TMR TEEN SUMMIT REGISTRATION

TMR TEEN SUMMIT REGISTRATION

Pastor John Gaddis / July 20-23, 2026
Camper Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Grade in September*
Gender*

MaleFemale
Does the camper have a phone number or email?

YesNoI don't know
Camper Phone Number (if applicable)
Please enter a valid phone number.
Camper Email (if applicable)
example@example.com
Home Address*

Address

Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information
Name*

FirstLast
Relationship to Camper*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Address

Address Line 2

CityState / Province

Postal / Zip Code
Employer*
Work Phone Number*
Please enter a valid phone number.
Email
example@example.com
Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Church Information
Home Church Name
Pastor

FirstLast
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church I'm Coming With (if different)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Insurance Information
Medical Insurance Company
Policy Number
Group Number
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact
Name*

First NameLast Name
Relationship to Camper
Relationship to Camper*

FatherMotherGuardianOther
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Address*

Address

Address Line 2

CityState / Province

Postal / Zip Code
Colorado law requires "Names, addresses, and telephone numbers of persons who can assume responsibility for the camper in the event of an emergency if parent(s) or guardian(s) cannot be reached immediately." - 2.421 Campers' Records

CO Rules for Camps

Thus, the camp needs an emergency contact who is not a parent or guardian.
Name

First NameLast Name
Relationship to Camper
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Authorized Person to Pick up Camper

(Authorized people can be parents/guardians or any one else the parents/guardians authorize to pick up their campers. Please include the church if they will be taking your child home. If there is more than one person, please list all options in the additional information section.)
Authorized People*

Just parentsChurchSomeone other than the above options
Name

First NameLast Name
Name of the Church
Person Responsible

First NameLast Name
Relationship to Camper
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Address

Address Line 2

CityState / Province

Postal / Zip Code
Any additional information concerning authorized/unauthorized people for camper pick up:

Medical History
List any communicable diseases the camper has had: (such as hepatitis, measles, mumps, meningitis, diphtheria, rubella, salmonella, tuberculosis, giardia, or shigella)*
List any serious illnesses the camper has had: (such as Diabetes, Asthma, Mononucleosis, Epstein-Barr Virus, RSV, Leukemia, Juvenile Rheumatoid Arthritis, Cytomegalovirus, other)*
List any surgical operations the camper has had:*
List any known drug reactions and/or allergies for this camper:*
Will your child be bringing any medication with them to camp?*

YesNo
ANY MEDICATIONS TO BE TAKEN AT CAMP MUST BE IN THE ORIGINAL CONTAINER, AND ALL MEDICATIONS (OTHER THAN TYLENOL, ADVIL, AND CLARITIN) MUST COME WITH THE DOCTOR'S INSTRUCTIONS IN ORDER FOR THE NURSE TO BE ABLE TO ADMINISTER THE MEDICINE TO THE CAMPER. (Please reference frequently asked questions [for parents] on our website for more instructions about bringing prescribed medications.)

Understand and agreeDisagree
Please list all medications currently being taken by the camper:
Specify any special diet the camper will be on at the time of admission to TMBC:*
Please list any activity exceptions:*
If there is a need to update any of these fields (i.e., diet, medication being taken, or activity exceptions) after you have submitted your registration, please let the camp know by emailing office.tmbc@gmail.com. Thank you!
Primary Doctor/Office
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

General Release Form
I hereby give permission for my child to attend and participate in all of Treasure Mountain Bible Camp’s activities on/off the camp property. I hereby absolve Treasure Mountain Bible Camp from liability to me or my child because of an injury received while attending camp at Treasure Mountain Bible Camp. In case of any accident or serious illness, I hereby authorize Treasure Mountain Bible Camp to call upon a physician of their choice and to follow their instructions. If emergency treatment or hospitalization is required, I request Treasure Mountain Bible Camp to notify me. I also understand, if my child is sent home for any reason, there will be no refund. I also understand that my camper’s picture or testimony may be used in the promotion of the camp.
Signature*

Clear
Date

MonthDayYear
Date

Camp Policies 2026
According to Colorado law, each camper's parents/guardians must read and have the ability to ask questions about the camp's policies. Please use this link to read the camp's policies. Please sign below once you have read them. If you have any questions, please email office.tmbc@gmail.com or call (970) 930-7859.
Signature

Clear
Date

MonthDayYear
Date

Payment & Submission
Please pay with one of these options:

Pay the Full Camp Price today - online with card or by mailing cash or check.
Pay the Registration Fee Only (will be subtracted from the total payment due upon arrival.)
Pay the Total Fee upon arrival at camp.

There is an $8 processing fee to pay with card. If you prefer to pay with cash or check rather than card, please send your payment to the camp office: 1700 Marble Quarry Rd. Marble, CO 81623.
No payment is required to submit this form.

If you would like to submit a payment at a later date, please hit the "Submit" button below to submit your form without payment. Thank you!

My Products

Registration Fee Only - $55 + $8 processing fee(the remaining balance will be due at camp)

$63.00

Full Camp Price - $155 + $8 processing fee (includes the registration fee)

$163.00

Returning 2026 Camper Price - $105 + $8 processing fee

$113.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

IF YOU DO NOT RECEIVE A CONFIRMATION EMAIL, WE DID NOT RECEIVE YOUR RESPONSE.
Should be Empty:

TMR TEEN SUMMIT REGISTRATION

Camper Information

Parent/Guardian Information

Church Information

Insurance Information

Emergency Contact

Authorized Person to Pick up Camper

Medical History

General Release Form

Camp Policies 2026

Payment & Submission

No payment is required to submit this form.

Payment Methods

IF YOU DO NOT RECEIVE A CONFIRMATION EMAIL, WE DID NOT RECEIVE YOUR RESPONSE.