China Camp Registration 2020

China Camp

Dates and times

Thursday, July 8- Saturday, July 10, 2021
Camp is from 9:30 AM to 3:30 PM each day of camp.

Location

South Tulsa Baptist Church
10310 S. Sheridan Rd., Tulsa, OK

Who is invited
- Campers between the ages of 4 (by August 1, 2021) to 6th grade completed.
- Junior high students who have completed 7th and 8th grade.
- Adults are encouraged to volunteer and attend workshops.
- Nursery is available for younger children.
- High school students have fun volunteering as teen counselors!
Activities for everyone
- Learning about China
- Making new friends
- Parents enjoy attending workshops and fellowship with other families.
- Friday evening is Family Night. More details will be sent later. This evening event is free.
- Saturday will conclude with a special program presented by the campers that will be live streamed and recorded for parents to watch!
- Enjoy shopping? Our camp store will sell items from China
Cost
- $160 per camper
- $100 per junior high student
- $50 per high school teen counselor
- $70 per Parent Package
What COVID-19 precautions will be taken at camp?
- Masks will be provided and required for any participant over the age of 5 while inside the church building. (Masks will not be required outdoors)
- Temperatures taken at the door with a drive through drop-off
- Reduced class sizes
- Instead of travelling to different classrooms, campers will have a designated classroom and teachers will travel to them
- Hand sanitizer available in each classroom and outside bathrooms
- Classrooms and highly trafficked areas will be sanitized after camp each day
Parents, we need you!

The success of camp depends on parent volunteers. Please consider volunteering. Click here for the camp volunteer application form. We will contact you in 1-2 weeks after you submit the form. A separate application is required for each adult volunteer.

Questions?

We are here to serve you. Email rfloyd@dillonadopt.com or call us at 918-749-4600.
China Camp Registration
Parent name *

First Name Last Name
Cell phone *

Area Code Phone Number
Parent name

First Name Last Name
Additional phone

Area Code Phone Number
How would you like to be contacted if we need to get in touch with you while your child is at camp? *

Text Phone Call
If you opt to receive text messaging, you will only be messaged by authorized personnel of Dillon International, Inc. No purchase is required to receive text messages from Dillon International, Inc., and we do not charge to receive them. However, standard text messaging rates from your wireless carrier may still apply. Any costs related with receiving a text message are the responsibility of the individual receiving it. Check with your cellphone provider for details on receiving text messages (SMS).
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Include my address, phone number and e-mail to be compiled into a Camp Directory for other camp families to see. *

Yes No
How did you hear about Dillon's China Camp? *
Did another family refer you to camp this year? If yes, let us know, and we'll give them a gift card to our camp store!
Camper (4 years old by August 1st - 6th grade completed)

If you do not have any campers, please scroll to the next section (Jr. High Student).
Camper 1
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year (Leave blank if N/A)
T-shirt size
If you would like your child to be in the same class as another child who is the same age, you may list the name of one camper. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
Camper 2
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year
T-shirt size
If you would like your child to be in the same class as another child who is the same age, you may list the name of one camper. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
Camper 3
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year
T-shirt size
If you would like your child to be in the same class as another child who is the same age, you may list the name of one camper. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
Camper 4
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year
T-shirt size
If you would like your child to be in the same class as another child who is the same age, you may list the name of one camper. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
Jr. High Students (completed 7th & 8th grade)

If you do not have any Jr. High students, please scroll to the next section (High School Students).
This year we are offering two separate programs for Jr. High students. Due to feedback from parents and volunteers, we have found that Jr. High students sometimes are not ready to be teen counselors. Below are the explanations for our two Jr. High Program options.

Beijing Program: In this program your Jr. High student will be able to continue with being a participant at camp. As a Beijing Program participant, your student will be able to spend more time with friends, do a few adoption and identity activities, and more in-depth cultural classes. The cost of this program is $100 per participant.

Teen Counselor in Training Program: The TCT program is for participants who would rather be a camp volunteer instead of a participant. Due to Jr. High students needing a little extra help with leading campers, your child will be matched with a high school student for their volunteer time. With this new matching process we cannot guarentee your child be placed with all the friends they are requesting. The cost for this training program is $60 per participant.
Jr. High Student 1
Which program would your Jr. High Student like to be a part of?

Beijing Program ($100 per student) Teen Counsleor in Training Program ($60 per student)
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year
T-shirt size
If you would like your child to be in the same class as another child who is the same age, you may list the name of one Jr. High student. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
Jr. High Student 2
Which program would your Jr. High Student like to be a part of?

