Dear Registrar,

I give permission for my child(ren) and myself to participate in all activities and to receive emergency treatment. The parent/child named on this form agree to be included in any photographs and/or video production and any Haycock-related mailings.

__ /__ /__ x _______________________________________ Date Signature of Attending Adult

__ /__ /__ x _______________________________________ Date Signature of Parent or Guardian

Note: Please complete a separate registration form for each parent/child program. Registrations should be received one week prior to camp sessions.

A $100.00 non-refundable, non-transferable deposit per program MUST accompany all regis-trations. This deposit is applied to the camp fee.

All campers are welcome regardless of race, color, sex, religion or national origin.

Contact the office at 610-346-7155, info@haycock.org or www.haycock.org for more information.

Parent’s Name ____________________________________

Child’s Name ______________________________________

Birthdate _____________________ Age ________________

Additional Child’s Name ____________________________

Birthdate ____________________ Age ________________

Street _____________________________________________

City ______________________________________________

State _______Zip __________

E-mail ____________________________________________

Home Phone (_______ ) _____________________________

Cell Phone for ______________ (_____ ) _______________

Church you attend _________________________________

Child’s Cabin Mate Request _________________________

Card Payment: VISA / Mastercard / Discover (Deposits non-refundable/non-transferable)

Card#

Exp. Date Amt. Charged

2 0 1 5 P A R E N T / C H I L D R E G I S T R A T I O N( 2 0 1 5 S u m m e r R e g i s t r a t i o n o n o t h e r s i d e )

Checks should be made payable and sent to: Haycock Camping Ministries 3100 School Rd. Kintnersville, PA 18930

PARENT /CHILD PROGRAMS(Please check appropriate box)

Father & Son Paintball Overnight (Boys 11 and up) .... $160/pair

n March 27-28.....................................(Additional Camper $80)

Father & Daughter Spring Retreat (Girls 7-16) ............. $150/pair

n May 1-3 ..........................................(Additional Camper $75)

Dad & Lad Overnight (Boys 5-12) .................................. $90/pair

n May 29-May 30 ................................(Additional Camper $45)

Mother & Son Overnight (Boys 5-12) ............................$90/pair

n June 5-6 ..........................................(Additional Camper $45)

Father & Daughter Canoe Adventure (Girls 12 and up) $150/pair

n June 5-7............................................(Additional Camper $75)

Father & Son Summer Mini Camp (Boys 7-16) ............ $150/pair

n June 21-23........................................(Additional Camper $75)

Father & Son River Adventure (Boys 12 and up) .......... $150/pair

n Aug 14-16 ........................................(Additional Camper $75)

Father & Son Fall Classic (Boys 7-16) ........................... $150/pair

n Sept 11-13 ........................................(Additional Camper $75)

/ $

Please Print Name of Card Holder

Authorized Signature

Billing Address: (if different from mailing address)

Emergency Contact ___________________________________

Phone (_______ ) _____________________________________

Relationship ________________________________________

Please include a list of any camper or parent with known allergies or health conditions requiring treatment, restrictions or other accommodations while at camp.

____________________________________________________

____________________________________________________

Medical payments are required at the time ser-vices are rendered (excluding hospital care). Haycock Camping Ministries is NOT responsible for medical costs incurred by parent or child while at camp.

T-Shirt Size (circle 2)Youth S, M, L,

Adults S, M, L, XL, 2X

2015

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HAYCOCK HAYCOCK HAYCOCK HAYCOCK HAYCOCK HAYCOCK CAMPING CAMPING CAMPING MINISTRIES MINISTRIES MINISTRIES CAMPING MINISTRIES CAMPING CAMPING CAMPING MINISTRIES CAMPING MINISTRIES CAMPING MINISTRIES CAMPING CAMPING CAMPING MINISTRIES CAMPING3100 School RoadKintnersville, PA 18930ADDRESS SERVICE REQUESTED

3100 School RoadKintnersville, PA 18930

2015 CAMPING SEASONContact us at 610.346.7155

or info@haycock.org. Reserve your spot now at

www.haycock.org!

