Camp Anew Registration 2025
  • Camp Anew Registration

  • Before continuing to regististion, please read the followng carefully.

    Cost per camper: $240

     

    If you need financial assistance please request a scholarship application by filling out the form at this link

    Once we have received the application our team will review and respond to your request within 7 days. 

    If you are requesting a scholarship please do NOT continue on to registration until AFTER hearing back from Starlight staff.

     

    Thank You!

  • Primary Guardian Information

  • Format: (000) 000-0000.
  • Emergency Contact Information

    Other than primary guardian:
  • Format: (000) 000-0000.
  • Information regarding person(s) who died:

  • Camper Information

  •  - -
  • CAMP ANEW HEALTH INFORMATION

  • Health Care Provider

  • Format: (000) 000-0000.
  • Medical Conditions and/or Restrictions:

  • Diet and Nutrition

  • Allergies

    If allergies exist, please explain reaction and severity:
  • Medications

    Medication must be in the original/labeled containers sealed in a ziplock and labeled bag.
  • Rows
  • Parent/Guardian Authorization for Health Care:

    My child has permission to engage in all prescribed camp activities except as noted. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the camp staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury.
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  • Camp Anew Release and Waiver

  • I (guardian's name) In consideration of my child's participation in Starlight Ministries/Camp Anew (SM/CA) program, do herby acknowledge, appreciate, understand, and agree:

  • 1. I am aware of the risk of dangers, hazards, and injury inherent in my child’s participation of SM/CA.

    2. I assume all risks – both those known and those unknown - in connection with my child’s participation in SM/CA, including but not limited to transportation to and from events or programs, accidents, thefts, slips, falls, mortification, shock, emotional stress or damage, and including those risks arising from independent activities my child may undertake supplemental to any SM/CA activity or program.

    3. I, for myself, and for my child, and on behalf of our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SM/CA, its governing board, officers, agents, employees, volunteers, or representatives (“releases”) from and against any and all liability WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

     4. My express intent is that this document shall bind the members of my family and spouse if I am alive, and my estate, family, heirs, administrators, personal representatives, or assigns if I am deceased, and shall be deemed as a liability release, waiver, discharge and covenant not to sue the above releasees. I further agree to save and hold harmless, indemnify, and defend releasees from any claim by me or my family, arising out of my participation in the activity. This release is intended to apply to any and all bases of liability or potential liability and is specifically intended as a release of liability for any and all harm and from any and all liability claims, including but not limited to those based on negligence, whether caused by SM/CA or not.

    5. My child’s participation in SM/CA is voluntary.

    6. There are no undisclosed health-related reasons or problems precluding or restricting my child’s participation in SM/CA. I assume all responsibility for any and all medical treatment of my child, including the cost thereof, that may be required by me either as a result of injury to me or otherwise.

    7. I agree and hereby grant releases permission to authorize emergency medical treatment for my child if necessary, and that such action by releases shall be subject to the terms of this document. I understand and agree that releases assume no responsibility for any injury or damages that might arise out of or in connection with such authorized emergency medical treatment.

    8. This release shall be construed in accordance with the laws of the state of Michigan. If any term or provision of this release shall be held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected thereby.

  • I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT FULLY and I understand its terms. In signing this release, I acknowledge and represent that I have fully informed myself of the content above, and I sign as my own free act and deed, understanding that it is to be construed as a release to the greatest extent allowed by law. No oral representations, statements or inducements, apart from the foregoing written statement, have been made. I certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above pertaining to all releases. For myself, my heirs, assigns and next of kin, I release and agree to indemnify and hold harmless the releases from any and all liabilities incident to my minor child’s involvement or participation in SM/CA, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by law.

    FOR PARTICIPANTS UNDER THE AGE OF 18 (at the time of registration)

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  • Warner Camp - Mitch Rossen Climbing Wall/Zip Line and Quinten Greiner High-Ropes Course

    RELEASE & INDEMNITY AGREEMENT & CONSENT FOR MEDICAL TREATMENT
  •  I understand that, before I will be allowed to use the Climbing Wall/Zip Line/High-Ropes Course at Warner Camp, I must listen to and adhere to Warner Camp’s Climbing Wall/ Zip Line/ High-Ropes Course orientation, belaying techniques, climbing techniques, and proper climbing wall etiquette. I also understand that proper closed-toe shoes, and other climbing specific clothing is necessary.

    As part of the consideration for participating in the climbing wall/Zip Line/ High-Ropes Course being offered by Warner Camp, I hereby release, hold harmless, and forever discharge Warner Camp, its employees and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by me or to any property belonging to me while participating on the climbing wall/ Zip line/High Ropes Course.

