Good Shepherd UMC
    Summer Camps 2019

    Registration Form

     Help defray the costs of our programs using a secure, encrypted system. The cost of using online giving for credit cards is 2.9% + $0.30/transaction. The cost of using online giving for ACH (bank account) is 1% + $0.30/transaction. You will be given the opportunity to cover the fees in addition to your donation, and will be given an emailed receipt for tax purposes.

    Participant Information

    Parent/Guardian Information

    Health Information (Will be stored confidentially)

    Insurance Information: 

    We are requesting a donation to help offset the costs of the programs. Suggested donation levels are as follows:
    1 student: $10/week
    2 or more students from the same household: $20/week or $35 for both weeks
    If you are able, please consider "sponsoring" another student who can't afford the camp by increasing your donation level. All donations are tax deductible. Scholarships are available.
    Please contact Pastor Randy at goodshepherd.youthprograms@gmail.com or 410-243-1129 with any concerns regarding donations.
    Online donations are preferred. Please designate "Summer Camps." Cash is not accepted for security reasons.
    ***Please plan to arrive early on the first day of camp each week. We may have additional forms to sign depending on the week's activities. Please contact Pastor Randy Keith via the contact forms located elsewhere on the website, by email at goodshepherd.youthprograms@gmail.com or by phone at 410-243-1129 with any questions.***
    By electronically signing below, I attest that the information contained on this form is accurate to the best of my knowledge and ability.

    I also understand that while the following does not represent an exhaustive list, a camper may be immediately dismissed from the program for the following reasons:
    -Leaving the site or established boundaries;
    -Bringing a weapon (defined as any object designed, used for, or capable of inflicting bodily harm or physical damage); alcohol; drugs; or any illegal substance to camp; a firearm; explosives; or anything else deemed inappropriate by the staff or volunteers;
    -Inappropriate interaction (physical or verbal) from the participant and/or their parent(s)/guardian(s) with staff, volunteers, or any other program participant's (parent(s), guardian(s), and/or students); and
    -Striking or hitting an employee, volunteer, or participants.

    In the unlikely event that a program fills to capacity, I understand that I will be notified as soon as possible so that I can make other arrangements for my student. 

    I also agree to update the staff with any changes to the information I've provided in a timely manner. 

    If you have questions, concerns, or need more information, please contact Pastor Randy Keith at goodshepherd.youthprograms@gmail.com or 410-243-1129.