The West Haven Board endeavours to make the camp experience available to as many children as possible. Campers who wish to attend more than one camp should indicate first and second choices. Acceptance to a second camp will be based on availability of space 2 weeks prior to that camp. For applications for one camp only, place an X next to the camp which you wish to attend. (

Appropriate camp should be chosen based on camper’s age by December 31, 2009 )

__Camp I West Haven Wanna Bees (7&8 years) July 6 - 8

__Camp II Junior Teen (14 - 15 years) July 12 - 17

__Camp III Junior ( 8-11 years) July 19 - 24

__Camp IV Intermediate (12 - 13 years) August 2 - 7

__Camp V Junior ( 8 - 11 years) August 9 - 14

__Camp VI Intermediate (12 - 13 years) August 16 - 21

__Camp VII Senior Teen ( 16 - 18 years) August 21 - 23

Name________________________________Gender M__ F__ Age(at time of camp)___________

Mailing Address_______________________________________________________________

Postal Code___________________ e-mail address_____________________________________

Parent/guardian name(s)_________________________________

Phone: home___________________work________________

Have you attended West Haven before? Yes___ No_____

Home Church ________________________________________

Campers are placed in small groups for some activities and chores. Campers may choose one person that (s)he would like to be in a group with (please make sure campers name each other). We may not be able to accommodate all requests.:

Name:____________________________

Registration fee for camps I and VII is $44 per camper. A deposit of $24 is payable with this application. The remainder is due when you arrive at camp. Registration fee for camps II - VI is $110 per camper. A deposit of $50 is payable with this application. The remainder is due when you arrive at camp. A discount is available for families with more than 2 children attending camp. Cheque or money order to be made payable to West Haven Camp and mailed with this application and completed health form to:

APPLICATIONS WILL BE ACCEPTED BASED ON POSTMARKED DATE. HAND DELIVERED, EMAILED OR PHONED IN APPLICATIONS NOT ACCEPTED. Any enquiries pertaining to this application should be directed to the volunteer registrar’s voice mail at 686- 0724 or email westhaven@live.com . The registrar will get back to you. Please respect the privacy of our volunteer registrar and refrain from calling her at home.

No child will be accepted for camp without all portions of the application and health form being completed. Please note that health care at camp will be provided by a trained first aider unless a volunteer nurse is available. Priority will be given to United Church families until June 1^st. Thereafter, applications will be accepted as they arrive.

______________________________________________________________________________
Signature of parent/guardian Date

Photos taken at camp may be used for promotional purposes. Please sign below if you give permission for your child’s photo to be used in this way.

______________________________________________________________________________
Signature of parent or guardian Date

In the event that I/we will not be picking our child up from West Haven Camp on closing day or in the event of an emergency, I/we hereby authorize the release of our child to the following individual(s):

Name: ____________________________________________

Relationship: _______________________________________

Address____________________________________________

Phone number:______________________________________

Child’s name: ________________________________________

If there is a person(s) whom the child should not be released to, please name that person(s) here:

______________________________________________________
Parent(s)/Guardian(s)Name(s):

 _____________________________________________________
Signature(s):

______________________________________________________
Witness:                                                                                     Date:

______________________________________ ________________
Witness                                                                                     Date