Anglican Diocese of

Edmonton

Mission: To invite and assist campers and

staff to grow in Christian discipleship by

means of Christian community within an

enjoyable camping atmosphere.

BASE CAMPBASE CAMP

CAMP EXPLORECAMP EXPLORE

*CAMP COME ALIVE*CAMP COME ALIVE(*Now Hastings Lake Bible Camp)(*Now Hastings Lake Bible Camp)(*Now Hastings Lake Bible Camp)

SUMMER CAMPSSUMMER CAMPSSUMMER CAMPS

201020102010

Featuring:Featuring:Featuring:

www.edmonton.anglican.org

MEDICAL

1st Emergency Contact Name:

Relationship to Camper:

Contact Number:

2nd Emergency Contact Name:

Relationship to Camper:

Contact Number:

Doctor’s Name:

Doctor’s Phone Number:

Alberta Health Care Number:

Other Insurance Information:

Does the participant have any ongoing illness?

Is the participant currently on or needing any medica-tions? Please list and bring, in the original containerwith the original label attached, any prescription andnon-prescription medications (Tylenol, Tums, Gravol,herbal remedies, etc.) the participant may need, with

written instructions for administering the medication.

Does the participant have asthma or hay fever? How

severe?

Has the participant had a life threatening reaction to

common allergens?

(ex: bees, insects, food, or drugs such as penicillin).

Please list.

With regards to special needs children, please refer

enquiries to the attention of the Camp Director.

MEDICAL Cont.

Does the participant have a condition that requires a

special diet?

Are there are any special issues, conditions, behavioralconcerns or special instructions in regards to your childwe should be aware of? What do you as a parent do to

support your child?

If there is not enough room on this form,

please feel free to attach additional pages.

In case of emergency every reasonable effort will bemade to contact parents/guardians and then the emer-gency contact person. In the event I cannot be reached: Ihereby give permission to the medical person selected bythe camp staff to provide proper treatment for my child.I state that all relevant and important information is listed

above.

Parent/Guardian Signature:

Date:

I give permission for photographs of the camper and cre-ated materials from the camper to be used in advertising

of the Diocese of Edmonton Summer Camps:

Yes No

Also to be used on the Diocesan Web Site:Yes No

Camper’s T-Shirt Size: Please circle

(We cannot guarantee availability of sizes, but will do our

best!)

Youth: Medium Large

Adult: Small Medium Large X-Large

Camp fees must be paid in full prior to the start of

each camp.

Please make cheques payable to

The Anglican Diocese of Edmonton Summer

Camps.

Payment options are:

Include full payment with registration form.

OrSend $25.00 (non-refundable deposit, part of campfee) with the registration form. 50% of the balancemust be received by June 15, 2010. The remaining

balance is due 14 days prior to start of Camp.

Cancellation: If a camp is cancelled, a full refundwill be issued. If a participant withdraws or can-cels their registration, a full refund, minus the$25.00 non-refundable deposit, will be issued.There is no refund one week prior to Base Camp,or Camp Explore. There will be a $20.00 feecharged for all NSF cheques. Camp Directorshave the right to withdraw a camper’s applicationdue to camp safety concerns (a full refund will be

issued in these cases).

The enclosed Registration Form, along with a

$25.00 non-refundable deposit, may be mailed to:

Anglican Diocese of Edmonton

Summer Camps

Synod Office

10035 – 103 Street

Edmonton, AB T5J 0X5

For more information and/or forms please

visit:

www.edmonton.anglican.org

BASE CAMPBASE CAMPBASE CAMPPine BayPine BayPine Bay

A week-long canoeing, camping and swimming, ad-venture for teens (Grade 7-9). Base Camp will beheld July 18-24, 2010 at Pine Bay in majestic William

Switzer Park, on the edge of Jasper National Park.

The cost is $300.00/camper.

Bus transportation to and from camp will be pro-

vided. Pick-ups may be arranged along the route.

Enrollment is limited to 25 campers.

Please register by June 15th, 2010

CAMP EXPLORECAMP EXPLORECAMP EXPLORE

This is one adventure canoe enthusiasts won’t wantto miss! Campers will practice their paddling skills,while navigating the North Saskatchewan River inthe beautiful Rocky Mountain House and Nordegg

areas.

This five-day camp for youth (Grades 10-12) runs

from June 30th–July 4th, 2010.

The cost is $200.00/person

(includes transportation, food and equipment)

Please register by: June 1st, 2010

SCHOLARSHIPSSCHOLARSHIPSSCHOLARSHIPS

Scholarships to all camps are avail-able. For more information on

The Kevin Campbell Scholarship

Fund, and the

Richard Gordan Utas Trust Fund,please visit

www.edmonton.anglican.org

REGISTRATION

Camper’s Name:

Parent/Guardian’s Name:

Address:

City/Province:

Postal Code:

Home Phone Number:

Adult’s Work or Cell Phone:

Other Contact Number:

Email Address:

Name of camp you would like to attend:

Date of Camp:

Cost:

Birth date (D/M/Y):

School Grade for September 2010:

Gender:

Home Parish or Denomination:

Can this Camper swim 25 meters with a lifejacket

on?

Has this Camper been to one of our camps before?

If yes, what camp and year did they attend?

Please let us know how you found out about the

camps:

CAMP COME ALIVECAMP COME ALIVECAMP COME ALIVE***Hastings Lake Bible CampHastings Lake Bible CampHastings Lake Bible Camp

This summer, we are partnering with the LutheranBible Camp at Hastings Lake! Situated on 20 beau-tiful acres on the south shore of Hastings Lake,this camp is a 30-minute drive east of SherwoodPark. Camp facilities include: insulated cabins, alarge dining hall, a chapel, an outdoor pool andmore. Campers will experience fun-filled dayspacked with crafts, recreation, Christian educa-tion, worship, and evening campfires. Be sure topack good shoes for trail walks, a bathing suit for

swimming and a hat for all the sunshine!

Hastings Lake offers a full range of camp programs

June-August. Two of the camps are:

Kidz Kamp 1 (ages 8Kidz Kamp 1 (ages 8Kidz Kamp 1 (ages 8---11)11)11)

July 4July 4July 4---9, 20109, 20109, 2010

Kidz Kamp 2 (ages 8Kidz Kamp 2 (ages 8Kidz Kamp 2 (ages 8---11)11)11)

August 8August 8August 8---13, 201013, 201013, 2010

For more information on the camps at Hast-ings Lake, and to register call: 780-662-2557

or visit: www.hastingslake.com/