UMW: Pastor Camp 2022

Christian Conference Center

2022 Pastor's Camp

Join colleagues and friends for a special church camp experience September 26-28, 2022 at the Christian Conference Center. Wake up with energizers and a keynote, enjoy conversations in small groups, create and share meaningful worship, rest, enjoy time together on Holy Ground, and end the day sitting around the campfire.

Tiff and Josh will serve as your directors. Camp starts at 2 p.m. on September 26 and concludes at 11 a.m. on September 28. Registration includes meals, cabin lodging (yes, bring your own bedding!), and a special Pastors Camp t-shirt. (Must register by Sept. 12 in order to receive a t-shirt.)

Camper Information

Name*

Gender*

Male
Female

Country*

Address*

City, State and ZIP Code*

Name AND City of your church*

T-Shirt Size (must register by 9/12 for t-shirt)

Allergy Information

Allergy Information*

No known allergies
Food
Medicine
Environment
Other

Please describe what the camper is allergic to, the reaction seen, and how it is treated.

Diet/Nutrition

Diet/Nutrition Needs*

This camper eats a regular diet.
This camper eats a regular vegetarian diet.
This camper has special food needs.

Please describe any special food needs.

General Health and Wellness Questions

Has/does the participant:

Have recurrent/chronic illnesses?*

Had a recent infectious disease?*

Had a recent injury?*

Had asthma/wheezing/shortness of breath?*

Have diabetes?*

Had seizures?*

Has fainting or dizziness?*

Passed out/had chest pain during exercise?*

Traveled outside the country in the past 9 months?*

Please explain any "yes" answers, noting the number of the question.

Healthcare Providers

Primary Doctor

Doctor Phone Number

Restriction Information

Restriction Information*

I have reviewed the program/activities and feel that I can participate without restrictions.
I have reviewed the program/activities and feel that I can participate with restrictions.

Please describe restrictions:

Emergency Contact Information

Emergency Contact Name*

Relationship to Camper*

Country

Address (if different from camper)

City, State and ZIP Code

Phone Number*

Camp Session and Payment Options

Pastors Camp $150.00* ($150.00)

Camp fees include five meals, two nights lodging in the air conditioned cabins, camp t-shirt and costs for programming and staff.

If your congregation or place of employment will be covering the cost to attend, please type "PAYLATER" in the coupon code box.

Payment may be mailed to the CCC (5064 Lincoln St., Newton, IA 50208) or brought to check-in on Sept. 26. Camp fees should be paid in full by the start of camp.

Coupon Code

Running Total

$150.00

Total

$150.00

Authorization Information

Photo/Video Authorization

Unless checked below, I accept that the participant/s likeness may be used in any online or print publications or social media by the Christian Conference Center and/or the Christian Church in the Upper Midwest.

I DO NOT give my consent.

Covid-19 Information

The Christian Conference Center staff has been learning everything we can about how to best serve our guests during the pandemic. We have put extra cleaning and safety measures in place for all user groups at the CCC. We are doing everything in our power to make the CCC as safe as possible for campers, volunteers and staff. While we are still determining our final protocols for overnight camp and cannot completely eliminate the risk of a Covid-19 spread, we can promise that the following measures will be in place: lower bed capacity, physically distanced group gatherings, mask requirements in large groups, outdoor recreation whenever possible, and extra air filtration systems in our large group meeting spaces. As the pandemic continues to change and as CDC restrictions change along with it, we will update our protocols and will update camper families as soon as possible.

Covid-19 Camper Agreement*

I have read and understand the Covid-19 information provided on this form, and I agree to follow health and safety protocols that are required by the Christian Conference Center for participation.

Billing Information

Name*

Card Number*

Visa
Mastercard
American Express
Discover

Expiration Date*

Country*

Address*

City, State and ZIP Code*

Email*