Beijing Program ($100 per student) Teen Counselor in Training Program ($60 per student)
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year
T-shirt size
If you would like your child to be in the same class as another child who is the same age, you may list the name of one Jr. High student. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
High School Students (completed 9th through 12th grade)

High school students have the opportunity to participate as teen counselors at camp. If you do not have any teen counselors, please scroll to the next section (Special Considerations and Parental Consent).The cost is $50 per high school teen counselor.
Teen Counselor 1
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year
T-shirt size
If you would like your teen to be in the same class as another teen who is the same age, you may list the name of one teen. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
Teen Counselor 2
First Name Last Name
Gender
Years attended camp
Date of Birth

Month Day Year
Country of Birth
Province/City of Birth
Adopted through Dillon?

Yes No
Grade completed
Adoption Year
T-shirt size
If you would like your teen to be in the same class as another teen who is the same age, you may list the name of one teen. Keep in mind that we cannot guarantee placement together, but we will do our best to accommodate.
Special Considerations and Parental Consent
Please explain any allergies or special dietary needs (food, medicines, insects, plants, etc.) for any participants or teen volunteers listed.
Please explain any medical needs, intellectual disabilities, restrictions in activities or other challenges we need to be aware of or accommodate.
If your child(ren) will need one-on-one care, please specify.
Participation Agreement

I give full permission for my child(ren) to participate in the activities while at Dillon International’s Heritage Events conducted by Dillon International, Inc.,("Dillon") on July 8, 9, and 10, 2021. I fully and unconditionally release, remise, discharge and hold harmless Dillon (including its parent entities, affiliates, their current and former officers, directors, members, agents and employees), together with South Tulsa Baptist Church and providers of services, host and volunteers from any and all claims, charges, complaints, demands, actions, causes of action, suits, damages, liabilities and expenses (including attorneys’ fees) however caused, that might arise from my child(ren)’s participation in camp.

Photo Release

I hereby authorize Dillon International to use pictures of myself or my child(ren) taken in a photograph, digital image, videotape, motion picture, and/or testimonial (written words). I grant permission to use a camper’s photograph or other media for display on the Dillon website, social media account, and/or inclusion in Dillon publications. I understand that Dillon will not put any identifying information in the photo or video.

COVID-19 Waiver

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious. As a result, federal, state, and county governments, along with federal and state health organizations recommend social distancing and wearing masks. The liability insurance covering this event requires social distancing and wearing masks.

Dillon International, Inc. has put in place preventive measures to reduce the spread of COVID-19, but Dillon International cannot guarantee that you or your child(ren) will be not become infected with COVID-19.

I recognize that while Dillon International has undertaken reasonable steps to lessen the risk of transmission of COVID-19 in connection with attendance at Dillon International’s Heritage Events, there are certain inherent risks associated with attending Dillon International’s Heritage Events regarding COVID-19.

On my behalf and on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless Dillon International and South Tulsa Baptist Church, their employees, agents, volunteers and representatives from all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating to Dillon International’s Heritage Events. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of Dillon International and South Tulsa Baptist Church, their employees, agents, volunteers and representative whether a COVID-19 infection occurs before, during, or after participation in Dillon International’s Heritage Events.

I understand my family must fill out an online risk assessment within 24 hours of attending Dillon International’s Heritage Events and must complete an online safety training that will be provided by Dillon International prior to attending Dillon International’s Heritage Events.

I understand my (or my child(ren)’s) temperature will be taken before entering the camp facility. No individual with a temperature of 100.4 F or above will be permitted to enter the facility. Temperatures will not be recorded.

COVID-19 Disclosure Agreement

I willingly agree to contact Dillon International if any camp participant included in this application begins displaying symptoms of COVID-19 or receives a diagnosis of COVID-19 within 14 days of being present at Dillon International’s Heritage Events. I understand a 24-hour phone number will be provided to me by Dillon International for this purpose. I further understand that this information is to be used for contact tracing purposes only, and that the affected individual’s identifying information will be kept confidential and will not be shared with other camp participants.

Signature

I have read, fully understand and consent to the terms and liability release in the above participation agreement, photo release, COVID-19 waiver, and COVID-19 Disclosure Agreement.
*

Clear
Adult Volunteers

If you are planning to volunteer, you will receive the link to a volunteer application after you click Submit at the end of this registration form.
Please add $7 to my total to help Dillon with the cost of my volunteer background check. (Any contributions are greatly appreciated, but this is in no way required to volunteer with us.)
Participant Fees

The participant fee includes lunches, snacks, T-shirt, group photo and activities. Multi-child and parent volunteer discounts apply. If you would like to apply for a partial scholarship, please email development@dillonadopt.com.
Camper Fee

1 Camper: $160 2 Campers: $320 3 Campers: $480 4 or More Campers: $640
Camper Fee with Teacher Discount

1 Camper: $80 2 Campers: $160 3 Campers: $240 4 or More Campers: $320
Beijing Program Fee

1 Camper: $100 2 Campers: $200 3 Campers: $300 4 or More Campers: $400
Beijing Program Fee with Teacher Discount

1 Camper: $50 2 Campers: $100 3 Campers: $150 4 or More Campers: $200
Teen Counselor in Training Program Fee (No teacher discount available)

