Camp Strand Family Day
Saturday, May 6, 2017
8:30 am-6:00 pm
Camp Twin Lakes - Will-A-Way
210 S. Broad Street Unit 5
Winder, GA 30680
Registration
All registration forms must be completed and submitted by April 21, 2017.
Registration fee: $50.00 for a family of 4
The registration fee covers all informational sessions, activities, lunch, dinner and refreshments for each person up to a family of 4.
Each additional person will be charged a fee of $10.
Once registration forms are received a confirmation email will be sent with details regarding Family Day activities.
You may submit registration form online at campstrand.org
Or you can print the form and mail it to:
Camp Strand
1280 Heatherland Drive
Atlanta, GA 30331
For additional information please contact us via email at campstrand@gmail.com
Registration Form
Name (person in family with Alopecia) ____________________________________________
Date of Birth__________________________
If child:
Mother’s Name__________________________ Father’s Name_________________________
Siblings Name and Age___________________________________________________________
Parent/Caregiver Phone Number__________________________________________________
Parent/Caregiver Emergency Number______________________________________________
Email address__________________________________________________________________
If parent:
Address_______________________________________________________________________
City_________________________ State____________________________________________
Total number of family members attending Family Day________________________________
Name of Participants____________________________________________________________________
______________________________________________________________________________
PHOTO & WEB RELEASE: We give our permission for Camp Strand/Melvin Jones Foundation to use any photos for any promotional materials.
Dated:_____________________Parent/Guardian:_____________________________________
HEALTH & HISTORY
Please list all allergies (food or environmental):
______________________________________________________________________________
Please list any activities that participants of Camp Strand Family Day should be restricted:
Please identify any medical conditions:
______________________________________________________________________________
I hereby certify that the named participants are in good health and fully able to participate in all activities of Camp Strand Family Day and that I know of no restrictions, physical impairments, or any other facts, which in any manner limit his/her participation in such a program.
Dated:_____________________Parent/Guardian:_____________________________________
RELEASE OF LIABILITY – READ BEFORE SIGNING
I, ___________________________ (Full Name) acknowledge, appreciate, and agree that:
1. The risk of serious injury from all Camp Strand Family Day activities involved in this program is always present due to the nature of the activity.
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my or my child’s participation.
3. I willingly agree to comply with the program’s stated and customary terms and conditions for myself or my child’s participation.
4. It is expressly understood and agreed that Camp Strand, Melvin Jones Foundation, and Camp Twin Lakes and all of the board members and planning committee and individuals involved shall not be responsible or legally liable for any losses of personal property or for any bodily injuries, or the results thereof, incurred and suffered by the applicant or in connection with any activities or programs.
I hereby acknowledge that I am voluntarily participating in this event and agree to assume any such risks.
Dated____________________ Name:________________________________
Parent/Guardian: _____________________________________
Directions to Camp Twin Lakes– Will-A-Way
210 S. Broad St., Unit 5, Winder, GA 30680
770-867-6123
From Atlanta (approx. 1 hour):
Take I-85 North to exit #106: Hwy 316 East toward Athens/Lawrenceville.
Travel 21 miles and turn left onto GA-81.
Travel 3.1 miles and the entrance to Fort Yargo State Park will be on the right.
Once through the main gate, take the first left at the guard station. (Just let them know that you are
going to Camp Twin Lakes- you do not need to pay.)
Then take the first right onto Will-A-Way Road which will lead you into Camp Will-A-Way and parking.
From Athens (approx. 30 minutes):
Take Epps Bridge Parkway to GA-316 W/US-29 N.
Travel 9.3 miles and turn right onto Hog Mountain Road/US-29/GA-53.
Travel 4.6 miles and turn left on S. Broad Street/GA-81.
Travel .6 miles and the entrance to Fort Yargo State Park will be on the left.
Once through the main gate, take the first left at the guard station. (Just let them know that you are going to Camp Twin Lakes- you do not need to pay.)
Then take the first right onto Will-A-Way Road which will lead you into Camp Will-A-Way and parking.
From Augusta (approx. 2.5 hours):
Take I-20 West to exit #172: US-78/GA-17 toward Thomas/Washington.
Travel 21.6 miles and turn left at N. Bypass E. Continue to follow GA-10/GA-17/US-78.
Travel 42.2 miles and turn left to merge onto US-29 South
Travel 6.3 miles and take exit #1: US-29 S/US-78 W/GA-16 W toward Monroe/Atlanta.
Turn left at Epps Bridge Road/Epps Bridge Parkway. Continue to follow US-29.
Travel 12.7 miles and turn right onto Hog Mountain Road/US-29/GA-53
Travel 4.6 miles and turn left on S. Broad Street/GA-81.
Travel .6 miles and the entrance to Fort Yargo State Park will be on the left.
Once through the main gate, take the first left at the guard station. (Just let them know that you are going to Camp Twin Lakes- you do not need to pay.)
Then take the first right onto Will-A-Way Road which will lead you into Camp Will-A-Way and parking.
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