Microsoft word - retreat brochure 08.doc

Dosage____________________________________________________ Name of medication______________________________________ Dosage____________________________________________________ Name of medication______________________________________ I give permission for the following medicatio Only as needed for__________________________________ _________________ times a day starting _______________ a.m./p.m. Only as needed for________________________________ _________________ times a day starting _______________ a.m./p.m. following regarding your child's medication. A camp designed for Students finishing the 6th – 12th grades. Helping teens find the right connection.
Westwood Baptist Church
The Pier Student Ministry
Name (print) __________________________ Date_____________ Signature___________________________ or cause of action, past, present, or future release, remiss and forever discharge the chaperones a my child such medical care, treatment and hospitalization I, the undersigned, do hereby consent to authorize and direct Date of last tetanus shot __________________ Address ________________________________ City ________________________ Business Phone #__________ Business # ____________________________ Are you active in a Address____________________________ City_________ State_____ Home # ___________________ Name__________________________ Age___ Grade___ Male Fe ______________ Phone # ___________________ Insurance Company _____________ Policy need to be aware of: ______________________________________________ ncy, notify: Name _________________________ Phone #_______________ We have 112 beds available!
, arising out of any injury to my child. Food ______________________________________________ Dietary restrictions ____________________________ Sheets & Blanket or sleeping bag, Pillow, Aqua Shoes or Flip Flops, Long pants for worship service or dress, 1 Piece swimsuits for girls, Old Cloths for the Games, Bath the chaperones of Westwood Baptist Church to obtain for & personal hygiene items, Towels & wash cloths, Sunscreen, Money for 1 meal on the way to Panama City and one meal on the way back, plus any spending money Bible & pens (notebook will be provided) A Good ATTITUDE!
****Limit luggage to 1 large suitcase & 1 carry on
Do Not to bring
Any illegal drugs, Alcohol, or tobacco products. No non-Christian music. (No secular music. Only what Glorifies God), and weapons of

Source: http://www.westwoodbaptist.net/the_files/pdfs/retreat_brochure_08.pdf