• KS FWB Church Camp - Camper's Form

    July 10-14, 2023
  • Registration Details:

    Registration Deadline for Campers is June 19, 2023 at 11:59 p.m.. Campers will not be allowed to come if not signed up by this date.

    Camp will be held at Praire View Christian Camp in Arkansas City, KS on July 10 through July 14.

    Payment:

    This form is just to sign up. You will still need to pay your camp coordinator at your attending church. The cost for camp is $200.

     

    If you have any questions, please contact your church camp coordinator first or contact Charlotte Brooks at Wellington FWB Church at 620.326.5521.

     You will need to put in the name of camper and parent information each time you register (it's a bit inconvenient but there's no way around it.)

  • Camper Information

    Please submit one form per camper
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  • PARENT/GUARDIAN INFORMATION

  • Emergency Contact (other than the parent above)

    In the case that we are unable to reach you in an emergency, please provide the name and number of someone we can contact (other than the parent above).
  • Release of Liability

  • I hereby agree to be responsible for the conduct and actions of my child and to release the Kansas State Association of Free Will Baptist and the Kansas State Association of Free Will Baptist Christian Education Board from any claims and demands that may occur during participation of "Church Camp." Furthermore, I agree to release the Kansas State Association of Free Will Baptist and the Kansas State Association of Free Will Baptist Christian Education Board and its workers and I will hold them harmless from any liability which may arise from accidents or incidents involving my child and myself, to the extent allowed by the law. I authorize attending adults or physician to administer emergency medical care to my child should the need arise.
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  • Dispensing Medications Form

    This form is derived from Kansas Department of Health and Environment. It has been formatted to be fillable. If you want to look at the original document and print and use the original, please go to the link provided. If you want to use the original, please still fill out the document below. https://www.kdhe.ks.gov/DocumentCenter/View/1038/CCL-027-Long-Term-Medication-Authorization-PDF
  • Authorization for Dispensing Medications to Children and Youth - Long-term Medications (Prescription and Non-Prescription)

  • Prescription medications must be in their original containers labeled with the child's/youth's first and last name; the name of the licensed physician, physician assistant (PA), or advanced practice registered nurse (APRN) who ordered the medication; the date the prescription was filled; the expiration date of the medication; and specific, legible instructions for administration and storage of the medication. Administer the medication only to the child designated on the prescription label in accordance with the instructions on the label. Non-prescription medications can be given with written permission and direction from the parent or legal guardian. Administer nonprescription medication from the original container labeled with the first and last name of the child/youth and according to the instructions on the label.
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  • **Stop date not to exceed one year from the start date. A new authorization is to be completed any time the medication, dosage, times to be given, or instructions from the parent or health care provider change from the information included on this form. Additional copies of this form may be attached to this page if more space is needed to record the administration of the medication for up to one year if there are no changes in instructions. Above information must be completed on each page but the parent's signature is required only once per year.**

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  • PVCC Registration Form

    This is required for all participants of Prairie View Christian Camp
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  • Camp Session Attending: Kansas Christian Education Board
  • Group Leaders: Charlotte Brooks, Jerrod Vickers
  • I understand that participants attending a camp session at Prairie View Christian Camp will be offered an opportunity to participate in multiple recreation opportunities including, but not limited to, swimming, paintball, rock climbing, repelling, and zip lining. Additionally, Junior High and High School participants may be offered an opportunity to trap shoot and go tubing and/or kayaking on the area river. I acknowledge and fully understand that 1. risks and dangers exist in the participation in and use of high ropes elements; 2. that participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to, bodily injury, disease strains, fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, death, or other ailments that could cause serious disability; and 3. by giving my child permission to participate in these activities and use this equipment, I assume all risks and dangers and all responsibility for any losses and/or damages incurred while participating in these activities.
  • To the best of my knowledge, my child is physically and emotionally able to take part in the camp program. In the event of a medical emergency, I give permission to the volunteer medical person selected by the camp management to do whatever is necessary for the health of my child as named on this form. I hereby release the camp from any responsibility other than normal supervision and care. In case of an accident, I will not hold Prairie View Christian Camp, their staff members, management, or officers liable. I have reviewed this form and certify that all appropriate medical information is included.
  • I recognize that this is a Christian camp, that the Bible will be studied, and that camp conduct will be expected that is consistent with Christian values.
  • I also give my permission for any appropriate photographs/videos to be used for future Prairie View Christian Camp promotional purposes.
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  • Suggested Items to Bring:

    Send Items for Each Individual Camper

    1. Bible, pencil, and notepad.
    2. Personal hygiene items (toothpaste, shower supplies, etc.).
    3. Turn in medication at camp to nurse.
    4. Clothing for 4 days (See dress code below).
    5. Bedding for twin mattress (sleeping bag, twin sheets, blanket, pillow, etc.).
    6. Towels/Wash Cloth.
    7. Swimsuit (See dress code below).
    8. Lifejacket or other swim assisted device if needed for your child.
    9. Money for offerings (Optional).
    10. Money for concessions (Optional - recommended $20).
    11. Tennis shoes (Required).
  • Rules for Kansas FWB Church Camp

    1. Campers should not leave the grounds without notifying the Director.
    2. No visitors are allowed at camp.
    3. Boys should not enter girl's sleeping area. Girls should not enter boy's sleeping area.
    4. Physical contact is not allowed between any campers specifically in a violent or intimate nature.
    5. Tobacco, e-cigs, drugs, and alcohol are prohibited at camp.
    6. Weapons and fireworks are prohibited at camp.
    7. Cell phones and other electronic devices are prohibited at camp.
    8. Campers and counselors must attend all activities and services.
    9. Campers should carry out all instructions given by camp workers.

    Any person who breaks these rules or encourages someone else to do so may be dismissed from camp on the first offense at the discretion of the Director.

    Dress Code:

    Knee-length shorts are allowed all day. Shorts are not allowed for evening service. Leggings are not permitted. Short sleeves shoudl reach the shoulder bone with no revealing midriff or chest. Closed-toed tennis shoes are very important for safety and comfort. During swimming, if girls are wearing a two-piece swimsuit they need a t-shirt on. Campers should arrive at check-in dressed in camp attire. Remember to pack 4 daytime outfits, 4 evening outfits, as well as sleeping and miscellaneous clothes as needed. 

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