Fillable Printable 2015 Camp and Retreat Registration Form - Wisconsin United Methodist Camping
Fillable Printable 2015 Camp and Retreat Registration Form - Wisconsin United Methodist Camping
2015 Camp and Retreat Registration Form - Wisconsin United Methodist Camping
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www.WIUMCamps.org 877-947-2267 608-837-3388
Please complete both sides of registration form! Separate waiver forms must be included for each
participant. Additional registration assistance can be found on page 11. All campers are required to have a
valid health record at camp. Please register for camps by the grade you will be entering in the fall of 2015.
Family Name Home Phone
Mailing Address City State Zip
Church Name Church Town
Name (rst parent/guardian/adult) Work Phone Cell Phone
Name (second parent/guardian/adult) Work Phone Cell Phone
Email
(When provided, will be used to send registration/conrmation materials. We do not sell, rent, lease our camper lists or email addresses.)
Card I.D. # is the last three digits on the
signature strip on back of your credit card.
PAYMENT INFORMATION: Full payment is due with registration form. A pastor-approved
Conference Scholarship form may be included as part of the full payment requirement.
Conference Scholarships will not be given in the form of reimbursements.
Make checks payable to:
Wisconsin UM Camps
Mail to: Camping Office
750 Windsor St., Suite 203
Sun Prairie, WI 53590-2149
Fax Form to: 608-837-8547
Office Hours: M-F from 8am-4:30pm
$
cost of camp
o Camper Payment* $ _______________ o Church Scholarship* $ _______________ o Conference Scholarship* $ _______________
(*Conference Scholarship form may be obtained from camping website; requires UMC Pastor's signature)
o I would like to donate $______ to the camp scholarship fund.
Payment Method: o Check o Credit Card: Visa or MasterCard will be accepted. o Please setup payment plan.
“WI Annual Conference” will be the name appearing on the charge.
Print Cardholder Name:
Card Number: Expiration Date:
Signature
Card I.D. #:
o I am a sophomore or junior in high school and would like to receive information about United Methodist Colleges.
Cardholder’s address
if dierent than
address above.
2015 CAMP AND RETREAT REGISTRATION FORM
(must be included) (must be included)
(option available on registrations prior to
March 1 and credit card payment only)
(form must be included)
First & Last Name of Camper/Retreat attendee Camp Dates Camp Title Birthdate Gender
9-1-15
Cost
Grade
as of
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www.WIUMCamps.org 877-947-2267 608-837-3388
CONSENT TO RECORDING AND USE OF PHOTOS AND VIDEO OF CAMPER. Representatives of the camp may
record, by video, photograph or other means of reproduction, the Camper’s name, voice, image and physical likeness, and
may use any such recorded matter for promotional purposes without further consent, notice or compensation.
ASSUMPTION OF RISK FOR CAMP ACTIVITIES. e Camper has my permission to participate in camp and retreat
activities, including, but not limited to, swimming and other water activities, canoeing, hiking, ropes courses, horseback
riding, rock climbing, campres, outdoor games, athletic competitions, transportation to and from camp facilities, meals
and other activities. THE CAMPER AND I ACKNOWLEDGE AND KNOWINGLY ASSUME ALL RISKS OF INJURY,
DEATH AND PROPERTY DAMAGE RESULTING FROM THE ACTIVITIES.
WAIVER AND RELEASE. On behalf of myself, the Camper, and our respective family members, heirs and assigns, I
hereby release and discharge e Wisconsin Annual Conference of e United Methodist Church and e Wisconsin
Conference Board of Trustees of e United Methodist Church, Inc., and each of their ocers, directors, members,
employees, agents, aliates, and volunteers, from any and all claims, liability, actions or suits for injury, death and
property damage arising from or related to camp and retreat activities. THE CAMPER AND I INTEND THIS TO BE A
COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY
L AW.
By signing below, I, the undersigned, am stating that I am the parent or legal guardian of the Camper whose name is set
forth below, and I have the right to contract for such Camper.
DO NOT SIGN THIS AGREEMENT UNTIL YOU HAVE READ IT IN ITS ENTIRETY.
Please photocopy this waiver and submit one fully completed
and signed copy for each individual attending the camp.