1 Student: $60 2 Students: $120 3 Students: $180 4 or More Students: $240
High School Teen Counselor Program

1 Counselor: $50 2 Counselors: $100 3 Counselors: $150 4 or More Counselors: $200
High School Teen Counselor with Teacher Discount

1 Counselor: FREE 2 Counselors: FREE 3 Counselors: FREE 4 or More Counselors: FREE
I am including a $75 late fee after July 3rd. Important: Registrations received after July 3rd may result in your child(ren) not receiving a camp t-shirt. We apologize for this inconvenience. I am applying for a scholarship
Total Participant Fees (Please note, this total does not reflect scholarships.)
Nursery (infant to 3 years old)

This year, we will only be offering nursery for children whose parents are volunteering. There will not be a charge for children whose parents volunteer, but we do ask that you register your child below so we can be prepared to welcome them!
Thursday Morning Nursery

1 Child 2 Children 3 Children
Thursday Afternoon Nursery

1 Child 2 Children 3 Children
Friday Morning Nursery

1 Child 2 Children 3 Children
Friday Afternoon Nursery

1 Child 2 Children 3 Children
Saturday Morning Nursery

1 Child 2 Children 3 Children
Parent Package
We are offering a parent package that includes entry to all of the workshops, lunch discussion panels, access to lunch at camp, camp t-shirt, and Saturday lunch. This package will provide each family with a nametag at the beginning of the camp that will allow you access to all parent activities while at camp. We are selling the parent package for $70, which this year is a $130 value.

** While the parent package will be in-person at the church, Parents who would like to only attend a few workshops will have the opportunity to attend select workshops via zoom. Information will be available closer to camp. We are also hoping to record these workshops and provide them to all volunteers free of charge.**
Thursday, July 8th Parent Orientation - FREE

Immediately following drop-off

Thursday, July 8th Chinese Culture Class

1:00 – 2:50PM

Parent Package Only

Friday, July 9th Chinese Culture Class

10:00 – 11:50AM

Parent Package Only

Friday, July 9th Adoption Class

1:00 – 2:50PM

$15/person online

Saturday, July 10th Adoption Class

10:00 – 11:50AM

$15/person online
Parent Package Fee
Parent Package Participant 1

First Name Last Name
T-shirt Size
Parent Package Participant 2

First Name Last Name
T-shirt Size
Parent Package Participant 3

First Name Last Name
T-shirt Size
Chinese Lunch

We will be providing an individually packaged traditional Chinese lunch that parents will be able to pick up from the church on Saturday. The cost is $10 per adult. This lunch will be provided to the campers, teen counselors, teachers, volunteers, and parent package participants, so please ONLY sign up here if you do not fall into one of those categories.
Number of adults coming for Saturday lunch
Camp T-shirt Order

Camp t-shirts are $20 per shirt this year. It is included in the camper's, Jr. high program, and parent package fee, so please DO NOT add those t-shirt orders in this area. T-shirts are also free for high school teen counselors and teachers.
Youth Small Amount
Youth Medium Amount
Youth Large Amount
Adult Small Amount
Adult Medium Amount
Adult Large Amount
Adult X-Large Amount
Adult 2X-Large Amount
Adult 3X-Large Amount
T-Shirts Total
Total Cost

Below you will find the total of your fees, parent package, Chinese lunch, and t-shirts. Please note, the amount calculated below does not reflect scholarships.
Total
My camper is enrolled in EPIC Charter Schools, and I would like to use my student's 2020-21 school year learning fund to pay for heritage camp. (EPIC will not pay for extra t-shirts, nursery, extra adults for Saturday lunch, or parent packages). The deadline for utilizing the EPIC payment option is May 29, 2021. Enroll before April 30th and receive the $30 early bird registration discount!
Help Dillon help others

You can make a tax-deductible gift for camp or as an unrestricted gift for Dillon International.
I would like to make a Lifetime Support Services Scholarship Fund donation to help another have the opportunity to participate in Lifetime Support Services activities:
I would like to make a general camp donation to Dillon in the amount of:
Make a payment

Total for fees, parent package, nursery, t-shirt, Saturday lunch and donations. Visa, MasterCard and Discover only, please.

Make a Secure Payment

USD China Camp

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Please double check your payment before hitting the Submit button. Did you pay with Visa, Discover or MasterCard only? Our system does not accept other cards. Please double check the card number, expiration date and 3 digits on the back. Please make sure that the address you provided is the address associated with the card.
Thank you!

We are so glad that your child will be joining us!
Should be Empty:

Camper (4 years old by August 1st - 6th grade completed)

Jr. High Students (completed 7th & 8th grade)

High School Students (completed 9th through 12th grade)

Special Considerations and Parental Consent

Adult Volunteers

Participant Fees

Nursery (infant to 3 years old)

Parent Package

Chinese Lunch

Camp T-shirt Order

Total Cost

Help Dillon help others

Make a payment