Living River Summer Camp Registration

Living River Summer Camp 2025 You & Me Registration

Please register all adults and children who are attending as a part of your "family group" together. There is no way for adults to register themselves unattached from the children they're attending with. Every child and adult attending You & Me Camp will be considered a "camper" for the purposes of the form. That means you too, parent, grandparent, or friend! Email office@livingriver.org with any questions.
Your Name*

First NameLast Name
Your Email*
example@example.com
How many campers (adult and child) are you registering?*

Insurance Information
Medical Insurance Company*
Contract Holder Name*
Group #*
Contract #*
Upload a copy or take a picture of your insurance card below:
Upload a picture of your insurance card -OR-

Browse Files

Cancelof
Take a photo of the front of your card.
If any camper in your group is on a different insurance, upload a copy or take a picture of the second below. If there is an additional isurance beyond these two or you have any questions, please email office@livingriver.org.
Upload a picture of your group's additional insurance card -OR-

Browse Files

Cancelof
Take a photo of the front of the card.

Payment and Consent

**If choosing "Bill me after Summer Camp" or "Bill my church," skip past the "Payment via PayPal" section to finish and submit the form. If choosing to pay the full or a partial amount now, you'll be taken to another browser window to pay. Make sure to finish and submit this form too! Thank you!
You may choose to:
- Pay now (either the full amount or the amount minus the Presbytery of Sheppars and Lapsley you expect to receive)
- Be billed your total by Living River after Summer Camp is over.
- Or, if you have made arrangements for your church to cover the cost of Summer Camp, you can select that option below, too.
Scholarships- The Presbytery of Sheppards and Lapsley offers $75 scholarships for any You & Me camper, child or adult. There is a limited number of scholarships, and you must complete the Presbytery of Sheppards & Lapsley application to be considered for their scholarship. If you plan to apply for a camp scholarship and would like to pay what would be your remaining total after receiving the scholarship now, please choose the correct option below when checking out with PayPal. If the Presbytery does not receive your application or they run out of scholarship and you choose to pay the reduced registration fee now, you will be billed the remaining total. To complete the scholarship application go to http://pslpcusa.org/summer-camp/ and click the "Apply for Scholarship" button.

Additioinal Assistance- If you need additional financial assistance beyond the Presbytery scholarship, please email office@livingriver.org.

Bring a Friend Discount- If you are inviting new friends to Living River this Summer for the "Bring a Friend Discount" and you choose to pay now, your earned discount will be added to your next year's total (instead of receiving a refunded amount for this year's total). Or, you can choose to be billed by Living River after Summer Camp, so that your total reflects your discount. New friends need to both complete registration and participate in camp.
Payment Responsibility*

I understand that I am responsible for the full amount if Living River does not receive scholarship funds from the Presbytery or my home church.
Payment Options*

I am going to pay the full amount or a partial amount now.Bill me my total after Summer Camp.Bill my church.
Subtotal:
Are you planning to apply for the Presbytery of Sheppards and Lapsley scholarship for all of your campers (adult and children)?*

YesNo
Potential Scholarship Total:
Total:
Total to Pay through PayPal:

prevnext( X )
USDRegistration Total
Photos/Publicity

I understand that photos of my child or me may be used by Living River for publicity purposes in print or on social media. Names will not be printed. If I do not wish photographs of my child to be used in this capacity I will notify staff, in writing, before the beginning of the camp session.
Informed Consent and Acknowledgement

I, the undersigned, being the parent or legal guardian of the child named above permit my child to participate in all camp activities and I will hold Living River harmless in case of injury or illness. I understand that I will be notified in case of medical or surgical emergency involving my child. However, in the event that I or persons I have designated cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. I understand Living River will not be responsible for medical expenses incurred, but that such expenses will be my responsibility as parent/guardian. I will notify the camp director of any problems or restrictions which would affect participation in normal camp activities prior to the camp period. I also understand that the adult supervisors reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child. I agree to abide by the decisions of the director(s) in the case of sending the camper home due to illness or fails to abide by the camp rules.
Confirmation

Your electronic signature below is equally as binding as an original, manual signature. Your signature applies the above consent forms to every camper you have registered.
Signature*

Clear
Should be Empty: