Camper Registration-Cash-Check-Angel Tree - Camp Occohannock on the Bay

Camper Name *

Gender

Date of Birth *

Grade (One they are FINISHING this school year) *What grade are they finishing in 2024-2025 school year0 / 2

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Email Address *

Phone Number *

T-Shirt Size *T-Shirts

Parent/Guardian Information

Parent/Guardian Name (Full Name) *

Parent Date of Birth

Email Address *

Cell Phone *

Home Phone *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Emergency Contact Person - Should we not be able to reach Parent/Guardian *

Relation to Camper *

Emergency Contact Phone Number *

Please list below all those who are permitted to pick up your camper. *Please list all people and their relation to the camper. If you would need to change this, you can by contacting our Camp Registrar at 757-442-7836 or email: campootboffice@gmail.com

Church Information

Church Name

Church City & State

Denomination

Pastor's Name

Children's or Youth Pastor Name

Health Form

A PARENT OR GUARDIAN MUST COMPLETE THIS FORM. THE DIRECTORS, HEALTH COORDINATOR AND CAMP COUNSELORS WILL HOLD INFORMATION FROM THIS FORM CONFIDENTIAL. THE INTENT OF THIS FORM IS TO PROVIDE THE CAMP DIRECTOR AND HEALTH COORDINATOR THE INFORMATION NEEDED TO PROVIDE APPROPRIATE EMERGENCY CARE. KEEP A COPY OF THIS FORM FOR YOUR RECORDS. ATTACH ADDITIONAL PAGES OR DESCRIPTIONS AS NEEDED. PROVIDE CHANGES TO THIS FORM TO THE HEALTH COORDINATOR AT CHECK- IN ON THE FIRST DAY OF CAMP.

List Any Known Allergies and Reactions *

Describe any other past or current injury, illness, disease, treatment, surgery, or affliction the camp should know about in case of emergency. *

Will you be providing any over the counter medications or prescriptions medications for your camper? *

OOTB Employees have permission to provide routine first aid and include applications of:Hydrocortisone CreamNeosporinCalamine LotionTECNU (Cream for poison ivy, sumac, oak)Tylenol or IbuprofenNo Call Me First

Diet & Nutrition *Eats a Regular DietVegan (no meats, seafood, eggs, or dairy)Vegetarian (no meats)Gluten-Free (Celiac)Gluten-Free (Allergy or Preference)Dairy FreeOther: (Please answer in next question)Check all that apply

Diet & Nutrition Follow-Up (if you selected Other above): Please tell us your child's nutrition/diet needs below:

Additional Information

I hereby grant permission for my child to be videotaped/photographed while participating in Camp OOTB activities. *Yes, I grant permissionNo, my child CANNOT be in any photos & videos

Roommate Request: List the full name of any campers (up to 2) that your child wants to room with.

I will need VA Beach Pick up (located at BayLake UMC)? (Cost is $10) *

Payment Information- Please check all that apply: *

Are you looking to receive scholarship through Angel Tree? (This program is for families registered with Angel Tree Prison Fellowship, who have a family member who is incarcerated) *YesNo

If you are requesting Angel Tree Prison Fellowship Scholarship - please answer: Name of Incarcerated Parent/Family Member in the home AND RELATIONSHIP to camper

If you are requesting Angel Tree Prison Fellowship Scholarship - please answer: Last known facility of incarcerated family member.

Payment Information

To complete your registration, a $25 deposit must be made. You can mail a check to Camp OOTB (9403 Camp Lane, Belle Haven, VA 23306) or you can pay by credit card through this link (once you hit submit). Your registration will not be confirmed until the deposit has been submitted. **If you are an Angel Tree Prison Fellowship Applicant, your $25 deposit will be credited to your camper/family for our Bayside Canteen (Camp Store) at the conclusion of your week at camp. If you have any questions, you can contact our Camp Registrar at campootboffice@gmail.com or call 757-442-7836