Clone of Camper Registration Form

Camper Registration Form

Fill out the form carefully for registration.
Camper's Name

First NameMiddle NameLast Name
If different than listed above, what is your camper's preferred name they go by?
Birth Date

MonthDayYear
Grade Entering Fall of 2025
Gender

MaleFemale
TShirt Size

Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult XLAdult 2XLAdult 3XL
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
The following information is requested to help our counselors get to know a little bit about your child before he/she arrives at camp. The information will be kept confidential and is only shared with the counselors who will be working directly with your child. Please be thorough in order to help us provide your child with the best camp experience possible.
Has the camper attended camp before?

YesNo
If yes, what type of camp (day or overnight) and for how many years?
Does your camper have an unusual fear of the dark, thunderstorms, or other things that camp staff should be aware of?

YesNo
If yes, what is the fear? Please describe their actions so we can better serve them.
Does the camper experience any of the following?

NightmaresSleepwalkingBedwettingHomesickness
If yes to any of these, please describe to us the frequency and severity, so we may better serve your camper.
Are there any recent events that may impact the camper's experience away from home?

YesNo
If yes, please describe the event or any information that we may need to know to better serve your camper.
Is there anything else about your camper that would be helpful for their counselors to know?

YesNo
If yes, please describe in detail so we know how to better serve your camper.
Please list any cabin request here. Please note that we are only able to place campers in the same cabin in they are in the same program, are in the same grade, or one grade apart.
Parent/Guardian- Contact Information
Parent/Guardian #1

First NameLast Name
MsMrsMrOther
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone/Cell Phone
Please enter a valid phone number.
Work Phone/Daytime Phone
Please enter a valid phone number.
Email
example@example.com
Parent/Guardian #2

First NameLast Name
MsMrsMrOther
Home Phone/Cell Phone
Please enter a valid phone number.
Work Phone/Daytime Phone
Please enter a valid phone number.
Email
example@example.com
Emergency Contact Information

In case of emergency, the parents or guardians listed above will be contacted by the camp director or camp representative. Please know that only the people listed on this registration form will be able to take your camper off property.
Please list those people in addition to the parents/guardians who are permitted to pick up your child.
1- Name/Relationship
1- Phone Number
Please enter a valid phone number.
2- Name/Relationship
2- Phone Number
Please enter a valid phone number.
3- Name/Relationship
3- Phone Number
Please enter a valid phone number.
Medical Release Information (Insurance Information)

Policy NumberName of Health Insurance Provider
Primary Physician

First NameLast Name
Physician's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physician's Phone Number
Please enter a valid phone number.
Hospital Preference
Please list any medical problems, including any requiring maintenance medication (Examples: Diabetes, Asthma, Seizures) and required treatments for anything listed.
Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?

YesNo
If yes, explain:
Is your child allergic to any type of food or medication?

YesNo
Does your child require a special diet?

YesNo
The purpose of the above listed information is to ensure that medical personnel have details of any medical condition which may interfere with or after treatment.
I understand that I will be notified in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize calling medical professionals and providing any necessary medical services in the event my child is injured or becomes ill.
Type Full Name
I understand that New Day Fellowship will not be responsible for any medical expenses incurred, but such expenses will be my responsibility as parent/guardian.
Type Full Name
Please select how you heard about New Day Fellowship Youth Camp:

Afterschool ProgramWebsiteSchoolWord of MouthFlyerOther
Terms of Agreement
Photo Release: I hereby give permission for my child to be photographed during New Day Fellowship's Youth Camp. I understand the photos will be used to keep a journal of activities, to share during Power Point Presentations, and/or reports to our donors or promotional purposes including flyers, brochures, newspapers, and the Internet. I understand that although my child's photograph may be used for advertising, his or her identity will not be disclosed.
Parent/Guardian's Initials
New Day Fellowship will not be responsible for lost or damaged personal property. All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per the physician orders. Children's photos and quotes may be used for publicity purposes.
Type Parent/Guardian Name Here

First NameLast Name
Registration Information
Registrations

Registration will start at 4:00 PM Sunday, August 3rd for campers (ages 6-17) at 1045 Mount Shepherd Road Ext, Asheboro, NC 27205. Registrations and payment are due no later than July 13, 2025 to guarantee your child's spot. Payment due is $150 per camper. If you are paying by check, please make the check payable to New Day Fellowship, or if you would like to pay online, you can go to ndofnc.com and follow the donation prompt.
Refunds

If you cancel 7 days or more in advance, all camp fees will be refunded or transferred to another week of camp. If you cancel within 48 hours prior to the week of camp registered for, there will be no refund. Exceptions will be considered in the case of illness or family emergency, if requested in writing.
Camper Necessity List

Toothbrush and ToothpasteShampoo and ConditionerSoap or Body WashBag to carry toiletries (small mesh bag works great)DeodorantFeminine Products (if needed)Appropriate Swimwear and a dark colored shirt to wear while swimming (boys and girls)Swim shoesTowelsPillowSheets, Blanket, and/or Sleeping Bag, and a Pillow with a pillow caseAppropriate Clothes (pants or shorts), socks, shoes, shirts, and undergarments (Please wear closed toed shoes due to rocky terrain.) Please remember as your sending clothes for your camper that the goal is for everyone to stay respectful with their attire. Please keep in mind we will be playing games all day and will shower before church services each evening. Each child will need 2 sets of clothes per day.SocksPajamasHatBag for Dirty ClothesBible with notebook pencil or pen
Please bring all campers' medications with them at check-in, so it can be secured and given as directed. All campers medication needs to be labeled with clear instructions.
Electronic Policy

We ask that campers leave all electronic devices at home. Any cell phones or electronic devices found will be taken and given to the parents/guardians at the end of the week. If you need to speak with your camper, in case of emergency, you can call the camp director Michael Lucy (336) 847-7164 at any time.
Any alcohol, drugs, tobacco products, vapes, weapons, and fireworks are prohibited. Any such items found will be taken and given to parents/guardians at the end of the week.
Thank you for allowing your youth to come and be part of our youth camp. We are excited to see what the Lord is going to do in everyone's lives.
New Day Fellowship Youth Pastor/Camp Director Michael Lucy can be reached for questions or in case of emergencies at (336) 847-7164, or by email at chevyvortec1996@gmail.com
Should be Empty:

Camper Registration Form

Parent/Guardian- Contact Information

Emergency Contact Information

Terms of Agreement

Registration Information

Registrations

Refunds

Please bring all campers' medications with them at check-in, so it can be secured and given as directed. All campers medication needs to be labeled with clear instructions.

Electronic Policy

Any alcohol, drugs, tobacco products, vapes, weapons, and fireworks are prohibited. Any such items found will be taken and given to parents/guardians at the end of the week.