Summer Camp 2021 Online Registration

Summer Camp Registration 2021

Camper's Full Name *

First, Middle, and Last

Gender *

Male
Female

Birthdate *

Age (while at camp) *

Grade (Fall) *

Mailing Address *

City *

State *

Zip Code *

Parent/Guardian's Name *

First

Last

Parent's E-mail Address

Do you regularly attend a church?

If yes, which one?

Cabin Mate Request

(You may request only one friend. Your friend must also request you.)

Choose a Camp Week *

Pioneers Camp (Ages 14-18) June 20-25
Explorers Camp (Ages 11-13) June 27-July 2
Day Camp (Ages 6-9) July 5-9
Discovery Camp (Ages 8-10) July 11-16

(Ages while at camp.)

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Camp Fees

Reservation fee due with Registration, Remainder due by sign-in. You will be given the option to pay your registration online after you submit this form. Optionally, the reservation fee can be mailed to: Camp Ozone, 232 Camp Ozone Rd. Rockwood, TN 37854 Checks should be addressed to "Camp Ozone" Please put the camper's name in the memo area.

Overnight Camp - $225 total camp fee. $50 non-refundable deposit due with registration, remainder of $175 due by Check-in. Camp fees cover lodging, meals, activities, T-shirt, and a craft. Day Camp – $125 total camp fee. $50 non-refundable registration fee due with registration, remainder of $75 due by Check-in. Camp fees cover lunch, snack, activities and a craft

Camp Fee Online Payment (will be processed through Paypal)

Reservation Fee (required to reserve your place, and will be deducted from total camp fee) - $ 50.00
Day Camp Full Payment - $ 125.00
Overnight Camp Full Payment - $ 225.00
I will send payment through the mail and understand my camper's spot is not reserved until a reservation fee is received. ( Camp Ozone, 232 Camp Ozone Rd, Rockwood, TN 37854) - $ 0.00

Snack Shack (Overnight Only)

1 item per - $ 10.00
2 Items per - $ 20.00
3 items per - $ 30.00

Campers at Overnight Camp (not day camp) will have 10 opportunities to buy snacks at the Snack Shack. $10 in their SS fund will allow them to choose one item (a drink, candy, or other snack) each time. Campers may choose to forgo their snack at any SS time and instead donate their snack money to the missions fund.

Souvenir Package (optional for either Overnight or Day Campers)

Souvenir Package - With T-Shirt - $ 25.00
Souvenir Package - Without T-Shirt - $ 15.00

Souvenir package includes the following: A TN Orange Camp Ozone Shirt (with option #1), Camp Ozone Fan/Flashlight combo with batteries included, Camp Ozone Flier (foldable, with storage pouch), and Three candies. Parents can buy their campers a souvenir package. It will be delivered to them on Tuesday of their camp week. Below please choose a color of flier (red, green, or blue), let us know your child’s favorite candy choices, and provide text for a note that will be included with their gift. If you would prefer, at check in you can also drop off a note to be included. This is a great way to “Say Hi” to your camper while they are at camp! Gift packages can be purchased anytime up until the Monday of your camper’s week.

Souvenir Order Specifics

Registration is not complete without a $50 Reservation fee. Space is limited. Reservations will be made on a first-come, first- served basis.

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Camper Release (Photo ID Required for pick up)

Please list Parents/Guardians and emergency contacts. In the event of an emergency, we will contact adults in the order listed below. This will also act as a list of those people authorized to pick up your child from camp.

Name

Relationship

Phone Number

Name

Relationship

Phone Number

Name

Relationship

Phone Number

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Medical Information

Any known health or behavioral concerns?

Other Information (anything else you would like us to know about your child’s behavior or physical, emotional, or mental health including activity restrictions.):

Any Drug Allergies?

Food Allergies/ Restrictions? (If food modifications are significant, please contact us to make prior arrangements. You may be asked to provide easy-to-prepare substitutions.)

Other Allergies?

Insurance Company

Policy Number

Primary Care Physician

Phone Number

(Our insurance will not cover any pre-existing conditions. In case of accident or injury, your insurance will be considered primary. Camp Ozone insurance will be submitted as secondary.)

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Bring Medication and completed Medication form (from confirmation packet) in a gallon-sized storage bag to check-in. You must bring current medication in its container with instructions.

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Release and Waivers

Release and Waiver: The information given above is correct and complete as far as I know. I understand that there are risks of physical injury involved in camp activities, and I agree to accept the full risk as a part of my child’s participation. I further agree to indemnify, hold harmless, and defend Camp Ozone, its board members, executive officers, staff, and employees from any and all claims for injuries, damages, or loss sustained by me or my child arising out of, connected with, or in any way associated with Camp Ozone.

Emergency Authorization: I hereby give permission to the first aid personnel selected by the camp director to provide standard first aid care, administer over-the-counter medication, seek emergency medical treatment, and arrange related necessary transportation. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp personnel to order x-rays, routine tests, hospitalize, secure proper treatment for and to order injection and/or surgery for my child as named above. I agree to the release of medical records necessary for treatment, referral, billing, or insurance purposes.

Promotional Release: I hereby give permission for the use of photos/videos in which my child may appear to be used for any promotional materials.

By making application: - I agree to have all my child’s medication turned in to the camp nurse at registration. - I give my child permission to participate in the entire camp program unless otherwise noted. - I understand that if my child misbehaves or brings unacceptable items he/she will be sent home without a refund. - I assure that my child will not bring a cell phone and will abide by the dress code sent with the confirmation.

I have read and agree to all of the Waivers and Releases listed above.

I would like to receive Camp Ozone e-mail newsletters and updates

A confirmation packet will be sent to acknowledge your child’s reservation.

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