Camp Sychar Youth Registration

July 18th-July 28th

CAMP DATES
Camp Sychar Youth Registration

We are so excited that you will be joining us for these 10 exciting and life changing days! Please make sure that you complete all portions of the application. Before you complete the registration below please make sure you have read the two documents on the previous page! Camp fee is $110 for all campers. Please plan to make payment when youth check-in at camp. Payment can also be mailed to the Youth Program mailing address. Please note any mailed payments will not be processed until camp begins.
Camper Name
Last Name*
First Name*
Middle Name*
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Date
Camper's Information
Address*
City*
State*
Zip*
Home Phone*

Area CodePhone Number
Emergency Contact Name(if parent or guardian is not avaliable)*
Emergency Number*

Area CodePhone Number
Emergency Number #2

Area CodePhone Number
Birth Date*

MonthDayYear
Parent or Legal Guardian Information
Parent/Legal Guardian*
Relation*
Work Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
Parent /Legal Guardian 2
Relation 2
Work Phone 2

Area CodePhone Number
Cell Phone 2

Area CodePhone Number
Tractor Crew Request

Those interested in tent crew must be able to arrive at camp the Monday prior to the start of camp. Individuals must be able to lift 30+ lbs.
Do you request to be a member of tractor crew?

YesNo
Camper Buddy

Come to camp and bring a friend who has never been to camp and you both will receive $20 off your registration cost! Invite several friends and save $20 for EACH FRIEND that comes to camp with you! Bring 2 friends and you save $40, 3 friends will save you $60, and so on!*To be eligible for this discount, one camper must be a returning camper and one camper must be new to Camp Sychar. Invited campers must be registered for a minimum of 3 nights. Each invited camper can only be ‘used’ once for the discount.
Are you brining a First Time Friend?*

YesNO
First Time Friend Name

First NameLast Name
Church Information

If Applicable. You do not need to attend a church to attend Camp Sychar!!
Church you attend
Church City
Church you are coming with (if any)
Email Confirmation
Parents Email (camper confirmation will be sent by email)
Camper's Email
Other Information
Will you be at Camp all 10 days?*
If No, please indicate the days you will be attending

7/187/197/207/217/227/237/247/257/267/277/28
Payment Information

$110 Registration Fee
Payment Method:*

Pay IN PERSON at drop offPay via MAILED CHECK (Mail to: Camp Sychar Youth- 1083 Carousel Ct. Westerville, Ohio 43081
YOUTH COVENANT
I have read and fully intent to comply with the youth covenant as stated above*

Yes
Student please sign digitally below:
Date*

MonthDayYear
Date
SUPERVISED OFF CAMPUS GROUP ACTIVITIES PERMISSION FORM

I give permissions for my son / or daughter to participate in the following activities (Select ALL that apply):
I give permission to participate in Camp Sychar group recreation activities at the community park across the street*

YesNo
I give permission to participate in swimming and recreation activities at the Hiawatha Community Pool across the street with the Sychar youth*

YesNo
If my youth is physically unable to walk to group activities, I give permission for them to ride in an automobile driven by a staff member, to and from these activities (no less than 3 people per car)*

YesNo
Guardian please sign digitally below:
Date*

MonthDayYear
Date
Parent Authorization and Waiver
I have read all of the Parent & Youth Information Sheets, including the Housing Policy statement, and understand that while in the Youth Program youth are assigned living quarters in youth dormitories, and youth are not permitted inside cabins or any other non-youth lodging.*

Yes
Please sign digitally below:
Upon submission of this registration form you will be redirected to the Camp Sychar Nurse Medical Form. Please complete this form in order to complete your registration!
Should be Empty:

July 18th-July 28th

Camp Sychar Youth Registration

Camper Name

Camper's Information

Parent or Legal Guardian Information

Tractor Crew Request

Camper Buddy

Church Information

Email Confirmation

Other Information

Payment Information

YOUTH COVENANT

​SUPERVISED OFF CAMPUS GROUP ACTIVITIES PERMISSION FORM

Parent Authorization and Waiver

SUPERVISED OFF CAMPUS GROUP ACTIVITIES PERMISSION FORM