2025 Middle School Camp #1 Registration

Dunes Middle School Camp #1

July 5 - 9, 2025
Camper Name (the name you put here will go on their camper name tag)*

First NameLast Name
Birthday*

MonthDayYear
Date
Gender*

MaleFemale
Grade Next Fall*
Home Church
Parent's Name*

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*

Area CodePhone Number
Other Phone Number

Area CodePhone Number
Email*
example@example.com
Emergency Contact*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Is anyone, other than the parent listed above authorized to check camper out of camp? *
Please provide specific names and relationship to camper

Cabin Buddy Request

Please choose cabin mates. They should also choose you. These requests are not guaranteed.
Cabin Buddy Choice #1

First NameLast Name
Cabin Buddy Choice #2

First NameLast Name
Registration Submission

You cannot SUBMIT your registration until you have read and accepted the Parental Release & Permissions - The SUBMIT button will not appear until completed. By submitting, I agree that I am the parent/legal guardian of the child being registered.
PARENTAL RELEASE & AGREEMENT

A. The purpose of the Dunes Bible Camp (DBC) is to provide programs and/or a facility to assist Christians in bringing the gospel of Jesus Christ to every camper and to help Christians grow in their faith.

B. Any participant that engages in illegal activities endangers others or refuses to conform to the camp rules is subject to being sent home immediately. The parents or guardians will be responsible for transportation and will forfeit camp fees. Modesty dress is also required. The camp reserves the right to determine the standard of attire. I will not hold DBC responsible for any articles of clothing or personal belongings that are lost, stolen, or damaged.

C. My child has permission to participate in all activities on or off the grounds. I recognize that DBC has taken extensive safety measures, however, I also recognize DBC cannot guarantee that the participants, equipment, grounds, and/or activities will be free of accidents or injuries. I will defend DBC, its staff, employees, volunteers, and its Board of Directors from any claims of liability, loss, damage, expense, injury, or illness, including death, suffered from or in connection to my/my child's participation in the DBC camps, activities or any cause whatsoever.

D. I give permission for DBC to use any photo or video of my child for DBC publications or promotion/advertising. I release my right to any kind of remuneration for said photos or videos.

E. In the event that I cannot be reached in an emergency, I give permission to the physician selected by the camp director to hospitalize, secure proper treatment for, and order injection, anesthesia, X-rays, routine tests, and/or surgery; to release any records necessary for insurance purposes, and to provide or arrange necessary related transportation for my child.

F. I hereby authorize the directors and staff at DBC to act for me in their best judgment in any emergency requiring medical attention. I have made note of any medical or physical problems which might affect my child's ability to safely participate in the camp.
I have read and agree to the PARENTAL RELEASE & PERMISSION AGREEMENT*

YesNo
Signature*

Clear
T-shirt Size
If you register before June 1st, a camp shirt is included in this year's registration cost! Campers will receive their shirt at Check-In. If you are registering after June 1st, shirts will be available for your camper to purchase at the snack shack during camp.
Would you be willing to help transport other campers from your area to camp?*

YesNo

My Products

MS Camp - Tier 1$275.00

This tier covers the basic operational costs of our camp; to maintain our facilities and ensure a good experience for our campers.

MS Camp - Tier 2$315.00

This tier will help us expand our ministry, allowing us to improve our facilities and programs; creating a better experience for all campers now and in the years to come.

MS Camp - Pay Later$ Free

Choose this option if you'd like to pay with check/cash or if another person, church, or organization is covering your camper's fees. Please note, you will not be able to access this form again to pay with a credit card at a later date but you can call the camp office to do so.

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

NOTE: Enter your billing zip code in the field "12345"
Should be Empty:

Dunes Middle School Camp #1