Westside M4 Kids Camp Registration

Participant's Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

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Birthdate

YYYY

MEDICAL INFORMATION

ALL MEDICINE MUST BE TURNED OVER TO THE CHURCH CHAPERONES BEFORE LEAVING!

Does your child have an allergic reaction to bee stings, bites, etc?

To any medicines?

If yes, which ones?

EMERGENCY NUMBERS

Doctor's Name

First Name

Last Name

Doctor's Phone

(###)

###

####

Parent/Guardian's Name

First Name

Last Name

Cell Phone

(###)

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Place of Work

Work Phone Number

(###)

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Insurance Carrier

ID #

Insurance Carrier Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Insurance Carrier Phone Number

(###)

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M4 Ventures, LLC & Camps, & Waukaway Springs Christian Retreat Center are Christian organizations, and Christian standards of conduct, dress, and attitude are expected from each participant. I GIVE MY CONSENT FOR MY SON/DAUGHTER TO PARTICIPATE IN M4 Kids’ Camp. When it is deemed necessary for my son/daughter's health, the leaders may have my son/daughter hospitalized or use outside medical, surgical, or dental aid, in which case all such expenses shall be paid for by me. I understand that by attending, we as participants are assuming all risks related to any communicable disease. I shall in no way hold M4 Ventures, Waukaway Springs Christian Retreat Center, or its representatives responsible for any financial obligation. I understand that as a participant, my child may be photographed or videotaped during normal camp or event activities and these photos/videos may be used in promotional materials.

Parent/Guardian

First Name

Last Name

Today's Date

Thank you for filling out the entire form!

YYYY

M4 Camp Recap! Here's some of what your child has to look forward to this year!

Children’s Camp Sign-up

What: M4 Kids Camp (www.M4camps.com)

Where: Camp Waukaway (www.waukawaysprings.com)

2445 Fairway St.
Grenada, MS 38901

When: MONDAY - WEDNESDAY, July 7-9, 2025

Total Cost: $245 per participant. Child or adult.

This includes 2 nights lodging, 5 meals, all worship sessions, Bible studies, camp t-shirt, and camp activities.

Please Note:

This price does not include any fundraisers that will lessen the total cost of camp per child. IF YOUR CHILD FILLS OUT AN ENTIRE CALENDAR, THEN THAT WILL COVER THEIR CAMP COSTS.

Housing

Housing at Waukaway is done in several different settings. There are cabins that have a capacity of 8 per room with a private bath. There are bunkrooms that can hold between 10-12 with a private bath. Housing assignments will be ready when you arrive to camp. There is a possibility, depending on group sizes, that you will share a room with another church group.

Meals

Waukaway Springs kitchen staff provides excellent meals each day. Your first meal will be supper on Day 1 of camp. 3 meals will be provided on Day 2. On the last day of camp, breakfast will be provided. Churches will depart for home before lunch on Day 3 of camp.

Children’s Camp Sign-up

Westside Emmanuel Baptist Church