*Camper's Promise: "I agree to abide by the rules of the camp."
Name       

*Parental Agreement:
 "I approve of the use of pictures taken of my child to be used in promotion.  Also, in case of an emergency, I hereby give permission to the licensed physician, Emergency Room personnel, or hospital selected by Heartland Christian Camp to secure proper treatment, hospital care, anesthesia, or surgery for any child named on this form."
Name       

$5.00 Late Fee After May 31, 2008