Camp WaMaVa Online Registration

The Camper Fee is $200 per week per child.

The Board of Directors of Camp WAMAVA is pleased to offer a special
10% DISCOUNT for campers who are registered and paid in full by JUNE 1^st - $180/week

By applying online, you must pay in full after submitting this form in order for your application to be processed. Otherwise, please download the paper application.
Please fill out all available fields. The form cannot be submitted unless all fields are completed.
After completing all fields, click the “Submit & Proceed to Online Payment” button at the bottom of the page.
(You won't need to setup a PayPal account. PayPal allows credit card payments without creating an account.)
You will then receive payment instruction on the following page.

Any boy or girl without regard to their race, color, national origin, religion, handicap or sex, who will be in grades 3 through 12 in the fall and who is willing to abide by the camp rules may attend Camp WAMAVA. Applications are accepted on a first-come, first-served basis, as they are received by the camp registrar. Campers going into grades 4 through 9 may stay for a maximum of two (2) weeks.

Camper's First Name:

Camper's Last Name:

Camper's Date of Birth:
Month Day Year

Age:

M or F

Address:

Grade
(as of Fall 2009)

City:

State

Zip Code

Church Affiliation:

First Time Camper? Yes No

Guardian's First Name:

Guardian's Last Name:

Phone (Home):

Phone (Cell):

Phone (Work):

Guardian's Email Address: (this is the email to which we'll send your Registration number)

Emergency Contact:

Emergency Phone:

2010 Camping Schedule
Fees: $200 per week ($180 if full payment is received before June 1^st)

Week 1 - June 26 thru July 3 - Grades 3,4,5
Week 2 - July 3 thru July 10 - Grades 4,5,6
Week 3 - July 10 thru July 17 - Grades 5,6,7
Week 4 - July 17 thru July 24 - Grades 6,7,8
Week 5 - July 24 thru July 31 - Grades 7,8,9
Week 6 - July 31 thru August 7 - Grades 9,10,11,12

I will pay the full amount online. (You will be directed to online payment page after completion of registration.)

Note any significant problems and special needs:

Allergies (including drugs):

Prescription medications must be submitted in their original containers to the camp nurse at registration.

Insurance:

Insurance Phone:

Last Tetanus Shot:

Camp WAMAVA may feature my child's name, likeness or voice in any videotape, television, motion picture, audio recording, broadcast, website or still photograph production that will be produced by Camp WAMAVA and made available to the public or media.
(Please check one)
Yes No

I give my consent and authorize the Director of Camp WAMAVA or his appointed representative to secure any medical diagnosis or treatment from the nearest available qualified medical practitioner in the event of illness or injury. I understand that I will be notified, as soon as possible, or any accident or illness suffered by my child.

Note: Camp's insurance extends coverage for treatment of physical injuries, but does not cover treatment for illness.

IMPORTANT:
If your child requires any medications while at camp, please print out the Medication Instructions Form and bring it with you when you bring your child to camp.

By clicking on "Submit" below you are agreeing to abide by Camp WAMAVA's rules and guidelines as described in the Camp Information and Parent Guide.