Young Disciple Youth Bible Camp Camper Application 2023

Young Disciple Youth Bible Camp Camper Application 2025

This application should be completed by the camper applicant. Applicants may apply for one or both weeks.
I am applying for:*

Young Disciple Youth Bible Camp Week 1 (Ages 12–17; July 13–20)Young Disciple Youth Bible Camp Week 2 (Ages 12–17; July 20–27)
Applicant legal name*

First nameLast name
Preferred name

First nameLast name
Gender*

MaleFemale
Birth date*

MonthDayYear
Current age*
Email (use a guardian's contact info if you don't have your own)*
example@example.com
Home phone
Cell phone
Mailing address*

Address line 1

Address line 2

CityState / Province

Zip / Postal codeCountry
Roommate requests (up to three close to your age/grade)
Travel Information*

I am flying and will need to be picked up at the airport. I will provide the camp office with all flight details.*I am NOT flying but would like to be picked up by the YD bus at the airport.I will provide my own transportation to camp.Other
* Young Disciple provides airport pickup and drop-off service for those whose flights arrive at Spokane International Airport by 2:30 pm on July 13 or 20, and depart after 1:00 pm on July 20 or 27. Please send a copy of your flight itinerary to the YD office at least three weeks prior to camp.

Informed Consent and Acknowledgement

As parent and/or legal guardian of the applicant, I am in favor of the applicant attending camp and participating in all activities unless otherwise specified in writing. I hereby release the camp and its staff from liability in case of accident or illness, and I understand I am responsible for any charges incurred in treatment of my child's accident or illness. I hereby give permission to the medical personnel selected by the camp to administer natural remedies as deemed appropriate and/or to hospitalize and administer anesthesia and medications as necessary, or perform surgery on my child. I also give permission for Young Disciple Ministries to use videos or photos taken of my child during camp for promotional and/or illustrative purposes.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I UNDERSTAND 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.
Parent/guardian signature*

Clear
Parent/guardian name*

First nameLast name
Signature date*

MonthDayYear
Date

	Currently applies	Notes on condition/treatment
Ear infections
Bedwetting
Seizures
Fainting
Sleepwalking
Bronchitis
Asthma
Sinusitis
Frequent colds/sore throats
Restricted activities
Reason for restriction
Other

Young Disciple Youth Bible Camp Camper Application 2025