HAYCOCKHAYCOCKHAYCOCKRENTALRENTALRENTAL OPPORTUNITIES OPPORTUNITIES OPPORTUNITIES

Non Profit OrgUS Postage

PAIDLehigh Valley PA

Permit #121

CLUBCLUBCLUB WEEKENDS! WEEKENDS! WEEKENDS!Come join us at Haycock's Club Weekends,for Boys & Girls ages 6 to 12!ALL INCLUSIVE weekend features lodging, meals, Bible studies and Haycock activities such as archery, horses, pedal carts, crafts and much more!

Reserve your Church group's spot now!Call 610-346-7155Visit haycock.org

Boys April 24th-26thGirls May 15th-17th

Only $75 per person

Are you interested in renting Haycock’s

facilities for your fall, winter, or spring

retreat weekend or possibly for a full

week of camp in August? Haycock is

ready to meet your needs and help plan

the retreat that is best for your group.

Please contact us at info@haycock.org

or 610-346-7155 for more information!

Camp Haycock Rentals!

Arefacilitiesretreatweekready

Camp

Calling Men – Please join with us this fall for our first annual Haycock Men’s Retreat! We all know how much your kids enjoy our rustic adventure activities and we are giving you the chance to join in the fun. This weekend will challenge you in your walk with the

Lord and promote fellowship with your brothers in Christ. We will seek to live out Proverbs 27:17 "As iron sharpens iron, so one man sharpens another" during this retreat. Our Speaker will be Rev. Robert Reid, the Pastor at Large at Lancaster Bible College, and

he will be sharing on how to “Avoid Becoming a Shipwreck”. The theme verse for the weekend will be 1 Timothy 1:19 - “Cling to your faith in Christ, and keep your conscience clear. For some people have deliberately violated their consciences; as a result, their faith has been shipwrecked.” This weekend is designed to accommodate both individual men and men's groups of various sizes. In between our Sessions with Rev. Reid there will be plenty of time to simply relax or join in the fun on our Paintball Field, Zip-line Tower, Gun Ranges, or nearby opportunities for hunting, fishing, and golf. Make an effort to

attend this retreat; you will be glad you did!

HaycockHaycockHaycockHaycockHaycockHaycock Men's Men's Men's Retreat! Retreat! Retreat!

Friday, October 16 - Sunday, October 18$125 per person

(includes lodging, all meals, all activities) Fee for partial attendance is $100

(commuters or 1 night attendees).

Dear Parent,Please come and join us at our annual Open House! This year’s event will be held on Saturday, June 20 from 10 AM – 3 PM. This event is free to the public, and everyone who comes will get a chance to experience just a taste of what Haycock has to offer. May God bless your family, and we hope to see you at camp this year!

Dave Stiansen Executive Director

Rev. Robert Reid

Visit www.haycock.org or contact us at dave@haycock.org for more information

Card Payment: VISA / Mastercard / Discover (Deposits non-refundable/non-transferable)

Card#

Exp. Date Amt. Charged

Summer Camp Programs (Please check appropriate box)

CORE BOY’S CAMPSBoy's Mini Camp (Boys 7-10) ........................ $100 n July 5-7 n July 22-24Boy's Mini Camp (Boys 9-12) ........................ $100 n July 8-10 n July 19-21

Stockade (Boys 8-10) ...................................... $325 n July 5-10 n July 12-17 n July 19-24 n July 26-31

Trailblazers (Boys 10-12) ............................... $325 n July 5-10 n July 12-17 n July 19-24 n July 26-31

Battalion (Boys 12-14) ....................................$325 n July 5-10 n July 12-17 n July 19-24 n July 26-31

