2024 Adult Week Request 2024 Adult Week Requests "*" indicates required fields Step 1 of 3 33% Terms and Conditions (Please read carefully as these have changed)* I agree to the terms and conditions.I acknowledge and agree on behalf of myself and my family (including spouse, children and other invited guests of mine) (herein, my “Family”) that: Use at Own Risk I acknowledge and agree that the use of the facilities owned and operated by Christian Family Holiday Incorporated (“CFH”), included but not limited to the lake, beach area, playground, and grounds, is for use at each of my Family’s own risk. I further acknowledge and agree that CFH is not responsible for any injuries or damages, including but not limited to bodily injury, mental injury and/or property damage from any event, mishap, accident, loss, damage or injury suffered by myself or any of my Family resulting from or connected with or caused by the use of the services and facilities at CFH. Rules and Regulations I acknowledge and agree that myself or any member of my Family will abide by the rules and regulations of CFH, as they now exist or may be amended in the discretion of CFH. I acknowledge that we will participate in all camp activities and program and be respectful of the Statement of Purpose of Camp Kumuntome. Photography and Use of Photography by CFH Inc I hereby give CFH permission to use mine and/or any member of my Family’s photograph in promotional material (newsletters, Facebook) without further waiver. If this is not the case, I will email program@campkumuntome.ca and advise. Adult Name 1 Last First Adult 2 Name Last First PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Week SelectionPlease select your top two weeks. We will do our best to accommodate your choices. First ChoiceSunday June 16-Friday June 21 ($550)Monday September 9-Friday September 13 ($450)Second ChoiceSunday June 16-Friday June 21 ($560)Monday September 9-Friday September 13 ($460)Number of People in your group*Special RequestsHere you can list any allergies, or other requests. We would like to make an additional donation to camp. $10 $25 $50 $100 Other PhoneThis field is for validation purposes and should be left unchanged. Δ