• Student Registration

    Please read all information and fill out the form to the best of your ability.

  • Pricing:

    • $325 for early registration if registration is completed by March 31st and $100 deposit is postmarked by April 1st.
    • $350 for registration if registration is completed by May 31st and $100 deposit is postmarked by June 1st.
    • $100 deposit is non-refundable after June 1st.
    • $400 Late registration if registration is completed after June 1st.
    • All payments should come as one check per church unless you are the only person from your church.

    Checks should be made out to: NC West Youth

    Checks should be sent to:

    Jordan Wright

    PO Box 579, 15303 Highway 158

    Summerfield, NC 27358

     

     

    Location of Camp:

    Victory Mountain Wesleyan Camp

    3592 Youth Camp Rd, Sophia, NC 27350

     

    Camp Dates:

    High School June 26 - July 1

    Middle School July 10-15

     

    Questions:

    If you have any questions about camp please reach out to Chris Mikesell at pastorchris@shadygrove.net.

     

     

     

     

  • Student Information


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  • Emergency / Guardian Contact

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  • Media Permission

    Photographs, film, video, or other images may be taken of your student during camp. I consent to the use of my student's image for displays, brochures, videos, and other promotional materials with no compensation to the guardian or student.
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  • Medical

    If there is a section that does not apply to your student please leave it blank. It is your responsibility as the guardian to let camp staff know of any medical history that changes between completion of registration and event.

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    Pick a Date
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  • I, the undersigned parent or guardian of the student I am registering, do hereby authorize NC West Youth district leadership to consent to any emergency examination, x-ray, anesthetic, Medical or surgical daignosis or treatment and hospital care which is rendered under supervision of any physician or surgeon license under the provisions of medical practice act on the medical staff or a licensed hospital, whether search diagnosis or treatment is rendered at the office of said physician or said hospital. Further, as parent or guardian of the student named below, I do consent that my student may recieve an emergency medical treatment from any physician, hospital, or other medical center without necessity of first notifying me and do further agree to hold blameless any physician, hospital or other medical center for rendering such service. In addition, I will hold blameless North Carolina West district, Victory Mountain Camp or its leaders and other staff involved.

     

    I also agree (at my own expense) to pick up my child early from camp should any health issue arise.

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  • I the above signed parent or guardian; give permission to administer over the counter medications if the nurse deems it necessary. Dosages will be administered according to the directions on the bottle unless a physician directs otherwise.

  • Camp Rules

  • CAMP RULES
    1.   No members of the opposite sex in the same cabin.
    2.   No fighting
    3.    Camp curfew will be abided
    4.    No stealing
    5.    All vehicles will be parked at all times unless they are being used for planned activities (Student keys will be checked in a registration and returned upon leaving
    6.    No vehicles used for transportation around camp
    7.    Students must be present at all scheduled services and events in the designated locations
    8.    No PDA will be allowed
    9.    Modesty is of great importance. Leadership reserves the right to ask you to change and you must comply.
    10.No use of alcohol, tobacco, VAPES, and illegal drugs.
    11.Students will respect the property and facilities of Victory Mountain, along with the property of NC West Youth and that of other students. Students will be held responsible for any vandalism and destruction.
    12.No weapons of any kind. (Pocket knives and lighters are included).
    13.Although pranks are fun you cannot do anything to anyone’s stuff, or anything that is publicly humiliating.
    14.Electronic devices such as MP3 players, iPods, and cell phones cannot be used during scheduled programming, and may be confiscated if the student if a student does not comply with the rules.

     

    I agree (at my own expense) to pick up my student early from camp should a disciplinary problem arise. I also understand and agree that I am liable for any and all damages done to any property or belongings which are damaged as a result of my student's actions.

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