Signtures required

You can download a pastor's signature form here.

We need 3 signatures.

1. Your Pastor's signature to approve your child attending camp.

2. The parents signature in case of emergency

3. The student's signature, agreeing to the rules of the camp, which is located on the back of the form.

Upload Signed Form Here*

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A signed waiver by this registrant will be required before you can download your QR code. A link to obtain waivers for all registrants will be shown on the confirmation page.

PARENT / GUARDIAN INFORMATION

Parent/Guardian Name*

Email*

Mobile Phone Number*

Address*

Emergency Contact*

Emergency Contact Number*

Trusted Contacts (Individuals with permission to sign camper in/out from activities. Must be 18+ years old.)

MEDICAL INFORMATION

Licensed nurses administer medications and care for wounds or injuries that may occur during camp. The following information will be useful for the proper care of your child.

Does your child have any allergies?*

Does your child take any medications?*

Additional medical information that would be helpful for the camp nurses to know about your child (physical limitations, behavioral considerations, etc.)

I hereby grant my permission for the camper named above to receive necessary doctor and medical treatment, which includes over-the-counter medicine, that the camp nurses, or management deems necessary for his/her well-being.*

Does the camper get overwhelmed by loud noises and lots of activity? Would he/she benefit from noise canceling headphones or a quiet room to reset?

ORDER INFORMATION

Give the gift of registration with a voucher for a friend

Amount$

Recipient Email

We will send an email with the voucher code.

Add Voucher

Total

$235.00

Coupon Code

Your current total for 1 Camper is $246.68 (Show Summary)

BILLING INFORMATION

Name*

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

Mobile Phone Number*

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

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