BOY’S ADVENTURE CAMPS n Sports Camp (Boys 10-14) July 5-10 ....................$400 Paintball Adventure (Boys 13-16) ..........................$475 n Haycock OPS Alpha Week, July 12-17 n Haycock OPS Omega Week, July 26-31n Climbing Week (Boys 13-16) July 12-17 ...............$400n Marksmen (Boys 13-16) July 12-17 ......................$400n Horsemen (Boys 13-16) July 19-24.......................$400n Outpost Camp (Boys 12-15) July 19-24 ................$325n Music Camp (Boys 13-16) July 26-31 ..................$375n Kayak Adventure (Boys 13-16) July 26-31 ............$400n Leadership Growth Program (Boys 15-16) June 21-July 31 ........................................................... $650n Adventure Overnight (Boys 12-16) September 11 - 12 .................................................$80

GIRL’S CAMPSn Girl’s Summer Camp Week Girls 8-14, June 28-July 3 ............................................... $325n Girl’s Challenge WeekGirls 13-16, June 28-July 3 ............................................. $325n Girl’s Horsemanship CampGirls 13-16, (Max 10 Campers), June 28-July 3 ............. $400n Girl’s Music CampGirls 13-16, June 28-July 3 ............................................. $375

2 0 1 5 S U M M E R R E G I S T R A T I O N( 2 0 1 5 P a r e n t / C h i l d R e g i s t r a t i o n o n o t h e r s i d e )

Note: Please complete a separate registration form for each camper. Registrations should be received one week prior to camp sessions.Checks should be made payable and sent to: Haycock Camping Ministries 3100 School Rd. Kintnersville, PA 18930

Please Print Name of Card Holder

Authorized Signature

Billing Address: (if different from mailing address)

Dear Registrar,

Please register my child for the camping program(s) checked below in the registration box. I hereby grant permission for my child to participate in all activities, to receive emergency treatment, and to be included in any photographs and/or video productions used to promote Haycock Camping Ministries and any Haycock-related mailings.

A $100.00 non-refundable, non-transferable deposit per program MUST accompany all registrations. Deposits are applied to your camp tuition. Campers paid in full by May 1, may deduct $25.00 from the weekly fee (excludes those receiving financial assistance). Completed health form and physical are required to attend summer camp.

Financial assistance may be available upon request, and review by the camp office. All campers are wel-come regardless of race, color, religion or national origin. Medical payments are required at the time ser-vices are rendered (excluding hospital care). Haycock Camping Ministries is NOT responsible for medical costs incurred by your child while at camp.

Contact the camp office at 610-346-7155, or

info@haycock.org for more information.

Camper Child _______________________________________

Guardian/Parent Name ________________________________

Street _____________________________________________

City_________________________

State _______Zip _____________

E-mail ____________________________________________

Birthdate _________________________ Age _____________

Home Phone (_______ ) ______________________________

Cell Phone for ______________ (_____ ) ________________

n I'm a first year camper! ______ _____________________

I was refered by ______________________________________

Cabin Mate Request ___________________________________ (must be same age or grade and in same program)

Church you attend _________________________________

T-Shirt Size (circle 1)Youth S, M, L,

Adults S, M, L, XL, 2X

EARLY BIRD DISCOUNTS- Register and pay in full by May 1st to receive $25 off your camp fee!

FINANCIAL AID IS AVAILABLE! We want everyone to be able to experience Haycock. Please call 610-346-7155 or email info@haycock.org for scholarship information.

Summer Savings

CORE BOY’S CAMPSBoy's Mini CampBoys 7 - 10 $100 July 5 – 7, July 22 – 24 Boys 9 – 12July 8 – 10, July 19 - 21Mini Camp is perfect for the first time camper or those who wish to get a taste of overnight camp. This is the best of summer camp crammed into one-half week. Ease your way into a full week away as our low camper-to-counselor ratio fosters quick relationships and an atmosphere of comfort for those new to camp. Pick from any of our four mini-camp options that work best for you. After this preview, you’ll be begging to come back for a full week of camp!

