Location

Thompson Lake Christian Retreat

Address 593 ACM Road South

Libby, Montana

Phone: 406-293-5832 *There is no cell service at camp. Please only call this number for emergencies.

Email: tlcretreat@easthaven.org

 

Camp Fees

$130.00 per camper

Adult volunteers who go to camp to work will be free. Registrations will not be processed without full

payment or an approved application. If the camper cannot afford camp, please contact Matt Watts.

Refunds

If you cancel 14 days or more days in advance (prior to July 18th), all camp fees will be refunded. If

you cancel AFTER July 19th there will be NO refund. Exceptions will be considered in the case of

illness or family emergency if requested in writing to Matt Watts.

Health Forms

Every camper is required to submit health forms prior to camp arrival. Campers without the forms will

not be admitted to camp. The health form is for our church staff only.

Please return registration, payment and health forms no later than Wednesday, June 29th to Matt Watts.

Please make your checks out to The River Church.

 

You may either drop off your paperwork to Roots Christian Fellowship or mail it to:

 

Roots Christian Fellowship, PO Box 1058, Corvallis, MT 59828

 

Email: youth@rootsfellowship.com

 

Contact Numbers:

Matt Watts (Roots) 803.427.2379 youth@rootsfellowship.com

Larry Lee (The River) 406.579.5758

Christey Lee (The River) 406.369.2351

 

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Parent/Guardian - Contact Information

 

Parent/Guardian #1

First___________________ Last____________ Email _____________________ Lives with child: ⧠ Yes ⧠ No

Street Address __________________________________ Town/City _____________ State ___ Zip Code________ Home Phone

________________ Work Phone _________________ Cell phone _________________

Parent/Guardian #2

First___________________ Last____________ Email _____________________ Lives with child: ⧠ Yes ⧠ No

Street Address __________________________________ Town/City _____________ State ___ Zip Code________ Home Phone

________________ Work Phone _________________ Cell phone _________________

Emergency Contact Information – Alternate Pickup/Release

Emergency Contact #1

First Name ___________________ Last Name ___________________ Home Phone ________________

Work Phone ______________Cell Phone _______________ Email _____________________________

Relation to child ___________________ Authorized to pick-up youth ⧠ Yes ⧠ No

Emergency Contact #2

First Name ___________________ Last Name ___________________ Home Phone ________________

Work Phone ______________Cell Phone _______________ Email _____________________________

Relation to child ___________________ Authorized to pick-up youth ⧠ Yes ⧠ No

Medical Release Information

Insurance Information

Policy Number__________________________________ Name of Health Insurance Provider_________________

Primary Physician______________________________________________________________________________

Address______________________ Phone____________________________

Please list any severe medical issues, including any requiring maintenance medication (i.e. Diabetic, Asthma, Seizures).

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