    I understand that the risks associated with climbing wall/high-ropes activities include, but are not limited to Injury, disability or death resulting from:

     1. Falling from the climbing wall and impacting against wall surfaces or projections or the ground;

     2. Rope abrasion, entanglement or other activities Involving ropes on or near the climbing wall such as climbing, belaying, rappelling, lowering on rope, rescue systems, and other rope techniques;

    3. Contact with falling climbers or dropped objects;

     4. Musculoskeletal injuries resulting from the physical stress of climbing and/or belaying;

     5. Failure of ropes, slings, harnesses, climbing hardware, anchor points, other climbing equipment or any part of the climbing wall/high-ropes;

     6. Cuts and abrasions resulting from skin contact with the climbing wall/high-ropes.

    I understand and acknowledge that Warner Camp does not permit any un-roped activities, such as traversing and bouldering without a spotter. I further understand and acknowledge that Warner Camp requires the use of safety helmets. In the event of illness or injury, I hereby authorize the senior staff or supervisory staff or other agents toobtain 5 emergency, and I hereby assume the cost of such treatment. I understand that this authorization is given in advance of hospital care being required but is given to provide authority and power on the part of the Camp to give specific consent to the diagnosis, treatment, or hospital care which, in the best judgment of a licensed physician, isdeemed advisable. I agree that a photocopy of this signed release and consent form as effective as the original, and recognize that neither Warner Camp, or staff or other employees or agents assumes responsibility for, nor do they have any liability for, the medical assistance and care which may be so selected and provided.

     I further agree to indemnify and hold harmless Warner Camp, its employees and agents, from any loss, liability, damage or cost, including court costs and attorney's fees that they may incur due to my participation in this activity, except that caused by the negligence of Warner Camp, its employees or agents. This release and indemnity agreement is binding on myself, my heirs, assigns, and personal representatives. I acknowledge that I am 18 years old or older. If I am not at least 18 years old, I understand that my parent's or guardian's signature must appear below before I will be permitted to participate in the activity.

  •  - -
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  • Camper Information (2)

  •  - -
  • CAMP ANEW HEALTH INFORMATION (2)

  • Health Care Provider

  • Format: (000) 000-0000.
  • Medical Conditions and/or Restrictions:

  • Diet and Nutrition

  • Allergies

    If allergies exist, please explain reaction and severity:
  • Medications

    Medication must be in the original/labeled containers sealed in a ziplock and labeled bag.
  • Rows
  • Parent/Guardian Authorization for Health Care:

    My child has permission to engage in all prescribed camp activities except as noted. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the camp staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury.
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  •  - -
  • Camp Anew Release and Waiver (2)

  • I (guardian's name) In consideration of my child's participation in Starlight Ministries/Camp Anew (SM/CA) program, do herby acknowledge, appreciate, understand, and agree:

  • 1. I am aware of the risk of dangers, hazards, and injury inherent in my child’s participation of SM/CA.

    2. I assume all risks – both those known and those unknown - in connection with my child’s participation in SM/CA, including but not limited to transportation to and from events or programs, accidents, thefts, slips, falls, mortification, shock, emotional stress or damage, and including those risks arising from independent activities my child may undertake supplemental to any SM/CA activity or program.

    3. I, for myself, and for my child, and on behalf of our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SM/CA, its governing board, officers, agents, employees, volunteers, or representatives (“releases”) from and against any and all liability WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

     4. My express intent is that this document shall bind the members of my family and spouse if I am alive, and my estate, family, heirs, administrators, personal representatives, or assigns if I am deceased, and shall be deemed as a liability release, waiver, discharge and covenant not to sue the above releasees. I further agree to save and hold harmless, indemnify, and defend releasees from any claim by me or my family, arising out of my participation in the activity. This release is intended to apply to any and all bases of liability or potential liability and is specifically intended as a release of liability for any and all harm and from any and all liability claims, including but not limited to those based on negligence, whether caused by SM/CA or not.

    5. My child’s participation in SM/CA is voluntary.

    6. There are no undisclosed health-related reasons or problems precluding or restricting my child’s participation in SM/CA. I assume all responsibility for any and all medical treatment of my child, including the cost thereof, that may be required by me either as a result of injury to me or otherwise.

    7. I agree and hereby grant releases permission to authorize emergency medical treatment for my child if necessary, and that such action by releases shall be subject to the terms of this document. I understand and agree that releases assume no responsibility for any injury or damages that might arise out of or in connection with such authorized emergency medical treatment.

    8. This release shall be construed in accordance with the laws of the state of Michigan. If any term or provision of this release shall be held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected thereby.

