Camp to the World

2017 Registration Form

Register Online: www.camptotheworldja.com

Contact Us: info@camptotheworld.com

Parental / Guardian Information

Last Name:

Family Address:

First Name:
Title:

Mr./Mrs./Ms./Miss (circle one)

Home Phone:

Mailing Address (if different)

Business
Phone:
Cell Phone:
E-mail:
Relationship:
Are there any special circumstances that the camp should be aware of relating to the family situation?
Yes
No
If yes, please list below:

Emergency Contact
Last
Name:

Cell Phone

First
Name:

Relationship:

Camper Information
Last
Name:

Name of
School:

First
Name:

Last Grade Completed:

Gender:

Ever attended Camp before?

No

Yes

Date of Birth:

Is a sibling attending?

Yes

Has a family member ever attended Camp to the

World?

Yes/No

How did you learn about this camp?

Poster_ Flyer_ CTW website_ Teacher_

Guidance Couns_

No

Health Information
Does your camper have any allergies?

Yes

No

If yes, what is he/she allergic

to_____________________________________________________________________
Does your camper take any medication?

Yes

No

If yes, what
medication:____________________________________________________________________________
Is your child a vegetarian?

Yes

No

Please list any medication that your child will be taking at camp and the dosage:
_______________________________________________________________________________________________
_______________________________________________________________________________________________

ALL MEDICATION MUST BE IN ITS ORIGINAL CONTAINER WITH ALL

INSTRUCTIONS ATTACHED.
YOU WILL BE REQUIRED TI FILL OUT A MEDICATION ADMINISTRATION
DOCUMENT
BEFORE YOUR CHIILD ATTENDS CAMP
Are there any activity restrictions while at camp?
Yes
No
If yes, please explain below:
______________________________________________________________________________________________
_______________________________________________________________________________________________
Are there any special/behavioural considerations that the camp should be aware of to better
your childs experience?
Yes
No
If yes, please explain below:
________________________________________________________________________________________________________
_
________________________________________________________________________________________________________
_

Payment Method
2

Cheque

Cash

Credit Card

Cheques should be made payable to CTW Enterprises Limited and deposited at any branch
of Bank of Nova Scotia to Account No. 601169 / Transit No. 81505 (Oxford Road).
Cheques will not be accepted after June 30, 2017.
Kindly bring the bank payment slip with your Registration Form.

Parent Authorization
I hereby give consent for my child to participate in the full Camp to the World programme and
all activities unless I advise you in writing. I give permission for Camp to the World to use any
photograph my child is in for promotional material. To the best of my knowledge, my child is in
good health and I will notify the camp if she/he is exposed to any infectious diseases. I further
release and agree to indemnity and hold harmless Camp to the World and its officers,
servants or assigns from any liability concerning our childs involvement in the Camp to the
World programmes and further agree that the use of all Camp to the World/CASE facilities is
made at the risk of the registrant. In case of surgical emergency, I hereby give permission to
the physician selected by the camp director, to hospitalize, to secure proper treatment for and
to order injection, anaesthesia, or surgery for my child, as named on this form. Every effort
will be made to contact a parent/guardian in the case of emergency.

Registration must be accompanied by a JMD$1000.00 non-refundable deposit per

camper.

Payment Plan: If you require a payment plan please call our office to discuss.

After June 14, 2017, registrations must be accompanied by full payment.

Refund Policy: June 1 15: 75% of fee paid, June 16 30: 50% of fee paid,
After June 30: Nil

I understand that the camp administration reserves the right to dismiss a camper who,
in their opinion, is a hazard to the safety or the rights of others, or who appears to have
rejected the reasonable expectations of the camp.

A confirmation e-mail will follow receipt of registration form and deposit.

Please call camp office if you have not received a letter within 1 month.

Charges will appear on your statement under the name Camp to the World.

Outstanding balances after Sept. 1, 2017 will be charged interest of 1% per month.

______________________________________________ / ____________________________
Parent / Guardian Signature
Date

ADMIN USE ONLY

TConfDa
te:

Arriv
al

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PS1

PS2

PS3

Notes:__________________________________________________________________________________________________
_
________________________________________________________________________________________________________
_
________________________________________________________________________________________________________
_________________________ / ___________________________Administrator
Date

Camper Information

Camp to the World Mission Statement

The Mission of Camp to the World is to provide the atmosphere and mentors conducive to
enhancing the values of love, humility and respect for others and the environment. This
mission will be accomplished by the camp providing the campers with the opportunities to
observe and adopt positive behaviours.

We serve a diverse community

We encourage peacemaking, non violence, leadership and morality.

Caring for the land and environment that God has entrusted to us.

Visit our website for more information on preparing for camp. If you need any assistance or

if you have any questions, youre more than welcome to contact us!

Camp to the World

Postal
Address:

PO Box 6
Kingston 8
Jamaica W.I.

Mailing
Address:

Tel:

+1 (876)832-6678(L)/4063460(D)
Web: www.camptotheworldja.com
Email: info@camptotheworld.com

7 Stanton Terrace
Kingston 5
Jamaica W.I.