CAMPER REGISTRATION FORM

Important Reminders:

CAMPER INFORMATION

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Female
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Check here to remove your camper's contact information from the camper directory.
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REFERRAL INFORMATION

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Yes
No
Church
Online search
Social media
Radio or newspaper
Friend or family member
Other

PARENT/GUARDIAN INFORMATION

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Opt-out

PARENT/GUARDIAN 2 INFORMATION

Opt-out

EMERGENCY CONTACT (EC) INFORMATION

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MEDICAL HISTORY

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None
Fainting
Asthma
Hay Fever
Headaches
Upset Stomach
Seizures
Bee Stings (allergic reaction)
Nosebleeds
Bed Wetting (if so, please send adequate linens)
Other
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Camper has permission to receive all OTC treatments
Pain relievers (Advil, Midol, etc.)
Fever reducers (Tylenol, Motrin, etc.)
Anti-allergens (Benadryl, Zyrtec, etc.)
Indigestion relievers (Tums, Pepto-Bismol, etc.)
Topical antibiotic creams (Neosporin, Bacitracin, etc.)
Topical anti-itch creams (Caladryl, Cortisone)
Sun burn care (sun screen, aloe vera gel, etc.)
Electrolyte replacement drinks (Gatorade, Powerade, etc.)
Other
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INSURANCE INFORMATION

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No

MEDICAL RELEASE STATEMENT

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CABIN MATE REQUEST

CAMP POLICIES

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PAYMENT INFORMATION

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Young Explorers: June 7-9, 2018
Senior High: June 10-15, 2018
6th, 7th, & 8th Grade: June 17-22, 2018
3rd, 4th, & 5th Grade: June 24-29, 2018
5th, 6th, & 7th Grade: July 8-13, 2018
4th, 5th, & 6th Grade: July 15-20, 2018
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Email
US Mail

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