  • I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT FULLY and I understand its terms. In signing this release, I acknowledge and represent that I have fully informed myself of the content above, and I sign as my own free act and deed, understanding that it is to be construed as a release to the greatest extent allowed by law. No oral representations, statements or inducements, apart from the foregoing written statement, have been made. I certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above pertaining to all releases. For myself, my heirs, assigns and next of kin, I release and agree to indemnify and hold harmless the releases from any and all liabilities incident to my minor child’s involvement or participation in SM/CA, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by law.

    FOR PARTICIPANTS UNDER THE AGE OF 18 (at the time of registration)

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  •  - -
  • Warner Camp - Mitch Rossen Climbing Wall/Zip Line and Quinten Greiner High-Ropes Course (2)

    RELEASE & INDEMNITY AGREEMENT & CONSENT FOR MEDICAL TREATMENT
  •  I understand that, before I will be allowed to use the Climbing Wall/Zip Line/High-Ropes Course at Warner Camp, I must listen to and adhere to Warner Camp’s Climbing Wall/ Zip Line/ High-Ropes Course orientation, belaying techniques, climbing techniques, and proper climbing wall etiquette. I also understand that proper closed-toe shoes, and other climbing specific clothing is necessary.

    As part of the consideration for participating in the climbing wall/Zip Line/ High-Ropes Course being offered by Warner Camp, I hereby release, hold harmless, and forever discharge Warner Camp, its employees and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by me or to any property belonging to me while participating on the climbing wall/ Zip line/High Ropes Course.

    I understand that the risks associated with climbing wall/high-ropes activities include, but are not limited to Injury, disability or death resulting from:

     1. Falling from the climbing wall and impacting against wall surfaces or projections or the ground;

     2. Rope abrasion, entanglement or other activities Involving ropes on or near the climbing wall such as climbing, belaying, rappelling, lowering on rope, rescue systems, and other rope techniques;

    3. Contact with falling climbers or dropped objects;

     4. Musculoskeletal injuries resulting from the physical stress of climbing and/or belaying;

     5. Failure of ropes, slings, harnesses, climbing hardware, anchor points, other climbing equipment or any part of the climbing wall/high-ropes;

     6. Cuts and abrasions resulting from skin contact with the climbing wall/high-ropes.

    I understand and acknowledge that Warner Camp does not permit any un-roped activities, such as traversing and bouldering without a spotter. I further understand and acknowledge that Warner Camp requires the use of safety helmets. In the event of illness or injury, I hereby authorize the senior staff or supervisory staff or other agents toobtain 5 emergency, and I hereby assume the cost of such treatment. I understand that this authorization is given in advance of hospital care being required but is given to provide authority and power on the part of the Camp to give specific consent to the diagnosis, treatment, or hospital care which, in the best judgment of a licensed physician, isdeemed advisable. I agree that a photocopy of this signed release and consent form as effective as the original, and recognize that neither Warner Camp, or staff or other employees or agents assumes responsibility for, nor do they have any liability for, the medical assistance and care which may be so selected and provided.

     I further agree to indemnify and hold harmless Warner Camp, its employees and agents, from any loss, liability, damage or cost, including court costs and attorney's fees that they may incur due to my participation in this activity, except that caused by the negligence of Warner Camp, its employees or agents. This release and indemnity agreement is binding on myself, my heirs, assigns, and personal representatives. I acknowledge that I am 18 years old or older. If I am not at least 18 years old, I understand that my parent's or guardian's signature must appear below before I will be permitted to participate in the activity.

  •  - -
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  • Camper Information (3)

  •  - -
  • CAMP ANEW HEALTH INFORMATION (3)

  • Health Care Provider

  • Format: (000) 000-0000.
  • Medical Conditions and/or Restrictions:

  • Diet and Nutrition

  • Allergies

    If allergies exist, please explain reaction and severity:
  • Medications

    Medication must be in the original/labeled containers sealed in a ziplock and labeled bag.
  • Rows
  • Parent/Guardian Authorization for Health Care:

    My child has permission to engage in all prescribed camp activities except as noted. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the camp staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury.
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  •  - -
  • Camp Anew Release and Waiver (3)

  • I (guardian's name) In consideration of my child's participation in Starlight Ministries/Camp Anew (SM/CA) program, do herby acknowledge, appreciate, understand, and agree:

  • 1. I am aware of the risk of dangers, hazards, and injury inherent in my child’s participation of SM/CA.

    2. I assume all risks – both those known and those unknown - in connection with my child’s participation in SM/CA, including but not limited to transportation to and from events or programs, accidents, thefts, slips, falls, mortification, shock, emotional stress or damage, and including those risks arising from independent activities my child may undertake supplemental to any SM/CA activity or program.

