Engage Truth Student Summer Camp at Aspendale 2025

Engage Truth Student Summer Camp at Aspendale 2025
Camper Information
Campers Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Age of Camper
Gender:

MaleFemale
What Church does the camper/camp staff attend?
Grade
Does the camper take any medications the nurse should know about?
Signature of Parent or Guardian *

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Parent or Guardian Contact Information:
First Contact Parent or Guardian:

First NameLast Name
Parent Email
example@example.com
Relationship to Camper:
Phone Number*
Second Contact Parent or Guardian:

First NameLast Name
Email
example@example.com
Relationship to Camper:
Phone Number*
Emergency Contact:
Name

First NameLast Name
Relationship to Camper:
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are there any issues or concerns with the camper that we should be aware of?
Add answer here
Emergency Medical Release
IN case of an emergency, I understand every effort will be made to contact me or the emergency contact persons listed above, in the event that we cannot be reached, I hereby give permission to the physician listed on the form to hospitalize, secure proper treatment and order anesthesia or surgery for my child.
Physician’s Name:
Hospitial Affiliation:
Address:
Phone:
Medical Insurance Provider:
Policy and/or group #:

OTC Medication Form
Camper Name

First NameLast Name
Your camper’s health and well-being during camp is of utmost importance to us! For us to treat and properly care for your child, we ask that you fully complete this form even if your child doesn’t regularly take prescription or over-the-counter medication.

In addition to providing current prescription information there is room to provide information about OTC medicines you will be providing for your child while they are at camp. Our camp stock of OTC medicines is limited, so please provide anything you foresee your child needing during camp.

Please Note: All OTC medicines will be given following manufacturer’s recommendations. If your child is younger than 12 and the medicine sent is not recommended for children younger than 12, a signed statement from the child’s physician or health care provider authorizing administration of the OTC medicine will be necessary.

Suggested over-the-counter medicines: something for pain/fever [ex. children’s Tylenol or Ibuprofen], something for allergy relief [ex. Benadryl], and something for upset stomach [ex. Pepto Bismol]. You may wish to consult with your child’s physician or health care provider regarding what medication[s] to send.

If your child is bringing nasal sprays or inhalers and you wish your child to keep and self-administer them, then written authorization must be received from your
I DO give permission for the camp nurse to provide my child over-the-counter (OTC) medication (i.e. aspirin, ibuprofen, Benadryl, Pepto-Bismol, etc) we did not provide the nurse, to treat symptoms such as headaches, allergies, upset stomach, etc.I do NOT give permission for the camp nurse to provide my child over-the- counter (OTC) medication (i.e. aspirin, ibuprofen, Benadryl, Pepto-Bismol, etc) we did not provide the nurse, to treat symptoms such as headaches, allergies, upset stomach, etc.
Parent/Legal Guardian of:
Parent/Legal Guardian(Printed name)
Signature

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Date

MonthDayYear
Date

Allergies and Medications:
Does the camper have any known allergies?
Does your child need to take medication(s) during camp?*

YesNo
If your child requires medication, please specify:
The Permission to Administer Medication form must be completed and given to the Camp Director on the first day of each camp session. Medications must be accompanied by the original physician’s prescription with clearly written directions. If your child has other special needs (language, learning disability, speech, hearing, food allergies, etc) please contact the Camp Director at (915) 401-6065 prior to June 22nd, 2025.
Your Signature*

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MEDICAL CONSENT AND RELEASE AGREEMENT

Engage Truth Student Camp 2025

June 22nd-June 27th

To be filled out by parents or legal guardians of participants under 18 years of age.
Parent or Guardian Name, the parent and/or guardian of
Camper Name , a minor child, hereby acknowledge
that said child is presently under my care, custody and control. I hereby give said child my express permission to participate in all regular and special Engage Truth Ministries youth activities, both at and away from Engage headquarters, including specifically and without limitation vehicle travel to and from, and participation in all aspects of, the Engage Truth Student Summer Camp.

In the event there arises an emergency necessitating medical and/or surgical attention, I hereby consent and give my permission to the Engage Truth Ministries members, volunteer leaders or other representatives, or any attending physician, to make such decisions and to consent to or perform such medical treatments and/or surgery upon said child which may in their sole discretion be necessary and proper under the circumstances.

I, the undersigned parent and/or guardian of said child, do release, acquit, discharge and covenant to hold harmless Engage Truth Ministries, its staff, members, volunteer leaders, other representatives, agents, servants, or employees, Aspendale Mountain Retreat Center, and their respective staff, members, volunteer leaders, other representatives, agents, servants, or employees, from any and all actions, damages or liabilities arising out of any sickness or injury incurred by said child at any time in such activities, or incurred at any time in the treatment of any such sickness or injury.

I also give my permission for the above-named child to be transported to and from Engage Truth Ministries by rented vehicles or camp staff vehicles that are arranged and supervised by authorized and Engage Truth Ministries staff, members, volunteer leaders, other representatives, agents, servants, or employees of Engage Truth Ministries.
Your Signature*

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Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Photograph and Publicity Release Form
I Parent or Guardian Name parent/guardian of Camper Name
give Engage Truth Ministries permission to use my child’s name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of Engage Truth Ministries activities. I agree that Engage has complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the Engage events and missions. These uses include, but are not limited to illustrations, bulletins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. I acknowledge that I will not receive any compensation, etc for the use of such pictures, etc., and hereby release Engage and its agents and assigns from any and all claims which arise out of or are in any way connected with such use.

I have read and understood this consent and release.

I give my consent to the Engage Truth Ministries Apologetics to use my child’s name and likeness to promote the Engage Truth Ministries program, and/or their activities.
Student Signature*

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Parent/Guardian Signature*

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Date

MonthDayYear
Date
I do not consent to my child being photographed.
Behavior Agreement Form

Don’t do these things
- NO Public Display of Affection (PDA)
- NO hand holding
- NO whining
- NO bad attitudes
- NO bad language
- NO improper clothing
- NO alcohol, drug, tobacco, etc. use
Reasons to be sent home at YOUR expense:
- Making out with anyone (PDA)
- Physically hurting someone else
- Continued display of worldly behavior
- Continued disrespect of adults
If the rules are continually broken and behavior has not changed after these steps: (1) counselor intervention (2) meeting with one of our camp directors, then the Student will be sent home on nearest and soonest bus or airplane with the bill to be paid by the parents!
I have read and agree to follow these rules.

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I’ve read and accept full responsibility for the transportation cost to send home my son/daughter who has broken the rules.

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*parent / legal guardian (if under the age of 18)
Payment Options
- Early bird rate for camp ($275) needs to be paid before Jan 1st and there is a $50 deposit. On Jan 1st it will go up to the full rate at $320. For regular registration we should list that we want everyone to be paid by June 4th, 2025
- Check (preferred method) Please send a check to:
  Engage Truth Ministries
  P.O. Box #12523
  El Paso, TX, 79913
- Zelle: engagetruthministires@gmail.com
- Pay online by following this link:
  https://buy.stripe.com/fZeeXd4h9bJebokaEO
  If you choose to pay online, please consider giving a few extra dollars to help us cover service fees.
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Engage Truth Student Summer Camp at Aspendale 2025

OTC Medication Form