StockadeBoys 8 – 10 $325 July 5 – 10, July 12 – 17, July 19 – 24, July 26 – 31Have a blast enjoying all of the exciting activities Haycock has to offer. Bunk in our newly renovated stockade cabins and enjoy archery, swimming, air riflery, pedal carts, and more! Campers will watch the Bible come to life each day through lessons, skits, and singing while learning to take action for Christ in their daily lives.

TrailblazersBoys 10 – 12 $325July 5 – 10, July 12 – 17, July 19 – 24, July 26 – 31Crank up the fun with this exciting week of camp! Canoeing on the lake, .22 riflery, and riding Haycock’s new zipline are just a few elements that boost this program up to the next level. Boys choose elective activities such as archery, riflery, sports, etc., and earn awards as they learn safety tips and spiritual life lessons.

BattalionBoys 12 – 14 $325July 5 – 10, July 12 – 17, July 19 – 24, July 26 – 31The ultimate outdoor experience for young men! Spend extended time on Haycock’s Climbing Tower and High Ropes Course, canoeing on the Delaware, trail-riding on horseback, shooting shotguns, and everything else Haycock has to offer. Evenings are spent around the campfire at your lean-to site learning from God’s Word and making friendships that last a lifetime.

Paintball AdventureBoys 13 – 16 $475Haycock OPS Alpha week – July 12 – 17 Haycock OPS Omega week – July 26 – 31Paintball enthusiasts wanted!! Develop your tac-tical game skills, learn paintball safety standards, as well as the importance of character, honor, and integrity on and off the field through spiritual application. Traditional camp activities will be included in the week’s schedule. Cost includes paintballs and CO2. Paintball equipment is provided or campers may choose to bring their own. Personal equipment must be evaluated upon arrival to maintain fair play standards. Sign up quick as these weeks fill up fast!

Mark your calendars for future Haycock OPS events this Fall:*Black Friday Open – November 27th

MarksmenBoys 13-16 $400July 12 – 17Kick it up a notch with this adventure week specifically focused on target sports. Campers will grow in their knowledge of archery and riflery techniques through focused instruction with bows, .22 rifles, shotguns, and other high-powered rifles. Other camp activities will be included as well!

Climbing Week - NEW!Boys 13 – 16 $400July 12 – 17It doesn’t matter if you’ve been climbing for years, or if you’re just getting over your fear of heights. If you want to climb things at Haycock, then this is the program for you! Forget trees – during the week you’ll get to hone your skills on the climbing tower in camp, and take an over-night trip out of camp to tackle some real cliffs!

HorsemenBoys 13 – 16 (max 6 campers) $400July 19 - 24Join us this week to learn western riding tech-niques as you spend time caring for the daily needs of our horses and receive valuable instruc-tion. Spend 4-6 hours in the saddle daily and participate in other camp activities as well. Participants should have at least a basic level of riding ability. This week is once again offered at a lower price!

Leadership Growth Program (LGP)Boys 15 – 16 * $650June 21 – July 31This six-week program couples physical hard-ship and training with intense spiritual dis-cipleship to foster the development of boys into Godly leaders. Phase 1 includes the challenges of work projects, wilderness camping, hiking, and canoeing, along with the physical condi-tioning of running and swimming. Phase 2 emphasizes the development of leadership quali-ties through staff apprenticeship in all areas of our camp program. These young men will be continually challenged to function as a unit and to grow as Christ-like servants throughout the summer. Come and experience a summer that will change your life forever!*Acceptance is through application and per-sonal interview prior to camp. Interested young men must be 15 by July of 2015.