Camper’s Name or Retreat attendee (Printed)
Camper’s or Retreat attendee’s Signature
(if over 13 years old January 1 of camp year)
Camper’s Date of Birth
Today’s Date
Parent or Guardian’s Name or
Retreat attendee (Printed)
Parent or Guardian’s Signature
Today’s Date
waiver, release and consent
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www.WIUMCamps.org 877-947-2267 608-837-3388
registration information
HOW TO REGISTER
Please complete BOTH sides of the
registration form. Register for the grade you
will be entering in the fall of 2015. Please
photocopy additional registration forms as
needed. Return registration form and camp
fee to United Methodist Camping Office,
750 Windsor St, Suite 203, Sun Prairie, WI
53590-2149. If you prefer, you may fax to:
608-837-8547.
Secure online registration is available
at www.WIUMCamps.org.
BRING A FRIEND
When you register for camp, think about
inviting your friends to come with you. When
you attend a 5 night camp and bring a *new
friend to camp, you can receive a $25 discount
on your own camp registration. You could
recruit up to 4 new friends for a total discount
of $100.
*A new friend is someone who hasn’t attended
one of our camps in the last 3 years. To receive
the new friend discount, all registrations for
you and your friends must come in together,
in the same envelope. To register you and your
friends with our online registration, please
contact the camp registrar at 608-837-3388
prior to registration. No refunds will be made
for the bring-a-friend discount.
REGISTRATION DEADLINE
No registrations will be accepted aer noon
on ursday for a camp starting the following
Sunday. Generally, camp registration closes 2
business days before the start of camp.
CONFIRMATION
Registrations will be acknowledged promptly
by email when email is listed, otherwise
mailed. Your conrmation will include
registration details, health forms, and general
camp information. All online registrations will
receive conrmation via email.
PAYMENT AND
SCHOLARSHIP INFORMATION
Full payment is required before attending
camp. You may pay your camp fee with a
personal check, money order, Master Card
or Visa. “WI Annual Conference” will be the
name appearing on the charge. A 4-month
payment plan may be set up with registrations
made before March 1, 2015 and paid with a
credit card. Payment plan charges will be made
April 1, May 1, and June 1, 2015.
A $20 charge will be made for returned checks.
Many local churches have scholarship funds, or
you may qualify for a Conference Scholarship.
Scholarship forms may be included as
part of the full payment requirement. Note
that forms require a United Methodist pastor’s
signature. Scholarship forms are available at:
www.WIUMCamps.org.
Conference Scholarships will not be given in
the form of reimbursements. For scholarship
assistance, please contact your pastor.
You may contribute to the Wisconsin
United Methodist Camp Scholarship fund
through your church: Advance Account
#7050. Your gi is greatly appreciated.
CANCELLATION POLICY
If you must cancel, every attempt will be made
to schedule the camper(s) into another week
of camp. If it is not possible to schedule the
camper(s) into another camp, there will be a
$50 per person cancellation fee. (is may be
waived for health-related reasons.) All other
payments will be returned. No refunds will be
made on or aer the camp start date.
In rare instances, we must cancel a camp. If
that happens, you will be notied as soon as
possible, and every eort will be made to place
campers in an alternate camp. A $25 credit
toward the alternate camp will be given. If an
alternative camp cannot be found, then a full
refund will be issued.
CAMP AVAILABILITY
To see if a camp is available, please visit:
www.WIUMCamps.org.
HEALTH INFORMATION
All campers must have a complete health
history. No camper is admitted without a valid
health record. Wilderness Youth campers will
be required to have a valid health exam with
physician’s signature. Health forms will be
included in your registration/conrmation
packet/email or may be obtained online from
our web site. Please mail health forms to the
appropriate camp site two (2) weeks BEFORE
your camp start date. Please do not send the
Health Form to the Camping Oce in Sun
Prairie.
It is important that parents be contacted when
necessary regarding your child’s well-being and
safety. In the event of illness or an injury to your
child, the Site will make every attempt to contact
you, while proceeding with appropriate care for
your child. If there is a preferred number to
call rst, please let the Health Coordinator
know when you arrive at camp so that it may
be noted.
In the operation of the summer camp program,
no participant, as dened by program
regulations, will be discriminated against
because of race, sex, color, age, national origin,
or disability. Any person who believes that a
participant has been discriminated against
in any USDA related activity should write
immediately to the Secretary of Agriculture,
Washington, D.C. 20250
INSURANCE -
HEALTH AND SAFETY
An insurance contract is provided and the cost
included in the camp fee. is is a supplement
to your personal health/medical insurance.
