2026 Summer Camp Detailed Registration Form

Summer Camp Registration 2026

Deeper Life Bible Camp PO Box 27 Blackduck, MN 56630
Camper Information
Camper's Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
Grade Entering Fall 2026*
Week/Days Attending*
Please remember this is based on the grade the student is entering in the fall of 2026.
Gender at Birth*

MaleFemale
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Legal Parent/Guardian Information
Name*

First NameLast Name
Parents Email Address*
Cell Number*
Are you okay with receiving text messages to the Mobile Phone? Messages would only come from a staff member at DLBC.*

YesNo
Home Number*
Home Church/Denomination
Pastor Name
Church Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Camp Fees / Pre-registration Information
If party other than parent is responsible for any portion of the registration fee please indicate it below.

ALSO include if camper is a counselor or CIT this summer.
Party Responsible for Registration Fee:
Amount Responsible For:
BEFORE May 15th Pre-Registration: T-Shirt or Discount*
If T-Shirt is selected please make sure to specify size below!
Pre-Registration T-Shirt Size
Week Long Camps

**Registration starts on Sunday at 4PM and ends on Saturday at 10AM**

Primary Camp

**Registration starts on Sunday at 4pm and ends Tuesday at 12:30.**
CAMPER DETAILS

First Time at DLBCTop Bunk Unacceptable
Optional - Is there anyone not authorized to check the camper out from camp?
CAMPERS SWIMMING LEVEL*

BeginnerIntermediateAdvancedCannot Swim - Life Jacket Required While Swimming
I wish to bunk with:
*It is our policy to avoid as much as possible, a group of THREE or more from the same church or area in the same cabin.
Racial/Ethnic History*

American Indian/Alaskan NativeAsianBlack/African AmericanCaucasian/WhiteNative Hawaiian/Pacific IslanderHispanic/LatinoNon-Hispanic/LatinoOther
Health History/Medical Information
The camper’s health insurance is responsible for any illness while at camp. DLBC provides accident excess insurance. This means that any medical bill resulting from injury must first be sent to your insurance carrier. All prescriptions must be paid by camper.
Health Insurance Company*
Employee Group / Policy Number
Medial Info - Please mark all that apply, even if only occasionally

AsthmaHeart ProblemsEpilepsyHeadachesBed WettingBowel HabitsSpecial Needs (specify under other)Behavioral Issues (specify under other)Autism Spectrum Disorder (ASD)Behavioral/Mental Health HistoryOther
If any of the above health conditions are checked, please comment/explain extent of condition and how it is managed (if none are checked please type none).*
Please list any FOOD, DRUG, or ENVIRONMENTAL allergies - list severity of each, noting any that require Epipen or medication intervention. (if no allergies please type none in the box)*
Minnesota State Law requires ALL campers to be immunized.

(Standard School Immunizations)
Immunizations are up to date*

YesNo
Date of last tetanus shot

MonthDayYear
Date
Medications
All Medications brought to Camp must be labeled and put into a zip-lock bag with the camper’s came on it. There must also be written instructions for the camp nurse, no medications may be kept in the camper cabins.
No medications will be given to your campers without written permission by parent/guardian. THIS INCLUDES OVER-THE-COUNTER MEDICATION. We are under the same laws and policies as the schools of Minnesota.
DLBC may give Tylenol or non-aspirin product as needed for headache/pain.*

YesNo
Emergency Information
Emergency Contact's Name (if parents not available)*

First NameLast Name
Relationship*
Phone Number*
Emergency Contact's Name (if parents not available)

First NameLast Name
Relationship
Phone Number
Guidelines

1. DLBC is a Christian camp. Therefore, we ask all campers and staff to seek to HONOR CHRIST in conduct, speech, and all other ways. Please bear in mind that, as a BIBLE CAMP, our desire is to be pleasing to God.
2. All campers and staff must first check in at the registration desk for assignment of cabins.
3. RESPECT one another, camp buildings, and equipment. For maximum enjoyment, get to know the other campers and staff as quickly as possible.
4. Parent/guardian permission to leave the grounds for outside activities or appointments must be submitted in writing at the time of registration and are subject to the director’s approval. Any camper who leaves the grounds without permission from parents/guardian and the director is subject to being sent home with no refund.
5. Report all illnesses and injuries to your cabin counselor immediately. The camp nurse will be in charge of all decisions made for treatment. NO MEDICATIONS are allowed in the cabins at any given time, with inhalers being the exception. Please check all medication in with the camp nurse upon registration. This is in accordance with Minnesota State Law.
6. All spending /offering money must be deposited in the camp bank. We are not responsible for lost or stolen money.
7. Learn the camp SCHEDULE quickly. Respond promptly to all bells and attend all camp activities.
8. Campers and staff are expected to dress appropriately for the various activities (meals, games, swimming, chapel, etc). Sometimes the things we wear and the way that we wear them can communicate things about us that we don’t intend and can also be a great distraction to others.
9. The following items cannot be used or brought to camp: IPODs, radios, radio/CD alarm clocks, video games, CD players, tape players, computers, pagers, cell phones, firecrackers, water balloons, squirt guns, paintball guns, and accessories, or knives or any other type of weapon. If they are brought to camp, your counselor shall turn them in to the director for safe keeping until you go home. DLBC is not responsible for damage to or loss of any items of great value you might bring to camp.
10. To keep camp a special, distraction-free place, we require campers & counselors to turn in cell phones and other electronic devices. Parent & camper signatures below indicate that you will abide by this policy. We understand that this can be difficult for both campers and parents, but it's amazing for campers & staff to be free from technology for just one week! We do allow campers to make necessary calls with the help of the director. In the case of illness, injury or homesickness, the camp nurse will be responsible to call home. And in case of emergency, contact the camp at (218)835-4902 and we will see that your child gets in contact with you.
11. Your assigned cabin is your home for the week. Do not enter another cabin without the counselor’s permission. In cases of emergency it is important to be with your cabin so that we can account for you.

Camper Responsibilities:

Your camp director and staff have been chosen by the DLBC Board/Committees, and have agreed to represent Deeper Life Bible Camp, Inc. in ministering to campers. All campers and staff must respect and follow the directors leadership. This policy will be enforced through the last moment of your camping session.
The director shall have the responsibility of discipline:
1. 1st Offense Verbal Warning from Director
2. 2nd Offense Camper/staff will be sent home with NO refund/payment.
For the safety of all campers and staff, DLBC is patrolled by security staff and the Beltrami County Sheriff’s Department throughout the sleeping hours and as needed at other times.

Media Release:

I am aware that photos/videos may be taken of my child at camp and I authorize the camp to use these for Deeper Life Bible Camp promotional purposes.
Medical Release and Authorization

As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Parent/Guardian Signature*

Clear

PAYMENT OPTION - One Payment option MUST be selected*

Week Long Camp Registration -- $195Includes online payment service fee

$201.00

Week Long Camp -- Deposit ONLY -- $100Includes online payment service fee

$104.00

Primary Camp Registration -- $60Includes online payment service fee

$62.00

Primary Camp -- Deposit ONLY -- $30Includes online payment service fee

$31.25

Other Mailing to camp, counseling, church scholarship, paying at camp

$ Free

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

ACH Bank Transfer

Should be Empty:

Summer Camp Registration 2026

Camper Information

Camp Fees / Pre-registration Information

Health History/Medical Information

Medications

Payment Methods