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Copyright © 2011 South Carolina Waterfowl Association. All rights reserved
Camp Woodie Registration and Permission Form
Summer 2012
All Information below MUST be submitted no later than 2 weeks prior to your child's arrival at
Camp Woodie!
Campers Name:
Last Name:
Week of Camp:
Birth Date:
Sex:
Grade:
Age:
Address:
Name:
Relationship to Camper:
Telephone:
Address:
Family Physician:
Telephone:
Address:
Address:(if different)
Telephone:
Camp Woodie Registration and Permission Form
In case of emergency, please notify:
Preferred Hospital:
Confidential Camper Information
This information will allow us to more readily adapt our program and personal guidance to your child's needs.
General Physical Condition
Mention any physical hanicaps, sleeping habits, nervous disorders, bed wetting, etc. Habits
Mention any undesirable habits or behavior problems which you would like us to help with. Can you suggest how we can help?Reinforcements
Are there any habits or behavior which you would like your child to develop or strenghten while at Camp? Can you suggest how we can help?Special Interests or Hobbies
Please list three special interests your child hasAccomplishments
What do you wish most that your child should accomplish from their stay at Camp Woodie?Name:
Name:
In the event of an emergency, who has permission to pick up your child?
Who will be dropping of and picking up your child?
Email Address:
Parent/Guardian:
Payment Information - Please Select One
We offer several options when paying for your child's week at Camp Woodie
1. Pay by Check
2. Pay by Credit Card over the internet
3. Pay by phone
4. Payment Plan
Once you have completed this form, please click the "Submit" button. The information you entered will be emailed to the Camp Director.
Hunter Education : Would you like your child to receive his/her hunter education certificate while at camp (Must be 10+ years of age) They must pass the DNR test to receive it. No additional charge to take the class or test.
Roommate Request
Please Tell Us How You Heard about Camp Woodie
