2025 Camp Ridgedale Registration Form

Camp Ridgedale Summer 2025 Registration Form
Join us for a summer of fun at Camp Ridgedale!

Our mission is to offer your family a secure and thrilling camp experience that inspires campers to embrace the Gospel of Jesus Christ. To ensure your child's summer filled with joy, please fill out the registration form completely and submit the $30.00 supply fee.
Who Can Sign up?
- Campers must have completed Kindergarten to be eligible for the Elementary camp (Completion of K-5th grades).
- Our CIT Program is open to students who have finished 6th through 12th grade. Campers who have completed 6th to 8th grade can enroll in our CIT Jr program for $130.00 per week.
  *Campers in 9th to 12th grade will register as CITs, with a flat rate charged for participation over a two-week period.
  CITs may serve additional weeks at the cost of field trips and extended care, if needed. Fees for any extra weeks will be invoiced after the completion of the initial two-week program.
What are Camp hours?

Standard camp hours run from 8 AM to 3 PM, with extended care available at a flat rate of $30 per week. Extended care includes early drop-off starting at 7:30 AM and afternoon care from 3:30 PM to 5:45 PM.

*At this time, our existing facilities and staffing limitations prevent us from accommodating campers with special needs or significant physical or behavioral challenges. For details on programs in our area that can support these needs, please reach out to us at communitykidsridgedale@gmail.com or call (423-704-8203).
Camper's Information
Last Name*
First Name*
Middle Name*
Gender*

MaleFemale
Address*
City*
State*
Zip*
Birth Date*

MonthDayYear
Grade entering in the fall*
*Which camp would your child like to attend?

Elementary Standard ( 8am- 3pm)Elementary+ Extended Care (7:30am-5:45pm)CIT Program (9th-12th)CIT Jr. (6th-8th)CIT Jr + Extended Care (6th-8th)
Parent or Legal Guardian Information
Parent/Legal Guardian First Name*
Parent/Legal Guardian Last Name*
Relation*
Work Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
Parent /Legal Guardian 2 First Name*
Parent /Legal Guardian 2 Last Name*
Relation 2*
Work Phone 2*

Area CodePhone Number
Cell Phone 2

Area CodePhone Number
Home Phone*

Area CodePhone Number
How would you like to be contacted while your child is at camp?

Work PhoneCell PhoneHome Phone
Emergency Contact Info

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. The first emergency contact must live no more than 1 hour away and be over the age of 18.
Emergency Contact #1 Name*
Phone Number*

Area CodePhone Number
Relationship to Child*
Emergency Contact #2 Name*
Phone Number #2*

Area CodePhone Number
Relationship to Child*
Email Confirmation
Parents Email*
- Be certain to enter your email address correctly on the registration form to receive camper confirmation.
Other Information
How did you hear about Camp Ridgedale?
Campers Home Church?
T-Shirt Size?*
First Time Camper?*

YesNo
Any siblings attending camp?*

YesNo
Camper Swimming Ability

Non-SwimmerBeginner Swimmer (can swim on front 20ft without flotation)Advanced Swimmer (can pass swim test)
Health Information
Does your Child have health coverage?

YesNo
Name and Phone Number of Primary Care Physician
Are immunizations up to date?

YesNo
Date of last tetanus shot
Any activity the camper should be restricted from?
Are there any physical, mental, or other conditions that may need special attention or medication during your time at camp?
Please submit a complete list of all medications, including prescriptions and over-the-counter items, for collection and distribution by Camp Administrative Staff. Rescue inhalers, epinephrine auto-injectors, topical ointments, and first-aid supplies will be managed by Counselors or Cabin Leaders. All medications must be in their original containers.
List any allergies (ex: bees,pollen,peanuts, dairy)
Any dietary needs or restrictions?
Do your child’s allergy/allergies require child care staff to monitor child for symptoms, take action if a reaction occurs, or give emergency medication to your child?

YesNo
In the event of an emergency involving my child(ren), I authorize the staff at Camp Ridgedale to provide and obtain emergency medical treatment for my child(ren) and to act as their guardian in approving medical care if I cannot be reached. I acknowledge that all emergency and medical expenses will be the financial responsibility of the parent or legal guardian.
I have read and agree to these terms*

Clear
Behavior and Discipline Policy

At Camp Ridgedale bullying is inexcusable, and we have a firm policy against all types of bullying. Here's our policy:
Any form of physical violence or bullying directed at campers or staff will lead to immediate removal from the program

