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2010 Western Camp Application

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									                                           2010 Western Camp Application
                                                                    July 12-18, 2010
                                                                                                                                                  Age on 7/12/10
Name:
Address:

City, State and Zip Code:
Phone #:                                                                    E-Mail:
                                                                            Check those that apply:
Home Church:                                                                Male     Female                     Married           Single

Roommate, housing, part-time requests: ____________________________________________________________


Willing to serve, PLEASE CHECK AT LEAST ONE:
     Cabin Counselor            Jr. Dept. Teacher                                                Nursery                           Sound Helper
     Adult Teacher              Jr. Dept. Helper                                                 Piano Player                      Power Point
     College/Career Teacher     Jr. Choir Director                                               Song Leader
     High School Teacher        Jr. Choir Helper                                                 Special Number
     Junior High Teacher        Craft Helper

I have read the information on this sheet and agree to abide by all guidelines.
Applicant's Signature                                       Parent's Signature*                                               Guardian's Signature*


*For anyone 18 and under who comes to Camp without a parent, these are the requirements:
       Parent's Signature, Guardian's Signature and completed and signed Medical Release / Liability Forms

*ATTENTION PARENTS: Children 12 years and under will stay with parents. Children under 18 years old must
be accompanied by their parents or guardian.
*CURFEW POLICY: Any campers not in their assigned room(s) after lights out will be warned of their negligence.
If a second warning is received, the camp advisory board will take disciplinary action.
*ZERO TOLERANCE POLICY STATEMENT: There will be ZERO TOLERANCE for the following misconduct:
Inappropriate sexual behavior; possession or use of illegal drugs, tobacco, or cigarettes; unauthorized leaving of
campgrounds. For any of the above violations, parents will be made aware and accountable, with the possibility
of the violator being sent home from camp.

REMEMBER TO BRING: Your Bible, notebook, musical instruments, warm clothing, flashlight.
Also, no skateboards or roller blades, please.
     - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

     FROM THE SOUTH:
                                                                                                                                    FROM THE NORTH:
       Exit I-5 at Exit 206
                                                                                                                                      Exit I-5 at Exit 212
  (Lakewood/Smokey Point).
                                                                                                                               (Stanwood/Camano Island).
 Turn left onto 172nd St. N.E.,                                                                                                Turn right onto Highway 532
    Cross over freeway and                                                                                                     and travel 5¼ miles west to
 proceed 2¼ miles to the first
                                                                                                                              Stanwood. Turn left at the 3rd
   stop sign. Turn right onto
                                                                                                                                light onto 88th Ave NW and
  Lakewood Rd. and travel 6
                                                                                                                              go ¼ miles to stop sign. Turn
miles to the stop sign at Marine
                                                                                                                                  right onto Marine Dr. and
 Dr. Turn right on Marine Dr.
                                                                                                                                  travel south for 4 miles to
    and go 1¼ mile to camp
                                                                                                                               camp entrance on the right.
      entrance on the left.


                      WARM BEACH CAMP: 20800 Marine Drive; Stanwood, WA 98292
           (360) 652-7575 or 1-800-228-6724 (WA only ); fax: (360) 652-8210 or www.warmbeach.com
REGISTRATION FEE FOR ALL CAMPERS ~ Non-Refundable
$10 on or before June 1
$30 after June 1
                                                                      Registration Subtotal $
FULL-TIME RATES ONLY
Type of Lodging                                  Adult     5 ~ 12         0~4
  Olympic View                                   $435      $125              0
  Mt. Baker                                      $395      $125              0
  Cascadian                                      $350      $100              0
  Glacier / Whistler                             $250        n/a            n/a
  Camper                                         $160      $100              0
                                                                        Full-Time Subtotal $
PART-TIME RATES ONLY
Select Meals for Part-Time
                 13 +        5 to 12         M   T   W    T       F       S     S
Daily Flat
             $     15.00 $        5.00
Rate
                                                                Part-Time Meals Subtotal $_______
Select Lodging for Part-Time
OV           $     75.00 $       25.00
Mt. Baker    $     50.00 $       25.00
Casc         $     45.00 $       20.00
GL / WH      $     20.00               n/a
Campsite     $     20.00 $       15.00

                                                              Part-Time Lodging Subtotal $_______
                                                                      SUBTOTAL OF FEES $
ADJUSTMENTS AND DISCOUNTS
$50 ~ Travel Discount (for those living outside of WA, OR, ID & BC)                         $(     )
Church Subsidies for Children under 17 ~ fill in amount your church provides                $(     )
5% Canadian Discount                                                                        $(______)

                                                                Subtotal of Amount Due: $ ______
                                                                            Amount Paid: $(     )
                                                                  TOTAL AMOUNT DUE: $ _______

   ---------------------------------------------------------------------
Make check or money order payable (in US Funds Only) to:          Western Camp ACC

Complete, sign and return application to: Jane Toth, 501 Catskill St, Richland, WA 99354.
For more information, email jtoth1@charter.net or call (509) 946-8444.

Lodging Descriptions:
Olympic View: Hotel style lodging ~ private bath, queen bed & single day bed w/ trundle
Mt. Baker: Family lodging, queen bed, 4 bunk style beds and private bath in each room
Cascadian: Lodge Style, queen bed, 2 daybeds, vanity sink, community bath/showers per wing
Glacier/Whistler: Singles lodging ~ bunk bed, community bath

 *Rates include lodging, linens (sheets, pillow case, blanket in all accommodations except the camp
            sites), towels and meals from supper Monday 7/12 through lunch Sunday 7/18

              For more info on rooms and camp facilities, go to www.warmbeach.com
             For more information, camp applications and Medical release/liability forms,
                                  go to www.accwesterncamp.com
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