Pioneer SDA Church: Camp Blanchisseuse 2025 Camp Registration Form Camper Information (Information will be kept private) What is your name? * What is your name? First Name First Name Last Name Last Name Date of Birth (ddMMyyyy): * Gender: * Male Female Phone Number: * Email Address: Current Address Are You An SDA? Yes No Current Church: Not an SDA, please state religion: Medical Records Please state any current allergies or medical condition: Emergency Contact Information Emergency Contact Name * Emergency Contact Name First Name First Name Last Name Last Name Relationship with Emergency Contact * Emergency Contact Phone Number: * Emergency Contact Address Camp Rules & Regulations(Please read carefully before agreeing to sign) 1.Christian behavior must be maintained while in transit and while at Camp. Avoid abuse of people or property, whining,complaining, foul language, crude and other undesirable behaviour. 2.Each camper is expected to attend all religious services and participate in the recreational and educational programs as well as assist their assigned group in their daily tasks. 3.Females: Wear dresses or skirts of knee length or longer to worship services. Always wear acceptable length andappropriate clothing unless special permission is given. No knitted or short tights are allowed or revealing clothing willbe allowed outside of dorms. 4.Males: Long pants to be worn to worship services. Pants are to be worn properly and not below the waist. Nobareback, vests and sleeveless shirts outside of the dorm. 5.Visitors are welcome. However, all visitors must register their visit with the Camp Director/Counselors and must agreeto abide by the camp rules. Visitors are not allowed in the sleeping quarters of campers. 6.No males in females’ dorms/tents and vice versa at ANY time, unless married couples. 7.No tobacco, alcoholic beverages, or drug use will be tolerated. 8.No knives of any kind without prior permission. No firearms, fireworks or weapons of any kind will be tolerated. 9.Electronic devices such as cell phones, laptops, etc. are permitted, but must be turned off during service, unless they arebeing used as part of the service. Any counselor reserves the right to take appropriate action if this is being abused.Please note that the Church/Camp is not responsible for damage to devices. 10.No excessive horseplay, no “Mushing” or destruction of property inside/outside campsite at any time. 11.No camper is to leave the campgrounds without permission from or knowledge of the Camp Director. 12.When lights are out, no camper is to be out of the dorms without a Counselor’s or dorm leader’s permission or accompanying. 13.The Camp Director and Council are responsible for enforcing all policies and rules and the supervision of their groups. 14.Swimming is only allowed in the sea during scheduled times and under supervision. All females must wear a tights orshorts 3-6 inches above the knee and bath suits that covers all private parts. 15.Any camper who is unwilling to abide by these camp rules may be sent home, and/or be disciplined by the CampCommittee or church. Camp Fees: Adults $300.00 Children under 12 $250.00Special consideration will be given to families of 4 or more individuals attending. To be retained by the Camp Committee. Agreement with Camper, Parent/Guardian.It is necessary for parents/campers to assume responsibility for the applicant/self. Below is a legal agreement for this purpose, which you must sign and return, before the application is accepted. In consideration of the acceptance of the named applicant, I, (the undersigned parent/guardian/camper), covenant and agree with the Pioneer Seventh-day Adventist Church Board which congregates at the Cor. Millard and Balisier Streets, Couva, that, I will at all times hereafter indemnify, keep indemnified, and save harmless the name of the Pioneer Seventh-day Adventist Church Board, members, or representatives. I understand that the said Pioneer SDA Church is not liable for any illness, accident or misadventure including property loss or damage to the named applicant, during the period that said applicant is a participant in the Pioneer Seventh-day Adventist Church Camp, to be held at the Blanchisseuse Secondary School in Trinidad and Tobago, during the period Friday 28th February to Tuesday 4th March 2025. I also agree unreservedly to abide by the above rules which I have read. Witness or hand(s) this day of (Enter Today's Date): * Camper's Signature * Parent / Guardian Signature Captcha Submit If you are human, leave this field blank.
