Camp Application 2025

Not Ashamed

Romans 1:16

For I am not ashamed of the gospel of Christ: for it is the power of God unto salvation to every one that believeth...
The Church of God Camp 2025

Due to scheduling conflicts out of our control camp will be later than normal this year and will be held August 29-Septmber 1 at Camp Utopia 1668 Camp Rd Springville Al 35146. The price of camp will be $115 however if you get your application in by August 1st you will receive a discounted price of $100. Please try to get your application in by this deadline to save you some money and help us with planning. T-shirts cannot be order after this date.
Name

First NameLast Name
Age at Camp
MaleFemale
E-mail
Phone Number:

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Would you like to purchase a camp t-shirt for $15 **Shirts cannot be ordered after August 1st deadline.

YesNo
Shirt Size

Youth XSYouth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XLAdult 2XLAdult 3XLAdult 4XL
Health Insurance Company
Contract/ Policy Numbers
Current Health Conditions

No Known Health ProblemsAllergies (inlcluding food)AsthmaDiabetesHeart ConditionHigh Blood PressureSeizuresOther
Please explain any medical conditions (ex: types of allergies/heart conditions/ seizures, etc.)
Is the camper under 18 years old and will need to take medication while at camp?*

Not under 18Under 18 and WILL need medicationUnder 18 but will NOT need medication
*All medication for anyone under age will need to be signed in with the camp nurses at registration. If parents are present and wish to keep their childs medication they will need to sign a wavier form that they will be responsible for the medication.
Date of last tetanus shot if know
Emergency Contact Name
Emergency Contact Phone Number
In case of an emergency, I understand that every effort will be made to contact my emergency contact. In the event that they cannot be reached, I hereby give permission to the camp staff to seek treatment for the camper as decided by the camp staff.
I grant to The Church of God and its representatives the right to take photographs of me and/or my children. I agree that The Church of God and its representatives may use such photographs for any lawful purpose for example, advertising, social media content, etc.
I give permission to be photgraphedI do NOT wish to be photographed
You will need to bring bedding and towels. Dress should be modest and appropriate. No shorts, sleeveless, cut off shirts, backless shirts/dresses, short dresses/skirts, or sheer clothing will be allowed. Covering will be required over swimwear to and from the pool area. No tobacco products will be allowed on the campground. No electronic games will be allowed.
Camper Signature (Parent/Guardian if camper is under 18 years old)*

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If signing for a minor please print your name

First NameLast Name
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The Church of God Camp 2025