Date:_____________________________________________ (must have a parent's signature if under 18) Signature:_________________________________________ I GIVE PERMISSION for Whispering Winds Bible Camp (WWBC) to secure medical treatment for the camper in case of illness or accident. I GIVE PERMISSION for my child to participate in all Summer Camp activities, both on and off camp property, either by walking or riding in camp vehicles, including (without limitation): hiking, backpacking, canoeing, kayaking, caving, water tubing, low ropes course, climbing wall and swimming. I ACKNOWLEDGE AND ACCEPT the risks involved in camping activities. I ACCEPT personal financial responsibility for any bodily injury sustained while my child is at WWBC. Furthermore, I PROMISE to hold harmless WWBC and its representatives for any injury related to Summer Camp. I GIVE PERMISSION for my child to attend Summer Camp and receive the Bible-based instruction provided. I GIVE PERMISSION to use pictures including the camper in organizational publicity. PARENT/ GUARDIAN AGREEMENT Camper's Insurance Co. and policy #:_________ _____________________________________________ Name of Policy Holder:______________________ Date of Last Tetanus Shot:_________________ List medications taken regularly, allergies, dietary needs, or other pre-existing medical concerns (attach separate page including your name and parents signature). Name:_______________________________________ Age:_____________ Male Female Date of Birth (mm/dd/yy):_________________ Parents:_____________________________________ Address:_____________________________________ City:__________________ State:____ Zip:______ Phone #:____________________________________ Emergency Phone #:_________________________ WWBC Fall Retreat / Teen Retreat West Please Circle which Retreat you plan to attend: Please be sure that the registration form reaches our office before the Retreat! Send registration and payment to: WWBC, PO Box 9, St. James, MO 65559 Registration Form P.O. Box 9 St. James, MO 65559 Return Service Requested Whispering Winds Bible Camp Fall Teen Retreats "IN THE BEGINNING..." Genesis 1:1-2:9 N Q November 14-16 "IN THE BEGINNING..." Genesis 1:1-2:9 Join us this November for our annual Fall Teen Retreat! We will be taking a look at our resident theme for next year - CREATION! Registration will be from 7:00-8:00 on Friday and pick up is from 1:00-2:00 on Sunday Ages: 13-19 P Y Cost: $55 Can't make it to our Teen Retreat in Missouri? Join us for our NEW Retreat in Kansas! Or better yet, come to both!! Teen Retreat West O V November 21-22 We want to reach out to you with an All New weekend! Whispering Winds Bible Camp staff will be traveling to Rose Hill Bible Church in Rose Hill, Kansas to put on a two day weekend retreat. Registration will be from 5:00-6:00 on Friday and pick up will be at 4:00 on Saturday Girls will stay in a bunkhouse nearby, while the guys will bunk in the church overnight. Cost is only $25 for three meals, one night's stay, fun activities and the study of God's Word. Ages 13-19 X You won't want to miss this weekend of firsts! Email us at [email protected] or give us a call at 1-800-748-7410 or 573-265-7445 W