    3. I, for myself, and for my child, and on behalf of our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SM/CA, its governing board, officers, agents, employees, volunteers, or representatives (“releases”) from and against any and all liability WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

     4. My express intent is that this document shall bind the members of my family and spouse if I am alive, and my estate, family, heirs, administrators, personal representatives, or assigns if I am deceased, and shall be deemed as a liability release, waiver, discharge and covenant not to sue the above releasees. I further agree to save and hold harmless, indemnify, and defend releasees from any claim by me or my family, arising out of my participation in the activity. This release is intended to apply to any and all bases of liability or potential liability and is specifically intended as a release of liability for any and all harm and from any and all liability claims, including but not limited to those based on negligence, whether caused by SM/CA or not.

    5. My child’s participation in SM/CA is voluntary.

    6. There are no undisclosed health-related reasons or problems precluding or restricting my child’s participation in SM/CA. I assume all responsibility for any and all medical treatment of my child, including the cost thereof, that may be required by me either as a result of injury to me or otherwise.

    7. I agree and hereby grant releases permission to authorize emergency medical treatment for my child if necessary, and that such action by releases shall be subject to the terms of this document. I understand and agree that releases assume no responsibility for any injury or damages that might arise out of or in connection with such authorized emergency medical treatment.

    8. This release shall be construed in accordance with the laws of the state of Michigan. If any term or provision of this release shall be held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected thereby.

  • I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT FULLY and I understand its terms. In signing this release, I acknowledge and represent that I have fully informed myself of the content above, and I sign as my own free act and deed, understanding that it is to be construed as a release to the greatest extent allowed by law. No oral representations, statements or inducements, apart from the foregoing written statement, have been made. I certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above pertaining to all releases. For myself, my heirs, assigns and next of kin, I release and agree to indemnify and hold harmless the releases from any and all liabilities incident to my minor child’s involvement or participation in SM/CA, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by law.

    FOR PARTICIPANTS UNDER THE AGE OF 18 (at the time of registration)

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  •  - -
  • Warner Camp - Mitch Rossen Climbing Wall/Zip Line and Quinten Greiner High-Ropes Course (3)

    RELEASE & INDEMNITY AGREEMENT & CONSENT FOR MEDICAL TREATMENT
  •  I understand that, before I will be allowed to use the Climbing Wall/Zip Line/High-Ropes Course at Warner Camp, I must listen to and adhere to Warner Camp’s Climbing Wall/ Zip Line/ High-Ropes Course orientation, belaying techniques, climbing techniques, and proper climbing wall etiquette. I also understand that proper closed-toe shoes, and other climbing specific clothing is necessary.

    As part of the consideration for participating in the climbing wall/Zip Line/ High-Ropes Course being offered by Warner Camp, I hereby release, hold harmless, and forever discharge Warner Camp, its employees and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by me or to any property belonging to me while participating on the climbing wall/ Zip line/High Ropes Course.

    I understand that the risks associated with climbing wall/high-ropes activities include, but are not limited to Injury, disability or death resulting from:

     1. Falling from the climbing wall and impacting against wall surfaces or projections or the ground;

     2. Rope abrasion, entanglement or other activities Involving ropes on or near the climbing wall such as climbing, belaying, rappelling, lowering on rope, rescue systems, and other rope techniques;

    3. Contact with falling climbers or dropped objects;

     4. Musculoskeletal injuries resulting from the physical stress of climbing and/or belaying;

     5. Failure of ropes, slings, harnesses, climbing hardware, anchor points, other climbing equipment or any part of the climbing wall/high-ropes;

     6. Cuts and abrasions resulting from skin contact with the climbing wall/high-ropes.

    I understand and acknowledge that Warner Camp does not permit any un-roped activities, such as traversing and bouldering without a spotter. I further understand and acknowledge that Warner Camp requires the use of safety helmets. In the event of illness or injury, I hereby authorize the senior staff or supervisory staff or other agents toobtain 5 emergency, and I hereby assume the cost of such treatment. I understand that this authorization is given in advance of hospital care being required but is given to provide authority and power on the part of the Camp to give specific consent to the diagnosis, treatment, or hospital care which, in the best judgment of a licensed physician, isdeemed advisable. I agree that a photocopy of this signed release and consent form as effective as the original, and recognize that neither Warner Camp, or staff or other employees or agents assumes responsibility for, nor do they have any liability for, the medical assistance and care which may be so selected and provided.

     I further agree to indemnify and hold harmless Warner Camp, its employees and agents, from any loss, liability, damage or cost, including court costs and attorney's fees that they may incur due to my participation in this activity, except that caused by the negligence of Warner Camp, its employees or agents. This release and indemnity agreement is binding on myself, my heirs, assigns, and personal representatives. I acknowledge that I am 18 years old or older. If I am not at least 18 years old, I understand that my parent's or guardian's signature must appear below before I will be permitted to participate in the activity.

