1. education
2. high school

Weekend Consent & Medical Form
In the event that your child becomes ill or is injured, we
request that Young Life be given permission to take your
child to the nearest medical facility or healthcare provider
and have the necessary treatment administered. Your
signature below will acknowledge your acceptance and
understanding of Young Life’s role in the medical care of
your child. In case of emergency, I understand that every
effort will be made to contact me. If I cannot be reached,
I hereby give Young Life the permission to act in my
behalf in seeking emergency treatment for my child in
the event that Young Life deems such treatment
necessary, I give permission to those administering
emergency treatment to do so, using those measures
deemed necessary. I absolve Young Life from liability in
acting on my behalf in this regard. I hereby grant
permission to Young Life to use, reproduce, and/or
distribute photographs, film, video, and sound
recordings of my child without compensation or
approval rights, for use in materials created to promote
Young Life.
Name of child_______________________________
Parent/Guardian_____________________________
Signature of
Parent/Guardian_____________________________
If above not available, please call person listed below:
Name_____________________________________
Relation ___________________________________
Phone Number______________________________
Address___________________________________
City _______________________________________
State _____________ Zip ___________________
Additional comments regarding medical history,
allergies, penicillin or drug reaction, etc., which may be
needed in any treatment:
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Insurance Company_______________________
Policy Number ___________________________
Young Life covers all injury claims that are less than $250. Any
claim exceeding $250 will be coordinated with your personal
insurance entirely. At that point, Young Life will become the
secondary carrier and will supplement your coverage. The
maximum amount of coverage available from Young Life is
$4,000.
A note to parents…
Young Life is getting ready again to head off for a
super weekend at one of its resorts for high
school students. Since your son or daughter is
interested in attending, you may be wondering,
“What is its purpose?” and “who is behind it?”
This brochure will answer some of those
questions. Our leaders and committee will be
glad to answer any other questions you may
have.
Young Life knows it has something to offer your
son or daughter to help them make sense of the
world's clamor. Our goal is to introduce kids to a
meaningful relationship with God. Young Life can
be that friendly voice of encouragement that kids
need today.
Behind Young Life stands a responsible Board of
Directors made up of men and women from
many different churches representing every part
of the United States. In each community where
Young Life is active, there is a group of
interested adults who sponsor and promote the
work locally. They also assume the responsibility
for the support and personnel. These groups are
called local committees and sender teams.
Todd and Melena Madonna
Tom and Shelly Anderson
Mike and Sharon Bennett
Scott and Claudia Fonda
David and Penny Gerrard
Josh and Daisy Isler
Bill and Patty Sohl
Melissa Sohl
Jackie Stancato
610.918.2561
610.458.9780
610.857.4323
610.594.6827
610.937.1474
610.647.3115
610.458.0647
610.639.2199
610.368.8017
Wreath Fundraiser
You can make $8 toward camp on every
wreath that you sell! These are beautiful 24”
wreaths priced at $25.
Your leader has
brochures to assist your sales. Collect money
with order. Checks should be made out to
“Young Life”.
th
Last day for orders is November 13 . Delivery
nd
will be the afternoon of December 2 .
WINTER
WEEKEND
2015
January 16-19
@ Lake Champion
Glen Spey, NY
Chester County
CCYL - WW2015
Registration Form
YOUNG LIFE
NAME ________________________________
WINTER
WEEKEND
ADDRESS ____________________________
______________________________________
CITY _________________________________
2015
ZIP CODE ____________________________
PHONE NUMBER ______________________
January 16-19
EMAIL _______________________________
Want to get away for a great weekend? Here’s your chance! You will have a
great time with friends while skiing, snowboarding, and all the other things Lake
Champion has to offer. You will start new friendships that will last a lifetime and
discover purpose in life that's more than just “getting by."
Come join us for an incredible weekend!
PARENTS’ EMAIL _______________________
SCHOOL _____________________________
GRADUATION YEAR ___________________
PARENT/GUARDIAN NAMES
______________________________________
PARENT/GUARDIAN SIGNATURE
How to sign up:
______________________________________
What to bring:
To save your spot at WW2014, fill out the
registration form (front and back), tear off,
and give it to your leader or mail it in to the
Young Life office with a $50 deposit (include
additional $15 if you need to rent skis or
snowboarding equipment) Deposit is nonth
refundable after January 5 , 2015.
~Warm clothing and spending money for the
snack shop and camp store.
~Paper bag dinner Friday night
~Money for Saturday dinner at the ski slope
~Money for fast food lunch Monday.
*All other meals are included*
**The camp provides linens and towel**
The Cost:
Without Ski Rental
With Ski/Snowboard Rental
$220.00
$235.00
Price includes transportation, lodging and all
the meals and activities at camp. The lift
ticket is included but you will need to include
$15 with your deposit if you need to rent
skis or snowboarding equipment.
Trips leave at 5:00pm on Friday. Return around
4pm on Monday. CELL PHONES will be
collected at the start of camp and returned for the
ride home. Use the contact information below for
Lake Champion communication.
Young Life of Chester County
P.O. Box 3029
West Chester, PA 19381
610.344.7330 yloffice@comcast.net
chestercounty.younglife.org
Young Life’s Lake Champion
247 Mohican Lake Road
Glen Spey, NY 12737
(845) 856-6871 www.LakeChampion.YL.org
PLEASE CHECK ONE:

I need to rent skis or snowboarding
equipment.
I have included my $15 rental fee along with
my $50 deposit ($65 total).

I do not need to rent skis or snowboarding
equipment.
I have included my $50 deposit.
Please make all checks payable to
Young Life and mail to:
Young Life of Chester County
P.O. Box 3029
West Chester, PA 19381
(Complete BOTH sides of reg. form & rip off)
Payments can be made directly through the
YL website giving.younglife.org/payments
FUNDRAISER available – ask your leader!