2015 Children’s Program Registration, Donation and Tee Shirt Order
The staff of the Simpson Park Camp Children’s Program welcomes you to our 2015 camp
meeting. This program is available for children from birth through 6th grade who are on the
campground for Family Camp with their family and friends. We provide services and activities
during every morning and evening service as well as activities each weekday afternoon. Parents or
guardians are fully responsible for their children at all other times of the day. When you arrive at
camp come to the Children’s Program office to complete your registration and receive a schedule of
activities and events.
The Children’s Program of Simpson Park Camp is provided on a faith support basis. There is
no registration charge, but we do encourage the giving of a love gift. This gift will help defray the
program expenses for the children. A conservative estimate for each child’s participation in all the
on camp activities for the week is $50.00. You may give your gift with your pre-registration, or you
may pre-register now and make a donation at camp.
Children’s Program t-shirts are available for pre-order with a suggested donation of $10.00
each. It is nice for each child to have a 2015 Children’s Program t-shirt, but they certainly are not
required. Reserve your t-shirt now to be sure of getting the size you want. If you prefer not to preorder we will have t-shirts at registration but we may not have all the sizes available when you
arrive. Please include payment for the t-shirts with your pre-order.
All children attending any of the children’s level programming for even one service must be
registered with the program. We must have a completed registration form (1 per family) and a
completed medical history record form that includes current medical information and
immunization records with medical insurance numbers, and the parent or legal guardian’s
signature (1 for each child) before any child can participate. You will need a new medical form for
each child. The medical history record form is available online at www.simpsonparkcamp.org.
If you cannot fill this out before coming to camp please make sure you bring the necessary
information with you to camp (updated immunization records, medical insurance numbers and the
parent or legal guardian signature). Forms will be available to fill out at the registration table.
Please make sure to list the name of the person responsible for the children during their stay at
camp. No child can be registered without a responsible party on the grounds.
Please fill the registration form out completely (available online: www.simpsonparkcamp.org)
and return it by July 3rd, 2015 to the Camp Office. Pre-registration is a great idea, especially if you
are bringing children other than your own. Please use one registration form per family. If you cannot
pre-register, please bring this completed form along with the necessary medical and insurance
information, including parent’s signatures, with you to the children’s registration area. Registration
will be open Saturday, July 25 and Sunday, July 26 from 2 to 4 p.m. and ½ hour before every
Tabernacle service.
We look forward to a great year with you and your children. We’re working on some fun new
activities and our Children’s Evangelist is going to be great. Hope to see you in July!
Shelby and Megan Thompson
Children’s Program Directors
Last name_____________________________________
SIMPSON PARK CAMP
CHILDREN’S PROGRAM
2015 REGISTRATION FORM
Allergies
Y
N
Parent Signature
Y
(FOR OFFICE USE ONLY)
*Parent Name(s) Please Print! ________________________________________________________________________________
Street Address_____________________________________________________________________________________________
City_____________________________________________
State_______________
Zip_________________
Home phone_________________________________________
Work Phone_____________________________________
E-mail address______________________________________________________________________________________________
I hereby give my permission to use my child’s likeness in print or electronically for camp publicity purposes only.
(Please initial if yes).______________________

CAMPER NAME
BIRTHDATE
AGE
GRADE IN FALL
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Person responsible for children at camp:
Name___________________________________________________
Camp Address:
Hotel_____
Lobb Lodge_____
Relationship_______________________________________
Campsite_____
Cottage_____
Other_____

Donation & T Shirt Order
Donation: (suggested $50.00 per child)
T-Shirt Purchase: (circle sizes)
Youth size
XS
Adult size
S
S
M
a tax-deductible receipt can be given for donation amounts above the suggested donation per child.
M
L
L
XL
XXL
________ X $10.00 per shirt
Make checks payable to Simpson Park Camp
Total
Credit card #_____________________________________ Exp date ________
Signature _________________________________________________________
Please return this form to:
Simpson Park Camp
70199 Campground Rd.
Romeo, MI 48065
Attn: Family Camp Children’s Program
$ __________
$ __________
$ __________