ADVENTURE CAMPS FOR BOYS

Sports CampBoys 10 – 14 $400July 5 – 10Haycock is proud to once again partner with Push the Rock Ministries to offer this exciting week of camp. This week is perfect for the boy who loves to compete in all different types of sports but also loves the outdoors. Push the Rock and Haycock staff will lead you in sports like soccer, flag football, volleyball, basketball, and street hockey. You will also have plenty of time to enjoy all the traditional Haycock “sports” like archery, riflery, the climbing tower, swimming, and more. Come and learn spiritual lessons as you work towards sharpening your athletic skills!

Outpost Camp - NEW!Boys 12 – 15 $325July 19 - 24NEW THIS SUMMER!! Like the outdoors, but not ready for an out-of-camp overnight trip? Set up camp out in the woods and practice your outdoor living skills like fire starting, orien-teering, shelter building, and rope tying. You won’t be leaving camp, so you’re always nearby to running water and hot meals. Get a taste of how it feels to “rough it” in the wilderness while participating in all of the regular camp activities.

Music CampBoys 13 – 16 $375July 26 – 31Music enthusiasts wanted! Whether you strum the guitar, bang on a drum, rock the keyboard, or just love to sing, this adventure week is for you. Sign up today and enjoy playing in a band, leading worship at our closing ceremonies, and learning new praise songs. Use your God-given talents to bring him glory. Prior musical expe-rience is necessary.

Kayak Adventure - NEW!Boys 13 – 16 $400July 26 – 31NEW THIS SUMMER!! What’s the worst part of taking a trip down the river? If you answered “having to get out at the end”, then sign up for Kayak Adventure! You’ll take several overnight trips during the week and also do all the regu-lar camp activities between trips.

Adventure Overnight - NEW!Boys 12 – 16 $80September 11 - 12 This is a new late-summer event for the young man who loves adventure. Come and spend a night out at the lean-tos, play some paintball, hang out on the climbing tower, and enjoy other exiting activities at Haycock all in less than 24 hours!

PARENT/CHILD PROGRAMS

Father & Son Paintball OvernightBoys 11 and up $160/pairMarch 27 – 28 (Additional Camper $80)Dads and sons arrive Friday night to spend the evening fellowshipping, learning about the equipment, and having a campfire and devo-tional. Paintball games will begin first thing after breakfast and consist of two sessions and a lunch break. Games will continue all day until the program concludes at 5 PM. Come and paint the woods and each other neon in various scenarios and in the Father vs. Son Finale!

Father & Daughter Spring RetreatGirls 7 – 16 $150/pairMay 1 – 3 (Additional Camper $75)Fathers and daughters get away for a weekend of uninterrupted time together. Come prepared to jump into God’s Word and strengthen your relationship with one another. Fellowship with other dads and girls as you take part in the many activities Haycock has to offer like horse-back riding, archery, riflery, canoeing, craft time, and our climbing tower with double zip line. Be sure to dress your best for our formal dinner on Saturday evening which is always a highlight of the weekend!

Dad & Lad OvernightBoys 5 - 12 $90/pairMay 29 – May 30 (Additional Camper $45)Get away as a father and son and discover all the fun and adventure Haycock has to offer while spending quality time together. This program is an excellent way to introduce your son to camp, make memories that will last a lifetime, and be encouraged to grow in your relationship.

Mother & Son Overnight Boys ages 5 – 12 $90/pairJune 5 – 6 (Additional Camper $45)We can’t let the dads have all the fun, so this is a chance for all the moms to come and have a blast at camp with your boys! We will cram in as many camp activities as we can in this 2-day, 1-night introduction to Haycock. We will also have special encouraging times from the Word specifically designed for mothers and sons. Grandmothers are welcome to attend with their grandsons as well. Please come and check out all the fun to be had at camp!

Father & Daughter Canoe AdventureGirls 12 and up $150/pairJune 5 – 7 (Additional Camper $75)Join us for a wet and wild adventure as dads and daughters conquer the Delaware River together. A fun-filled night camping in tents along the river wraps up a weekend on the water with memories to be made together around a cozy campfire. Space is limited so reserve your spot now!

