2023 High School Camp Registration

2023 High School Camp Registration

Grades 9-12. $299 per camper.
SCHOLARSHIPS AND DISCOUNTS AVAILABLE!

To apply for a PVCC scholarship, please go to pleasantvalleycamp.org/scholarships before you register. Upon approval, you will receive a scholarship code to enter when you register.

Save 50% on registration! If your home church participates in our partnership program to support the camp, ask your pastor or youth minister for a discount code to enter before you register.
Camper Information
Camper Name*

First NameLast Name
Grade*

9101112
Birth Date*

MonthDayYear
Gender*

MaleFemale
T-Shirt Size*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Home Church
Preferred Cabin Mates (List up to three)
Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*

Area CodePhone Number
Parent/Guardian E-mail*

Confirmation Email
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship*
Emergency Contact Phone Number*

Area CodePhone Number
Emergency Contact Alternate Phone Number

Area CodePhone Number
NOTE: We cannot accommodate special dietary preferences.

Please reach out to our camp manager Logan Jenott at 360-492-3451 or office@pleasantvalleycamp.org with questions or concerns about severe food allergies.
Please fill in your camper's medical and emergency information below, then continue to the bottom of the page for payment and to submit your registration.
Informed Consent and Acknowledgement

As the parent and/or legal guardian of the registered participant, I am fully aware of inherent hazards. I voluntarily allow my child to participate at Pleasant Valley Christian Camp. I assume responsibility for all risks of loss, damage, injury, or death.

GENERAL RELEASE AND WAIVER
Pleasant Valley Christian Camp activities may include (but are not limited to): laser tag, basketball, baseball, soccer, volleyball, field games, hiking, swimming, archery, campfires, arts and crafts, drama; music; playground, limited transportation on and off the grounds, etc. As the parent or legal guardian of the registered participant, I agree that my child is physically able to participate in all camp activities based on a physician’s examination.

The parent or legal guardian and personal representatives, assigns, heirs, and next of kin of the registered participant hereby release, hold harmless, indemnify and defend Pleasant Valley Christian Camp (including its agents, employees, and representatives) from any and all liability for injury or damages including, but not limited to, death, bodily injury, personal injury, emotional injury, or property damage which may result from any person using the above-described property and participation in any activities.

IMAGE RELEASE AND WAIVER.
I give permission to Pleasant Valley Christian Camp to use any photographs, videos, and/or audio recordings of the registered participant for printed and online promotional materials, including website and social media, without expectation of compensation, including, but not limited to, any royalties, proceeds, and/or other benefits derived from such photographs, videos, or audio recordings.
Medical Release and Authorization

As the parent and/or legal guardian of the registered participant, I authorize diagnosis and treatment by qualified and licensed medical professionals 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 registered participant’s life, physical disfigurement, physical impairment, or other undue pain, suffering, or discomfort, if delayed.

I give permission to the attending medical professional to proceed with any medical or surgical treatment and x-ray examination for the registered participant. In the event of an emergency arising out of serious illness, the need for major surgery, or accidental injury, I understand that every attempt will be made by the attending medical professional to contact me as quickly as possible and that this authorization is granted only after a reasonable effort has been made to contact me.

I grant permission to Pleasant Valley Christian Camp and its affiliates including program staff and camp staff to provide any needed emergency treatment prior to the registered participant’s admission to a medical facility.

This release is authorized for the dates and/or duration of the registered program.

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 registered participant, in my absence.

Camp Fees*

Full Registration$299.00

Canteen credit for snacks, drinks, T-shirts, hoodies, merchandise, etc.$5.00

You may select multiples of $5 (up to $100) in canteen credit. Unspent money can be refunded or donated to selected missions.

Quantity

Enter coupon

Total $0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Confirmation

BY SUBMITTING THIS REGISTRATION, 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.
Please stay on this page until it shows that your submission has been received. Check your email inbox for a confirmation message. If you do not receive a confirmation email, check your junk/spam mail folder or contact us at office@pleasantvalleycamp.org.
Should be Empty:

2023 High School Camp Registration

NOTE: We cannot accommodate special dietary preferences.

Payment Methods