
_________________ Expiration Date
___________________ Signature ________________________________
Refunds
or Cancellations: Refunds will be made only if
the cancellation is two weeks before the starting day of camp. Deposits will not be refunded. Please notify the office immediately of
cancellations.
Camper
Information: (PLEASE PRINT CLEARLY)
Legal
Name
________________________________________________________________________________________
First Middle Last
Name
to appear on nametag (if different from legal name):
_______________________________ Gender M F
Address
___________________________________________________________________________________________
City ___________________________________________ State _______________________ Zip __________________
Age
___________ Grade (completed)
_______________ Date of Birth
______________________________________
Camper
T-Shirt Size (circle one): XS S M L XL XXL
Father’s
Name ___________________________________
Home Phone ______________________________________
Work
Phone _____________________________________
Cell Phone
_______________________________________
Mother’s
Name
__________________________________
Home Phone ______________________________________
Work
Phone _____________________________________
Cell Phone
_______________________________________
Home
Church____________________________________________
City_______________________________________
Camper
Health Information:
Allergies,
Chronic Illness, or Disabilities
_________________________________________________________________
__________________________________________________________________________________________________
Last
Tetanus Immunization / booster (must be current) ______________________________________________________
Medication: Campers
are only allowed to bring medication in its original container. Prescription medications must be in a
prescription bottle with the campers name and physicians name and dosage
clearly printed on it. All other
medications must have campers name clearly labeled on each item. All medicine will be collected at
registration and dispersed by an appointed staff member. The camp does carry a variety of over the
counter medicines for use.
Routine
Medications:
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Medication |
Dosage |
Times to be Taken |
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Camper
may be given over the counter medication by an adult sponsor: Yes No
My
camper, _______________________, has my permission to participate in all
planned activities while attending Camp Quarterman. In signing this application, I certify that the information is
correct and give permission for (1) the use of photographs, recording or videos
in camp publicity; (2) transportation to be provided in private vehicles for
approved off grounds camp activities; (3) and the release of medical records
for insurance purposes in case of illness or accident.
I
have read and understand the camp information and policies and agree that
myself and my camper will adhere to them at all times. If the camper is in violation of these
rules, proper action will be taken. In
serious cases, I understand that the Director has the authority to dismiss the
camper and that I am responsible for their immediate transportation home.
Parent/Guardian
Signature ___________________________________________ Date
_______________________________
For
office use only: Camper Name
____________________________________
Camp Session _____________________
Postmark
Date ________________ Total Due _____________ Amount Paid _____________ Amount
Due ____________
Check in and out: Check in will be from 4:30 – 5:30 pm on the opening day of camp (Sunday). Please do not arrive before 4:30. In case of delay or last minute cancellation, please notify the office at (806) 383-6878. Any remaining payment is due at this time. All campers are to be picked up by 11:00 am on the last day of camp (Saturday). Out of courtesy to the staff and volunteers, please arrive promptly on the last day. Please do not disturb closing services if you arrive early. If someone other than the parent or guardian is going to be picking up the child, please inform the Director at check in.
Camp
Quarterman Code of Behavior:
Adherence
to the Camp Quarterman Code of Behavior is required from everyone who is a part
of the summer camp program, including campers, volunteers and staff.
·
I
will treat everyone with respect and dignity.
·
I
will not use inappropriate language during my stay at Camp Quarterman.
·
I
understand that each person has physical boundaries and I will not step over
their boundaries.
·
I
understand that sexual misconduct is unacceptable with the campers, counselors
and staff and will not be tolerated.
This includes sexual harassment, jokes containing sexual material or
sexual conduct.
·
I
understand that the use of alcohol, illegal drugs and tobacco products are
prohibited during my stay.
·
I
will treat others, as I would expect to be treated.
·
I
will treat the facilities with care and not abuse the property.
·
I
will have a positive attitude and encourage everyone to do the same.
Mail: Mail is an important part of your camper’s experience here at
Camp Quarterman. Please feel free to
write to them often. Do not send
large packages or any type of food or candy.
Camper mail should be addressed:
Camp
Quarterman
Camper
Name
232
East Cottonwood Street
Amarillo,
Texas 79108
Telephone
and Cell Phone Policy: Campers are not allowed to
make or receive phone calls during a camp session. Exceptions will be made in emergencies and urgent cases with
special permission from the Camp Director.
Emergencies: In the event you need to reach a camper due to an urgent matter
or an emergency, please call the BQCC office.
If no one is available, the answering machine will direct you to the
Camp Director’s cell phone number.
Visitor
Policy: VISITORS WILL NOT BE ALLOWED DURING CAMP
SESSIONS! This includes parents or
social visits from family or friends.
This is for the safety of the campers and staff.
Additional
Information:
Please bring informal, inexpensive clothing to camp. Camp Quarterman in not responsible for articles lost or left behind. Please mark all clothing and other belongings with campers name. Please bring enough clothing and toiletries to last the entire week. We do not do wash!
_____
Shirts _____
Shoes (hiking, tennis, sandals, pools shoes)
_____
Shorts _____
Sheets or sleeping bag and pillow
_____
Underwear and socks _____
Shower towels and pool towels
_____
Sweater/sweatshirt _____
Jeans or long pants
_____
Jacket/coat _____
Pajamas
_____
Clothing for Friday night banquet/dance _____
Can of shaving cream for fun day
_____
Toiletries (shampoo, soap, deodorant) _____
Sunscreen and bug spray
_____
Flashlight _____
Swimwear
_____
Items for talent show _____
Camera & Film
_____
Bible _____
Musical Instruments
_____
Letter writing materials _____
Balance Due
(paper, envelopes, stamps,
addresses)
Please
do not bring any of the following with you to camp:
Any
of these items brought to camp will be confiscated and held until the camper
departs. Campers who drive their own
vehicle to camp will be asked to turn in their car keys as soon as they
arrive. Camp Quarterman is not
responsible for jewelry, other valuables or lost items.