Father & Son Summer Mini-CampBoys 7 – 16 $150/pairJune 21 – 23 (Additional Camper $75) Start the summer off with this exciting, three-day mini-camp. Dads and sons (or grandfa-thers/grandsons, uncles/nephews, etc) will expe-rience all that camp has to offer, bond together with time in God’s Word, and also choose to sleep in our new stockade cabins or have the adventure of sleeping out in the lean-to sites. Come have all the fun of our popular Father/Son Fall Classic a few months earlier!

Father & Son River AdventureBoys 12 and up $150/pairAugust 14 – 16 (Additional Camper $75)Whether by canoe or by kayak, fathers and sons will head out together to conquer the Delaware River! The trip culminates with a night of camp-ing out in tents along the river. Take the oppor-tunity to develop a stronger relationship as you enjoy God’s creation along the way.

Father & Son Fall ClassicBoys 7 – 16 $150/pairSeptember 11– 13 (Additional Camper $75)Strengthen your relationship as father and son through the opportunities that abound at Haycock. Fly down the zip line next to your son, shoot guns, have a pedal cart race, or even challenge your dad to a game of gaga! Come prepared to have a blast with one another as you are challenged to grow in God’s Word. Boys are welcome to attend with a granddad, uncle or other adult role model too!

GIRL’S CAMPS

Girl’s Summer Camp WeekGirls 8 – 14 $325June 28 – July 3All the fun the boys have at camp tailored just for girls. Enjoy Haycock’s Climbing Tower, horseback riding, pool time, crafts, campfires, archery, and so much more! Female counselors encourage campers to build relationships, create lasting memories, and grow as Godly women.

Girl’s Challenge WeekGirls 13 – 16 $325June 28 – July 3Teen girls are challenged emotionally, physi-cally, and spiritually during this week through activities including canoeing, climbing, hiking, and service projects. Sleep the night away at our lean-to sites and be encouraged by female counselors to build relationships and grow in God’s Truth.

Girl’s Horsemanship CampGirls 13 – 16 (max 10 campers) $400June 28 – July 3Lessons in horse training combined with les-sons for spiritual growth create a unique opportunity for strengthening your walk with God! Perfect for the beginner rider or those who have never ridden before. Learn the basics of riding and horse care through daily barn tasks and time in the saddle. Along with lessons, campers will enjoy trail rides, rid-ing bareback, playing games, and other camp activities.

Girl’s Music Camp Girls 13 – 16 $375June 28 – July 3If you are a musician, this Haycock offering may be the perfect camp for you! Sign up today and enjoy playing in a band, leading worship at our closing ceremonies, and learn-ing new praise songs. Use your God-given talents to bring him glory. Prior musical experience is necessary.

Boy'sBoy'sBoy's Camp Camp Camp

ParentParentParent / / / Child Child Child Girl'sGirl'sGirl's Camp Camp Camp

Club WeekendsCome out for Haycock’s spring Club week-ends!! These programs are designed to offer an awesome, year-end retreat for your chil-dren’s ministry. We have two separate week-ends for boys and girls (ages 6-12), their church group leaders, and parents to join us at Haycock! This is an all-inclusive weekend, so leaders don’t have to worry about planning and can just focus on enjoying time with the youth you serve. You will get lodging, meals, Bible studies, all sorts of Haycock activities, and many special opportunities to form rela-tionships with your students for only $75 per person. Please contact camp at info@hay-cock.org or 610-346-7155 to reserve your church group’s spot now or ask any questions about these weekends! Check out the dates below….

BOYS CLUB WEEKENDApril 24 – 26 $75 per person

GIRLS CLUB WEEKENDMay 15 - 17 $75 per person

$50 OFFIf you are a First Time

Camper at Haycock you can receive $50 off the fee for any of our week-long camps! You

must send in this coupon with your registration to

receive this discount.

/ / / / / Camp Camp Camp

/ $

This summers theme: Why is your faith important to you?