Christian Camp Registration

2026 Church Camp/VBS Ages 4+ fully bathroom independent required.

New Hope Waimea
Camper's Information
Name

First NameLast Name
Gender
Birth Date

MonthDayYear
Age by June 29 (4-5)
Age by June 29 (6-8)
Age by June 29 (9+)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone

Area CodePhone Number
Emergency Contact Name

First NameLast Name
Emergency Number

Area CodePhone Number
Emergency Number #2

Area CodePhone Number
Half Day or Full Day
Week ONE June to July 3
Week TWO July 6 to July 10
Week THREE July 13 to July 17
Parent or Legal Guardian Information
Parent/Legal Guardian

First NameLast Name
Relation
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Parent /Legal Guardian 2

First NameLast Name
Relation 2
Work Phone 2

Area CodePhone Number
Cell Phone 2

Area CodePhone Number
Email Confirmation
Parents Email
Health Information
It is our policy to contact the parent or guardian as soon as possible in the event of a serious accident or injury. If the information has changed on the day of registration please see the health officer at that time. Please bring all medication in ORGIANAL CONTAINER or you will not be allowed to leave the medication or vitamins at the camp. No exceptions. All prescriptions must be in that campers name and the correct dosage.
Is camper free from infectious desease or conditions?
Are immunications up to date?
All fileds are required below. If nothing applies, please put "NONE" in the box. Thanks.
Any activity the camper should be restricted from?
Any physical, mental or other condition that would require special attention or medication while at camp?
List any past medical treatment that would be helpful for us to know.
List any allergies (ex: bees,peanuts, dairy)
Any dietary needs that we should know about?
List all medications, both prescribed and over the counter, all medications will be need to be administered by parents (except emergency medications.)
Signature

Please donate what you can for the time you have chosen to help keep this program going. Mahalo and God bless. (Cash and check accepted in person at the door.)

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Credit Card

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2026 Church Camp/VBS Ages 4+ fully bathroom independent required.

Camper's Information

Parent or Legal Guardian Information

Email Confirmation

Health Information

Please donate what you can for the time you have chosen to help keep this program going. Mahalo and God bless. (Cash and check accepted in person at the door.)

Credit Card