2016 Copper Island

Summer Youth

Camps

DATES

Elementary Camp

Ages: 9-11 July 5-9

Middle School Camp

Ages 12-14 July 12-16

High School Camps:

(Space Limited - Please Call)

Young Women’s Specialty Camp

Ages 15-18 July 19-23

Young Men’s Adventure Camp

Ages 15-18 July 26-30

copperislandexperience@yahoo.com

Phone: (778) 421-4883 or

(250) 720–1798

Canoes

Kayaks

Swimming

Friendships

Bible Stories

Hiking

Singing

Great Food

Crafts

Games

And lots more!

Wilderness

Dear Parent or Guardian,

Copper Island Camp is a place where your child can

have the fun of a summer camp. He or she will learn

moral and spiritual lessons from the Bible in the class-

room of our wilderness. Each one will have a role mod-

el who is individually selected and screened to give

your child one of the best weeks of his or her summer.

Copper Island Camp may well be the best five days

invested in your child’s summer.

Supporting families by enriching young lives ~

Copper Island Camp

WHAT TO BRING TO CAMP:

Bible

Sleeping Bag

Pillow

Comfortable clothes for

the outdoors and all

types of weather

Shoes for trail walk-

ing/hiking

Warm Jacket

PLEASE: no iPods, mp3 players, cd players, radios,

cell phones, electronic games, or hair dryers.

2016 Copper Island Camp Registration Form

Parent or Guardian: Please print,

fill out completely and sign.

Student’s Name:

____________________________________________

Birthdate: ______________ Male Female Parent(s) or Guardian(s) Name:

____________________________________________

Street Address:

____________________________________________ City:______________________ Province: _____

Postal Code:_________________________________

Contact Phone number: (_____) ________________

Who plans to pick your child up after camp? ____________________________________________ Family Doctor:_______________________________

Doctor’s Phone #:___________________________

Care Card #:_________________________________

Allergic Reactions:

Bee Stings_______________________________

Food___________________________________

Other__________________________________

Medication (include dosage & purpose) to be taken

regularly at Copper Island: ____________________

___________________________________________

Is there anything else we should be aware of regard-

ing your child?______________________________

___________________________________________

Rain Jacket

Towels for shower

and beach

Swimsuit

Personal Toiletries

Flashlight/Batteries

Bug Spray

Fishing gear

(optional)

We will meet at the Lady Rose Marine Services dock at

Harbour Quay at 7:30AM on Tuesday mornings.

Please pick-up your child Saturday, the last day of the

camp, at the Lady Rose Marine Services dock at 5:00PM.

Registration due by:_____________________

Please mail form to: Copper Island Camp

2775 9th Avenue

Port Alberni, BC V9Y 2M6

Phone: (778) 421-4883 or (250) 720-1798 or (250) 724-9989

Or give form to:______________________

Please select session attending:

Elementary Camp Fee: C$160.00

July 5-9, 2016 (ages 9-11)

Middle School Camp Fee: C$160.00

July 12-16, 2016 (ages 12-14)

Young Women’s High School Camp Fee: C$170.00

July 19-23, 2016 (ages 15-18)

Young Men’s High School Camp Fee: C$170.00

July 26-30, 2016 (ages 15-18)

Total Payment Enclosed: $_______________

In case of medical emergency or general medical care, I give consent for medical treatment by authorized personnel for my child named above. While every effort is taken for the safety and good health of our guests/students and because of the intrinsic dangers of wilderness experiences, Copper Island Camp / The Wilderness Retreat Society, its board, directors, employees, and volunteers are released from any liability in the event of an illness, accident, or trauma that may occur to one of our guests/students. The Director of Copper Island Camp reserves the right to dismiss any guest/ student who in his opinion is a hazard to the safety of others or who appears to have rejected the reasonable objectives and guidelines of Copper Island Camp. I certify the above child has my permission to attend Copper Island Camp and participate in all activities. I also realize that my child’s picture or shared stories of their time at Copper Island may be used in the promotion of the camp.

Signature of Parent or Guardian:

_______________________________________

Date:__________________________________

created for a purpose