Signal Mountain Youth Camp 2021 - CAMPER
  • Address of Camp:
    4400 Hassler Rd.
    Signal Mountain, TN 37377

    SENIOR TEEN REGISTRATION CLOSED.

    Contact info for questions regarding completion of this form:
    Email: alyssag@cogtn.org
    (423) 892-4831, extension 3
    Business Hours M-TH 8:00 - 12:00; 1:00 - 5:00

    *Please note: The Tennessee Youth & Discipleship Department is not accepting printed applications in the office. Only payments will be accepted in the office for ONLINE REGISTRANTS.

    COVID-19 Protocols & What to Expect:

    • We ask that all Youth Pastors/Children’s Pastors/Leaders help us with due diligence and do temp checks prior to departing for Signal Mountain. We don’t want to send individuals or groups home but will do so if needed in an effort to prevent exposure to COVID-19.
    • Temp Checks will be done upon entering the campgrounds BEFORE exiting your vehicle to ensure no one is arriving with a fever. If an individual has a temperature of 100.4 or higher, they will be allowed to wait 15 minutes for another temp check. If their temperature still registers as 100.4 or higher, they will be asked to depart the campground and only return if they have a negative COVID test result. If this individual rode to camp with a group, the entire group will be asked to depart the campground and only return if the whole group has a negative COVID test result.
    • Facemasks are optional
    • All indoor venues will have air sanitizers. These air sanitizers are completely non-toxic and can be used around people, pets, plants, and food. It contains no harsh chemicals, has no added fragrances, and leaves no sticky residue. Proven to kill 99.999% of a SARS-CoV-2 surrogate on surfaces and 95.7% in the air!
    • All cabins will be cleaned daily with a fogger and solution that is safe for everyday household use
    • Food Service Line Staff will wear masks while serving food.
  • PERSONAL INFORMATION

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  • MEDICAL INFORMATION

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  • Please select your church. If not listed, please type the name of your church in the provided space below.

    (CHURCHES ARE LISTED BY "CITY-CHURCH")
  • ROOMMATES: Please list the church you prefer to room with and/or specific names.

  • PASTORAL ENDORSEMENT

  • PARENT / GUARDIAN TERMS AND CONDITIONS

  • In Consideration of the services of Signal Mountain Youth Camp & Tennessee Church of God Executive Office, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “TNCOG”) I hereby agree to release, indemnify and discharge TNCOG, on behalf of my spouse, my children, my parents, my heirs, assigns, personal representative, and estate as follows:

    1. I acknowledge that outdoor adventure-based activities such as ropes or challenge course activities, missions project, paintball, go-carts, horseback riding, or all other physical activities entail known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.

    The risks include, among other things: This program is based on the “challenge by choice” principle. At any time you and/or your group are free to withdraw from participation in ropes course activities, missions project, paintball, go-carts, horseback riding, or all other physical activities and its potential for: slips and falls and falling; rope burns; accidental drowning, pinches, scrapes, twists and jolts that could result in scratches, bruising, sprains, lacerations, fractures, concussions, or stings, allergies, and associated diseases.

    Furthermore, TNCOG employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction.

    2. I expressly agree to assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate fully aware of the risks.

    3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless TNCOG from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of TNCOG’s equipment or facilities, including any such claims which allege negligent acts or omissions of TNCOG.

    4. Should TNCOG or anyone acting on their behalf, be required to incur legal fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

    5. I certify that I have insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I assume the risk of any medical or physical conditions I may have.

    6. In the event that I or my representative files a lawsuit against TNCOG, I agree to do so solely in the state of Tennessee, and I further agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect.

    By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against TNCOG on the basis of any claim from which I have released from herein.

    I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

    I hereby give my child permission to attend and participate in Tennessee Church of God Youth Camp. I hereby waive, release, and discharge any and all claims, demands, and causes of action against Camp Officials, the Church of God in Tennessee, and the International Offices of the Church of God, their agents, employees, and participants arising from any damages, property loss, or injury my child sustains at Tennessee Church of God Youth Camp. I further consent to allow Camp Officials to seek and obtain emergency medical or surgical treatment for my child should my child need medical treatment. I further grant permission for my child to appear in Camp Videos and any promotional videos or photography. I fully understand that my family’s insurance is the primary carrier for all accidents incurred at camp and the camp’s insurance is the secondary carrier.

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  • CAMP FEES

  • All pre-registered camp fees (MUST BE COMPLETED AT LEAST 2 WEEKS BEFORE YOUR CAMP BEGINS) include T-shirt & $10 in Canteen Cards. NO EXCEPTIONS.

    Early Bird (ends April 29, 2021): $130 in full or a Non-Refundable Deposit of $35 with the balance of $95 to be paid on or before the first day of camp.

    After Early Bird: $145 in full or a Non-Refundable Deposit of $35 with the remaining balance of $110 to be paid on or before the first day of camp.

    Due to limited capacity, walk-ons will not be allowed. All campers must be pre-registered.

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            Full Amount
            $145.00
              
            Deposit$110.00 remaining due on or before the first day of camp.
            $35.00
              
            Additional Canteen Cards (optional)$5 increments. Non-refundable. Canteen Cards can also be purchased at camp in the Canteen.
            $5.00

            Item subtotal:$0.00
              
            Camp Digital Video (optional)
            $10.00
              
            Total
            $0.00

            Credit Card Details
          • Payments can be mailed to: Signal Mountain Youth Camp, 7428 Old Lee Highway, Chattanooga, TN 37421. If you have trouble making payment, please contact our office (423) 892-4831, extension 3. **Payment (full or $35 deposit) must be received within 7 days of registration or application will be placed on a waitlist.

          • Camp Cost for each camper is NON-TRANSFERABLE;THIS WILL BE ENFORCED! Refunds will be returned minus the $35 deposit. All requests for refunds must be IN WRITING and need to be emailed to alyssag@cogtn.org or post-marked no later than July 15, 2021.

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