Coverage is subject to the terms and conditions
of the Master Contract held by the Wisconsin
Conference of e United Methodist Church.
Every eort will be made to ensure that your
camper has a healthy and safe camp experience!
ADDITIONAL INFORMATION
Personal information about campers provided
on registration forms, get-acquainted sheets,
and health forms is used exclusively for the
purpose of assuring your camper’s week will be
safe and fun-lled. We do not sell, rent or lease
or otherwise share our camper lists or e-mail
addresses.
All cabin assignments are made by the Event
Director. You may make a request for cabin
mates; however, they are not guaranteed.
e Camping Oce is open weekdays only.
Sorry, phone registrations cannot be accepted.
ose paying by credit card may use our fax
number: 608-837-8547 or register online using
the link www.WIUMCamps.org.
United Methodist Camping Office
750 Windsor St, Suite 203
Sun Prairie, WI 53590-2149
Fax: 608-837-8547
www.WIUMCamps.org
Camping@WisconsinUMC.org
www.WIUMCamps.org 877-947-2267 608-837-3388
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pricing
TIERED PRICING
Questions frequently arise about tiered pricing. Tiered pricing is a structure that many summer camps are now doing. e idea behind it is
simple: Pay however much works for your family!
Over the past several years, we have worked hard to keep fee increases to a minimum. Unfortunately, the costs to run a high-quality camp have
increased during this same time. is has caused us to rely on donations and o-season guest group fees to cover the remaining operational
expenses.
Recognizing that families have diering abilities to help oset our costs, we have instituted a voluntary tiered pricing structure. Rather than
raising all camp fees to levels that better help cover expenses — and risk losing out on ministry opportunities for those who might then not be
able to aord camp — we are giving you the option to pay more if you are able.
This pricing does not influence the quality of the camp experience for any child attending camp, but it does help us to continue to provide
excellent programs, stang, and facilities. is new pricing provides the opportunity for families to take an active role in supporting the true
cost of their child’s camp experience.
TIER A — Partially Subsidized Cost of Camp
Every eort is made to keep the cost of camp as aordable as possible. At this level, every camper’s fee is subsidized by other year
round programs and generous donations. We are glad to oer Tier A because it helps to keep camp aordable for as many families
as possible. Additional scholarships are also available to help make the cost of camp aordable for those who have a true nancial
need. See page 11 or your local church pastor for more information.
TIER B — Direct Cost of Camp
Electing to pay the Tier B price allows us to cover the direct expenses of a week at camp, including program costs, food, summer
sta and camp administration. is price results in less revenue than needed to maintain a balanced budget and to continue
improving the camper experience.
TIER C — True Cost of Camp
Tier C more closely accounts for the true costs of camp, including direct costs plus insurance, facilities upkeep and improvements,
new programming and activities, and the actual costs of running camp. Every family that is able to participate at this level can
enjoy knowing that they are sustaining our camping ministry and helping to keep it strong into the future.
Although it is up to you to decide what you can aord to pay toward your child’s camp experience, please consider selecting the highest price
your family is able to aord. By doing so, you’ll not only help to cover the true cost of running camp, but also protect every child’s opportunity
to meet Christ at camp! (For families and individuals who would like to give beyond their tier’s pricing, we appreciate all donations! ere is
an option to make a monetary donation on your registration form.)
Youth Camps
Full week (S-F) S-W S-Th W-F
Tier A (Partially subsidized) $390.00 $240.00 $315.00 $160.00
Tier B (Direct cost) $425.00 $255.00 $340.00 $170.00
Tier C (True cost) $450.00 $270.00 $360.00 $180.00
Horse and Wilderness Camps (H/W)
Full week (S-F) S-W S-Th W-F
Tier A (Partially subsidized) $495.00 $300.00 $400.00 $200.00
Tier B (Direct cost) $545.00 $330.00 $440.00 $220.00
Tier C (True cost) $595.00 $360.00 $480.00 $240.00
Family Camps
Adult Age 12-17 Age 5-11 Age 1-4 Maximum Family Rate*
5 Nights $330.00 $295.00 $235.00 $180.00 $1,050.00
4 Nights $280.00 $235.00 $195.00 $150.00 $955.00
3 Nights $230.00 $185.00 $155.00 $120.00 $795.00
2 Nights $165.00 $130.00 $110.00 $80.00 $525.00
*For the maximum family rate, a family is considered as no more than two adults and children under 18.