  •  - -
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  • Camper Information (4)

  •  - -
  • CAMP ANEW HEALTH INFORMATION (4)

  • Health Care Provider

  • Format: (000) 000-0000.
  • Medical Conditions and/or Restrictions:

  • Diet and Nutrition

  • Allergies

    If allergies exist, please explain reaction and severity:
  • Medications

    Medication must be in the original/labeled containers sealed in a ziplock and labeled bag.
  • Rows
  • Parent/Guardian Authorization for Health Care:

    My child has permission to engage in all prescribed camp activities except as noted. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the camp staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury.
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  •  - -
  • Camp Anew Release and Waiver (4)

  • I (guardian's name) In consideration of my child's participation in Starlight Ministries/Camp Anew (SM/CA) program, do herby acknowledge, appreciate, understand, and agree:

  • 1. I am aware of the risk of dangers, hazards, and injury inherent in my child’s participation of SM/CA.

    2. I assume all risks – both those known and those unknown - in connection with my child’s participation in SM/CA, including but not limited to transportation to and from events or programs, accidents, thefts, slips, falls, mortification, shock, emotional stress or damage, and including those risks arising from independent activities my child may undertake supplemental to any SM/CA activity or program.

    3. I, for myself, and for my child, and on behalf of our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SM/CA, its governing board, officers, agents, employees, volunteers, or representatives (“releases”) from and against any and all liability WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

     4. My express intent is that this document shall bind the members of my family and spouse if I am alive, and my estate, family, heirs, administrators, personal representatives, or assigns if I am deceased, and shall be deemed as a liability release, waiver, discharge and covenant not to sue the above releasees. I further agree to save and hold harmless, indemnify, and defend releasees from any claim by me or my family, arising out of my participation in the activity. This release is intended to apply to any and all bases of liability or potential liability and is specifically intended as a release of liability for any and all harm and from any and all liability claims, including but not limited to those based on negligence, whether caused by SM/CA or not.

    5. My child’s participation in SM/CA is voluntary.

    6. There are no undisclosed health-related reasons or problems precluding or restricting my child’s participation in SM/CA. I assume all responsibility for any and all medical treatment of my child, including the cost thereof, that may be required by me either as a result of injury to me or otherwise.

    7. I agree and hereby grant releases permission to authorize emergency medical treatment for my child if necessary, and that such action by releases shall be subject to the terms of this document. I understand and agree that releases assume no responsibility for any injury or damages that might arise out of or in connection with such authorized emergency medical treatment.

    8. This release shall be construed in accordance with the laws of the state of Michigan. If any term or provision of this release shall be held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected thereby.

  • I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT FULLY and I understand its terms. In signing this release, I acknowledge and represent that I have fully informed myself of the content above, and I sign as my own free act and deed, understanding that it is to be construed as a release to the greatest extent allowed by law. No oral representations, statements or inducements, apart from the foregoing written statement, have been made. I certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above pertaining to all releases. For myself, my heirs, assigns and next of kin, I release and agree to indemnify and hold harmless the releases from any and all liabilities incident to my minor child’s involvement or participation in SM/CA, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by law.

    FOR PARTICIPANTS UNDER THE AGE OF 18 (at the time of registration)

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  •  - -
  • Warner Camp - Mitch Rossen Climbing Wall/Zip Line and Quinten Greiner High-Ropes Course (4)

    RELEASE & INDEMNITY AGREEMENT & CONSENT FOR MEDICAL TREATMENT
  •  I understand that, before I will be allowed to use the Climbing Wall/Zip Line/High-Ropes Course at Warner Camp, I must listen to and adhere to Warner Camp’s Climbing Wall/ Zip Line/ High-Ropes Course orientation, belaying techniques, climbing techniques, and proper climbing wall etiquette. I also understand that proper closed-toe shoes, and other climbing specific clothing is necessary.

    As part of the consideration for participating in the climbing wall/Zip Line/ High-Ropes Course being offered by Warner Camp, I hereby release, hold harmless, and forever discharge Warner Camp, its employees and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by me or to any property belonging to me while participating on the climbing wall/ Zip line/High Ropes Course.

