Camp Judah Registration
  • Camp Judah 2025 Registration

    Located at Camp Hickory Hill, 2970 Kohler Road, Varysburg, NY Admin Phone: 585-786-2969 Email: CampJudah@gmail.com
  • Dates: June 29 - July 4, 2025

  • Registration Cost: $300

  • Ages: 11-17

    [Any campers under the age of 11 who attended Camp Judah previously are allowed to attend but will need to contact campjudah@gmail.com to register]
  • Parent/Guardian Information

  • Emergency Information
  • Camper Health Information

    Please fax the camper's most recent vaccination record to (585)786-8219 OR email to campjudah@gmail.com OR bring it to registration at camp.
  • A full Medical Health Form must be completed and signed by the camper's licensed health care provider prior to attending camp.

  • Medical Release and Authorization As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to Camp Judah and its affiliates including Directors and Nurses to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

  • Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Camp Judah during camp.  I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Camp Judah and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from camp sessions. 

  • Release for photographs and/or video footage

    I hereby give my consent to allow Camp Judah to use
    photographs and/or video footage of my child in camp publications, including promotional materials.”

  • Confirmation BY ACKNOWLEDGING AND SIGNING, 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.

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    • To complete your registration for Camp Judah, you will also need a health form submitted by the camper's health provider.

      The camper's physcian can complete the Online Health Form - Providers or you can download, print, and mail the PDF Health Form - Providers.

       

       

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