Examples of unacceptable behavior include
- Ignoring behavior guidelines or camp rules
- Using profanity, vulgar language, or obscene gestures
- Stealing or damaging personal or camp property
- Refusing to participate in activities or cooperate with staff
- Disrupting a program or leaving without permission
- Jeopardizing the health and safety of children and staff
- Using illegal drugs, alcohol, tobacco, or engaging in any form of sexual conduct
- Teasing, mocking, or bullying fellow campers or staff
- Engaging in fights of any kind
- Roughhousing at the pool
Are there any discipline or behavior issues that we need to be aware of ? Does your child hold a diagnosis that we need to be aware of? Has your child ever been dismissed from a program for behavior or discipline issues? If yes, please explain.
I have read and agree with the Discipline Policy *

Clear
Camper Photo Release
I grant permission for my child to be photographed and/or videotaped by the staff of Camp Ridgedale and Ridgedale Baptist Church, as approved by the program Director. The content will be utilized for advertising, public relations, and family enrichment purposes. I acknowledge that the images may be featured in print publications, online platforms, presentations, websites, and social media. Additionally, I understand that I will not receive any royalties, fees, or compensation for this use.*

YesNo
Signature*

Clear
Permission to Transport

Campers will participate in weekly field-trips, campers will be transported to trip locations in chartered transportation services.
I give permission for my child to travel by private transport for off campus activities. I understand that in order to provide transport, the driver must be the holder of a current driver’s license with proper endorsements and that vehicle(s) must be registered and covered by compulsory Third Party Insurance. *

YesNo
Signature*

Clear
Child Dismissal Release

Please list all individuals authorized to pick up your child from camp below. Each person must present a valid photo ID along with the assigned pick-up identification number to collect your child. Additional individuals can be added to the pick-up list during the summer program only with a handwritten note and confirmation from Camp Administrative Staff and the child's guardians.
Please list person(s) with permission to pick up your child from Camp.*
Please list any person(s) that may NOT under any circumstances be allowed to pick up your child.
Late Pick-Up

Extended Care hours end at 5:30, there will be a grace period ending at 5:45pm. Any Pick-up after 5:45pm will require a charge of $1 per minute. (6pm pick-up will cost $15.00) * Excessive tardiness could result in your child's dismissal from the program.
I have read and agree with the listed Child Dismissal and Late Pick-Up policies and fees.*

Clear
Payment Information

A non-refundable supply fee of $30 is required, this fee is in place of our registration fee and is NO longer applies towards camp tuition. Weekly fees must be paid in full at least one week before the start of each camp session. For instance, all payments for the period from May 30th to June 2nd must be completed by May 22nd. If you are registering multiple children, a unique discount code will be provided after you submit registration for the first camper. This code can be used up to three times. There is a 10% discount available for our Full Summer or upfront payment options. This discount has already been included in the prices listed below.
Please select week(s) attending*

7/14-7/18- The Space Race7/28-8/1- Celebration Vacation
Method of payment

Credit CardDebit Card

Camp Payment Options*

Supply Fee$30.00

Full Summer Standard (8-3pm)$1,170.00

Price reflects 10% discount.

Full Summer + Extended Care$1,431.00

Price reflects 10% discount.

Elementary Camp Standard $135.00

Quantity

Elementary Camp + Extended Care$165.00

Number of weeks

Elementary Camp Mini-Week *(8am-3pm)$110.00

Number of weeks

Elementary Camp Mini- Week + Extended Care$135.00

Number of weeks

CIT Program (9th-12th)$130.00

Flat rate applies to two-weeks of CIT program. Fees for additional weeks served will be invoiced following the completion of the required two week program.

CIT Jr. Program (6th-8th)$125.00

Standard Camp Hours (8am-3pm)

Number of weeks

CIT Jr + Extended Care$140.00

7:30am-5:30pm

Number of weeks

Enter coupon

Total $0.00

By clicking submit and providing your initials, you confirm that you are the parent or legal guardian of the camper named above and that you are over 18 years of age.

In the event of a medical emergency or for general medical care, I consent to medical treatment for the camper mentioned above by authorized personnel. The camp holds secondary insurance.

I acknowledge that the camper named above will only be released to the individuals listed, and that updates can be made during registration.

I understand and agree to pay all camp fees. I recognize that a non-refundable registration fee, for each child, is required at the time of registration. I accept financial responsibility and agree to pay Camp Ridgedale for the weeks I have reserved for my child(ren), regardless of their attendance.

If I need to swap or cancel weeks, I understand that this will only be permitted based on available space, and I must submit the appropriate documentation for approval. In such cases, I will receive only a 70% refund.

I certify that my child has my permission to attend camp and participate in all activities.
Signature

Clear
Initial and Date*
Should be Empty:

Camp Ridgedale Summer 2025 Registration Form

Join us for a summer of fun at Camp Ridgedale!

Who Can Sign up?

What are Camp hours?

Camper's Information

Parent or Legal Guardian Information

Emergency Contact Info

Email Confirmation

Other Information

Health Information

Behavior and Discipline Policy

Camper Photo Release

Permission to Transport

Child Dismissal Release

Late Pick-Up

Payment Information