    I understand that the risks associated with climbing wall/high-ropes activities include, but are not limited to Injury, disability or death resulting from:

     1. Falling from the climbing wall and impacting against wall surfaces or projections or the ground;

     2. Rope abrasion, entanglement or other activities Involving ropes on or near the climbing wall such as climbing, belaying, rappelling, lowering on rope, rescue systems, and other rope techniques;

    3. Contact with falling climbers or dropped objects;

     4. Musculoskeletal injuries resulting from the physical stress of climbing and/or belaying;

     5. Failure of ropes, slings, harnesses, climbing hardware, anchor points, other climbing equipment or any part of the climbing wall/high-ropes;

     6. Cuts and abrasions resulting from skin contact with the climbing wall/high-ropes.

    I understand and acknowledge that Warner Camp does not permit any un-roped activities, such as traversing and bouldering without a spotter. I further understand and acknowledge that Warner Camp requires the use of safety helmets. In the event of illness or injury, I hereby authorize the senior staff or supervisory staff or other agents toobtain 5 emergency, and I hereby assume the cost of such treatment. I understand that this authorization is given in advance of hospital care being required but is given to provide authority and power on the part of the Camp to give specific consent to the diagnosis, treatment, or hospital care which, in the best judgment of a licensed physician, isdeemed advisable. I agree that a photocopy of this signed release and consent form as effective as the original, and recognize that neither Warner Camp, or staff or other employees or agents assumes responsibility for, nor do they have any liability for, the medical assistance and care which may be so selected and provided.

     I further agree to indemnify and hold harmless Warner Camp, its employees and agents, from any loss, liability, damage or cost, including court costs and attorney's fees that they may incur due to my participation in this activity, except that caused by the negligence of Warner Camp, its employees or agents. This release and indemnity agreement is binding on myself, my heirs, assigns, and personal representatives. I acknowledge that I am 18 years old or older. If I am not at least 18 years old, I understand that my parent's or guardian's signature must appear below before I will be permitted to participate in the activity.

  •  - -
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  • Camper Information (5)

  •  - -
  • CAMP ANEW HEALTH INFORMATION (5)

  • Health Care Provider

  • Format: (000) 000-0000.
  • Medical Conditions and/or Restrictions:

  • Diet and Nutrition

  • Allergies

    If allergies exist, please explain reaction and severity:
  • Medications

    Medication must be in the original/labeled containers sealed in a ziplock and labeled bag.
  • Rows
  • Parent/Guardian Authorization for Health Care:

    My child has permission to engage in all prescribed camp activities except as noted. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the camp staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury.
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  • Camp Anew Release and Waiver (5)

  • I (guardian's name) In consideration of my child's participation in Starlight Ministries/Camp Anew (SM/CA) program, do herby acknowledge, appreciate, understand, and agree:

  • 1. I am aware of the risk of dangers, hazards, and injury inherent in my child’s participation of SM/CA.

    2. I assume all risks – both those known and those unknown - in connection with my child’s participation in SM/CA, including but not limited to transportation to and from events or programs, accidents, thefts, slips, falls, mortification, shock, emotional stress or damage, and including those risks arising from independent activities my child may undertake supplemental to any SM/CA activity or program.

    3. I, for myself, and for my child, and on behalf of our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SM/CA, its governing board, officers, agents, employees, volunteers, or representatives (“releases”) from and against any and all liability WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

     4. My express intent is that this document shall bind the members of my family and spouse if I am alive, and my estate, family, heirs, administrators, personal representatives, or assigns if I am deceased, and shall be deemed as a liability release, waiver, discharge and covenant not to sue the above releasees. I further agree to save and hold harmless, indemnify, and defend releasees from any claim by me or my family, arising out of my participation in the activity. This release is intended to apply to any and all bases of liability or potential liability and is specifically intended as a release of liability for any and all harm and from any and all liability claims, including but not limited to those based on negligence, whether caused by SM/CA or not.

    5. My child’s participation in SM/CA is voluntary.

    6. There are no undisclosed health-related reasons or problems precluding or restricting my child’s participation in SM/CA. I assume all responsibility for any and all medical treatment of my child, including the cost thereof, that may be required by me either as a result of injury to me or otherwise.

    7. I agree and hereby grant releases permission to authorize emergency medical treatment for my child if necessary, and that such action by releases shall be subject to the terms of this document. I understand and agree that releases assume no responsibility for any injury or damages that might arise out of or in connection with such authorized emergency medical treatment.

    8. This release shall be construed in accordance with the laws of the state of Michigan. If any term or provision of this release shall be held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected thereby.

  • I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT FULLY and I understand its terms. In signing this release, I acknowledge and represent that I have fully informed myself of the content above, and I sign as my own free act and deed, understanding that it is to be construed as a release to the greatest extent allowed by law. No oral representations, statements or inducements, apart from the foregoing written statement, have been made. I certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above pertaining to all releases. For myself, my heirs, assigns and next of kin, I release and agree to indemnify and hold harmless the releases from any and all liabilities incident to my minor child’s involvement or participation in SM/CA, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by law.

