APRIL 25-28, 2019 MID-SOUTH YOUTH CAMP HENDERSON, TN

CAMPAPPLICATIONISNOTCOMPLETE

UNTILTHESTATEMENTSBELOWARESIGNEDANDDATED:

CAMPER, I will abide by all camp rules, be a good sportsman, dress

according to camp policy and exhibit a good Chris�an example at all

�mes. I agree to follow the direc�ves of the Wayne County Chris�an

Camp directors and leaders at all �mes. I understand that failing to

comply with the rules of this camp may result in my dismissal from

camp and require my parent/guardian to make arrangements for my

early departure.

Camper Signature_________________________ Date ____________

PARENT/GUARDIAN: I, the undersigned parent or guardian, hereby

consent to my child___________________________, who is ______

years of age, par�cipa�ng in the ac�vi�es connected with Wayne

County Chris�an Camp at Mid South Youth Camp in Henderson, Ten-

nessee. I cer�fy that my child is able to par�cipate in all ac�vi�es in-

cluding sports and other camp related ac�vi�es (unless indicated in

the medical informa�on on the front of this applica�on). I also give

Wayne County Chris�an Camp permission for my child to be trans-

ported off the camp property to all camp-related ac�vi�es. In case of

accident or serious illness, Wayne County Chris�an Camp has my per-

mission to secure the proper medical a,en�on.

Parent Signature_________________________ Date _____________

A Christian camp hosted by

Churches of Christ In Wayne County

CHRISTIAN CAMP EST. 2009

A select group of teachers and counse-

lors under the direc"on of capable direc-

tors will supervise the ac"vi"es.

In addi"on to camp directors, the staff

includes a nurse, cra)s director, teach-

ers, counselors, kitchen/canteen staff,

and other such personnel as may be

deemed necessary to maintain healthful,

enjoyable, and spiritual condi"ons at all

"mes.

All campers need to arrive on Thursday,

April 25 by 5 p.m. as welcome ac"vi"es

will begin at 8 p.m. Camp will conclude

Sunday, April 28 around 11 a.m.

Students should arrive back in Wayne

County on Sunday between 1-2 p.m.

If a camper needs a ride to and/or from

camp please call the Waynesboro Church

of Christ office at 931-722-5520.

Directors and founders of Wayne County

Chris"an Camp are Gregg Lee (332-

5414), Tracy Love (676-5262) and Jeff

Skelton (332-1326).

Please feel free to contact them at the

numbers listed should you have any

ques"ons.

WCCCAPPLICATION2019

(mustbereturnedwith$30bySunday,April14)

Name ________________________________________________________

Address ______________________________________________________

City ___________________________________ Zip ___________________

Phone ________________________________________________________

Parents Work Phone ____________________________________________

D-O-B ________________ Grade ___________ M/F __________________

Church you aAend ______________________________________________

* I (____ will need / ____ will not need) a ride to and from WCCC

Do you have any physical handicaps?_______________________________

If yes, explain __________________________________________________

List any medica"ons you must take ________________________________

_____________________________________________________________

List any allergies you have ________________________________________

Do you have health insurance? ____________________________________

Insurance Co. __________________________________________________

Policy Informa"on ______________________________________________

Please circle a t-shirt size: Youth Sizes: S M L Adult Sizes: S M L XL XXL

Parents and Applicants must read and sign the informa�on on the back.

Please return this applica�on to your church or mail to:

Gregg Lee, 121 Parkway Drive Waynesboro, TN 38485, by Sunday, April 14

INFORMATION

COST

WHATTOBRING

STAFF

ARRIVAL

I am a: Returning Camper New Camper

Campers are NOT guaranteed correct t-shirt size if applica�on is not turned in by the deadline.

Wayne County Chris"an Camp (WCCC)

exists to offer students in Wayne Coun-

ty a safe and fun Chris"an camp experi-

ence with Christ as the focus. Cele-

bra"ng our 11th year, WCCC will be

April 25-28 at Mid South Youth Camp in

Henderson, Tennessee.

This camp is open to students in grades

4-12. WCCC is limited to the first 100

campers that pay their registra"on fee.

WCCC does not discriminate upon the

basis of sex, race, color, religion, na"on-

al origin, or handicapping condi"on.

Cost for the camp will be $30 per camp-

er. This fee will include everything the

camper will need at camp such as food,

cra)s, canteen, insurance, and t-shirt.

Campers are NOT guaranteed correct

t-shirt size if applica�on is not turned in

by the deadline.

Each camper should bring a Bible,

sheets (or sleeping bag), a pillow, tow-

els, blanket, toilet ar"cles, flashlight,

and any other equipment such as ball

gloves, cameras, etc. DO NOT BRING

electronic devices such as stereos, tele-

visions, video games, etc. No tobacco

of any kind is allowed on the

campground. Only “school appropri-

ate” shorts are allowed at WCCC.

Campers may get dirty!!! Please keep

this in mind when packing for camp.

Be sure to mark all personal items.

DIRECTORS

*If a camper needs a ride to and/or from camp please call the Waynesboro Church of Christ office at 931-722-5520.