Sponsor - Summer Camp Registration and Consent Form

Summer Camp Registration and Consent Form (Sponsors)

(One form per sponsor or married couple)
Select Camp Week*

Jr Week 1 (June 8-12, 2026)Jr Week 2 (July 6-10, 2026)Teen Week 1 (June 15-19, 2026)Teen Week 2 (July 13-17, 2026)
Name*

First NameLast Name
Spouse's Name (if coming)

First NameLast Name
List first and last names of any children coming with you who are not campers. If you have not already received prior permission to bring them, please contact us at secretary@hoosierhillsbaptistcamp.org for pricing to check on lodging. Space is limited.
Email*
Confirmation of form submission will be sent to this email
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Name*
Church City*
Church State*
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Insurance

Note: All attendees are under an accident insurance policy while on the campus. Coverage is an Excess Plan. All claims will first be submitted to the attendee's insurance carrier.
Insurance Policy Holder's Name

First NameLast Name
Policy #
Insurance Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Immunizations

DPTMMRSmallpoxWhooping CoughHepatitisOther
Tetanus Shot

YesNo
Date of Tetanus Shot
I Understand the Following:

Attendees are expected to cooperate in activities, and abide by camp policies of conduct and attire. The camp reserves the right to dismiss anyone who fails to follow these guidelines. I give permission for anyone named on this form to participate in all on-site activities. Photos or videos of anyone named on this form can be used for promotional purposes without remuneration. I understand that Hoosier Hills Baptist Camp is a Christian camp where Christian principles will be taught. I understand that camp may provide medical care for injuries or illness to anyone named on this form, that camp reserves the right to bill me for excessive medical supplies, and that all off-site medical expenses will be directed through my health insurance policy. I understand that camp coverage is an Excess Plan. I understand that if anyone named on this form has a communicable disease, sickness, or lice and/or nits, the camp reserves the right to take appropriate precautions, including dismissal.
Signature*

Clear
Name*

First NameLast Name
Date of Signature*

MonthDayYear
Cost
Select one (or both if spouse is attending)

1st Adult Sponsor ($100)2nd Adult Sponsor ($150)
Payment

Due at check-in on Monday.
How are you paying?

Through my churchIndividually (please select payment method below)
Payment Method

Check (make payable to HHBC and write "[church name] sponsor" and week attendingCashCredit Card
Checks or cash are preferred due to fees charged to us by PayPal.

Checks may be mailed to

HHBC
PO Box 237
Dillsboro, IN 47018
Attn: Registration
Note:

Sponsors must provide a copy of a recent church background check. Please send digital copy (PDF or picture) to secretary@hoosierhillsbaptistcamp.org, turn in a photocopy at check-in, or mail a photocopy to

HHBC
PO Box 237
Dillsboro, IN 47018
Attn: sponsor
If you do not receive a confirmation email, please let us know at secretary@hoosierhillsbaptistcamp.org
Should be Empty:

Summer Camp Registration and Consent Form (Sponsors)