    FOR PARTICIPANTS UNDER THE AGE OF 18 (at the time of registration)

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  • Warner Camp - Mitch Rossen Climbing Wall/Zip Line and Quinten Greiner High-Ropes Course (5)

    RELEASE & INDEMNITY AGREEMENT & CONSENT FOR MEDICAL TREATMENT
  •  I understand that, before I will be allowed to use the Climbing Wall/Zip Line/High-Ropes Course at Warner Camp, I must listen to and adhere to Warner Camp’s Climbing Wall/ Zip Line/ High-Ropes Course orientation, belaying techniques, climbing techniques, and proper climbing wall etiquette. I also understand that proper closed-toe shoes, and other climbing specific clothing is necessary.

    As part of the consideration for participating in the climbing wall/Zip Line/ High-Ropes Course being offered by Warner Camp, I hereby release, hold harmless, and forever discharge Warner Camp, its employees and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by me or to any property belonging to me while participating on the climbing wall/ Zip line/High Ropes Course.

    I understand that the risks associated with climbing wall/high-ropes activities include, but are not limited to Injury, disability or death resulting from:

     1. Falling from the climbing wall and impacting against wall surfaces or projections or the ground;

     2. Rope abrasion, entanglement or other activities Involving ropes on or near the climbing wall such as climbing, belaying, rappelling, lowering on rope, rescue systems, and other rope techniques;

    3. Contact with falling climbers or dropped objects;

     4. Musculoskeletal injuries resulting from the physical stress of climbing and/or belaying;

     5. Failure of ropes, slings, harnesses, climbing hardware, anchor points, other climbing equipment or any part of the climbing wall/high-ropes;

     6. Cuts and abrasions resulting from skin contact with the climbing wall/high-ropes.

    I understand and acknowledge that Warner Camp does not permit any un-roped activities, such as traversing and bouldering without a spotter. I further understand and acknowledge that Warner Camp requires the use of safety helmets. In the event of illness or injury, I hereby authorize the senior staff or supervisory staff or other agents toobtain 5 emergency, and I hereby assume the cost of such treatment. I understand that this authorization is given in advance of hospital care being required but is given to provide authority and power on the part of the Camp to give specific consent to the diagnosis, treatment, or hospital care which, in the best judgment of a licensed physician, isdeemed advisable. I agree that a photocopy of this signed release and consent form as effective as the original, and recognize that neither Warner Camp, or staff or other employees or agents assumes responsibility for, nor do they have any liability for, the medical assistance and care which may be so selected and provided.

     I further agree to indemnify and hold harmless Warner Camp, its employees and agents, from any loss, liability, damage or cost, including court costs and attorney's fees that they may incur due to my participation in this activity, except that caused by the negligence of Warner Camp, its employees or agents. This release and indemnity agreement is binding on myself, my heirs, assigns, and personal representatives. I acknowledge that I am 18 years old or older. If I am not at least 18 years old, I understand that my parent's or guardian's signature must appear below before I will be permitted to participate in the activity.

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  • Camper Information (6)

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  • CAMP ANEW HEALTH INFORMATION (6)

  • Health Care Provider

  • Format: (000) 000-0000.
  • Medical Conditions and/or Restrictions:

  • Diet and Nutrition

  • Allergies

    If allergies exist, please explain reaction and severity:
  • Medications

    Medication must be in the original/labeled containers sealed in a ziplock and labeled bag.
  • Rows
  • Parent/Guardian Authorization for Health Care:

    My child has permission to engage in all prescribed camp activities except as noted. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the camp staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury.
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  • Camp Anew Release and Waiver (6)

  • I (guardian's name) In consideration of my child's participation in Starlight Ministries/Camp Anew (SM/CA) program, do herby acknowledge, appreciate, understand, and agree:

  • 1. I am aware of the risk of dangers, hazards, and injury inherent in my child’s participation of SM/CA.

    2. I assume all risks – both those known and those unknown - in connection with my child’s participation in SM/CA, including but not limited to transportation to and from events or programs, accidents, thefts, slips, falls, mortification, shock, emotional stress or damage, and including those risks arising from independent activities my child may undertake supplemental to any SM/CA activity or program.

    3. I, for myself, and for my child, and on behalf of our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SM/CA, its governing board, officers, agents, employees, volunteers, or representatives (“releases”) from and against any and all liability WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

     4. My express intent is that this document shall bind the members of my family and spouse if I am alive, and my estate, family, heirs, administrators, personal representatives, or assigns if I am deceased, and shall be deemed as a liability release, waiver, discharge and covenant not to sue the above releasees. I further agree to save and hold harmless, indemnify, and defend releasees from any claim by me or my family, arising out of my participation in the activity. This release is intended to apply to any and all bases of liability or potential liability and is specifically intended as a release of liability for any and all harm and from any and all liability claims, including but not limited to those based on negligence, whether caused by SM/CA or not.

    5. My child’s participation in SM/CA is voluntary.

    6. There are no undisclosed health-related reasons or problems precluding or restricting my child’s participation in SM/CA. I assume all responsibility for any and all medical treatment of my child, including the cost thereof, that may be required by me either as a result of injury to me or otherwise.

    7. I agree and hereby grant releases permission to authorize emergency medical treatment for my child if necessary, and that such action by releases shall be subject to the terms of this document. I understand and agree that releases assume no responsibility for any injury or damages that might arise out of or in connection with such authorized emergency medical treatment.

    8. This release shall be construed in accordance with the laws of the state of Michigan. If any term or provision of this release shall be held illegal, unenforceable, or in conflict with any governing law, the validity of the remaining portions shall not be affected thereby.

  • I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT FULLY and I understand its terms. In signing this release, I acknowledge and represent that I have fully informed myself of the content above, and I sign as my own free act and deed, understanding that it is to be construed as a release to the greatest extent allowed by law. No oral representations, statements or inducements, apart from the foregoing written statement, have been made. I certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above pertaining to all releases. For myself, my heirs, assigns and next of kin, I release and agree to indemnify and hold harmless the releases from any and all liabilities incident to my minor child’s involvement or participation in SM/CA, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by law.

    FOR PARTICIPANTS UNDER THE AGE OF 18 (at the time of registration)

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  • Warner Camp - Mitch Rossen Climbing Wall/Zip Line and Quinten Greiner High-Ropes Course (6)

    RELEASE & INDEMNITY AGREEMENT & CONSENT FOR MEDICAL TREATMENT
  •  I understand that, before I will be allowed to use the Climbing Wall/Zip Line/High-Ropes Course at Warner Camp, I must listen to and adhere to Warner Camp’s Climbing Wall/ Zip Line/ High-Ropes Course orientation, belaying techniques, climbing techniques, and proper climbing wall etiquette. I also understand that proper closed-toe shoes, and other climbing specific clothing is necessary.

    As part of the consideration for participating in the climbing wall/Zip Line/ High-Ropes Course being offered by Warner Camp, I hereby release, hold harmless, and forever discharge Warner Camp, its employees and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, property damage, or personal injury, including death, that may be sustained by me or to any property belonging to me while participating on the climbing wall/ Zip line/High Ropes Course.

    I understand that the risks associated with climbing wall/high-ropes activities include, but are not limited to Injury, disability or death resulting from:

     1. Falling from the climbing wall and impacting against wall surfaces or projections or the ground;

     2. Rope abrasion, entanglement or other activities Involving ropes on or near the climbing wall such as climbing, belaying, rappelling, lowering on rope, rescue systems, and other rope techniques;

    3. Contact with falling climbers or dropped objects;

     4. Musculoskeletal injuries resulting from the physical stress of climbing and/or belaying;

     5. Failure of ropes, slings, harnesses, climbing hardware, anchor points, other climbing equipment or any part of the climbing wall/high-ropes;

     6. Cuts and abrasions resulting from skin contact with the climbing wall/high-ropes.

    I understand and acknowledge that Warner Camp does not permit any un-roped activities, such as traversing and bouldering without a spotter. I further understand and acknowledge that Warner Camp requires the use of safety helmets. In the event of illness or injury, I hereby authorize the senior staff or supervisory staff or other agents toobtain 5 emergency, and I hereby assume the cost of such treatment. I understand that this authorization is given in advance of hospital care being required but is given to provide authority and power on the part of the Camp to give specific consent to the diagnosis, treatment, or hospital care which, in the best judgment of a licensed physician, isdeemed advisable. I agree that a photocopy of this signed release and consent form as effective as the original, and recognize that neither Warner Camp, or staff or other employees or agents assumes responsibility for, nor do they have any liability for, the medical assistance and care which may be so selected and provided.

     I further agree to indemnify and hold harmless Warner Camp, its employees and agents, from any loss, liability, damage or cost, including court costs and attorney's fees that they may incur due to my participation in this activity, except that caused by the negligence of Warner Camp, its employees or agents. This release and indemnity agreement is binding on myself, my heirs, assigns, and personal representatives. I acknowledge that I am 18 years old or older. If I am not at least 18 years old, I understand that my parent's or guardian's signature must appear below before I will be permitted to participate in the activity.

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  • Payment

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        Camper Payment
        $240.00
          
        Additional donation

        The actual cost to send a camper to camp is $375. Your additional donation will help cover programming expenses for Camp Anew/Starlight Ministries.

        $135.00
          
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        Total
        $0.00

        Payment Methods

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        After submitting the form, you will be redirected to Apple Pay to complete the payment.
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