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Individual Registration Form

Individual Registration Form

Thank you for wanting to attend Camp Anderson Anchored's Summer Camp 2026! Each Camper must have their own registration form completed.  
28Questions
  • 1
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    • Week 1: June 15 - 19, 2026
    • Week 2: June 22 - 26, 2026
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  • 2
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  • 3
    Angle Tree is a program through Prison Fellowship Ministries.
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    All Angel Tree participants need to complete a separate registration form. Please go back to our website at www.anchored.camp to complete an Angel Tree Camp Registration form.

    If you are not an Angel Tree participant, please return to the previous questions and select "no". This will allow you to complete the Individual Camper Registration form.

     

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  • 5
    If applicable
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  • 6
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    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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  • 7
    -
    Pick a Date
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  • 8
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  • 9
    Indicate the CURRENT grade the camper is in.
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    • 5th
    • 6th
    • 7th
    • 8th
    • 9th
    • 10th
    • 11th
    • 12th
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  • 10
    Please select one.
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    • Extra Small
    • Small
    • Medium
    • Large
    • Extra Large
    • 2X Large
    • 3X Large
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  • 11
    While we do our best to accommodate bunkmate requests, sometimes lodging space does not allow for this to happen. Please advise your Camper the request has been noted and we will do our best to honor it.
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    This person has legal custody of the minor and will act as an Emergency Contact.
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  • 15
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  • 16
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    • Strong swimmer
    • Average swimmer
    • Struggling swimmer
    • Unable to swim
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  • 17
    This includes food, environmental, and medical allergies
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  • 18
    Please include food, environmental, and medical allergies.
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  • 19
    This includes prescription and over the counter medication.
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    All medications (prescribed and over the counter) will be turned into our Camp Nurse for daily administration and record keeping.
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  • 21

    CAMP ACTIVITY INFORMATION

    When campers arrive, they will be given the opportunity to sign up for daily staff-led activities. All river-based activities require campers to wear life jackets provided by the camp and are overseen by Certified Life Guards. The pool will be open and overseen by Certified Life Guards as well. Some Staff led activities that are available during camp are: 

    Gel Blasters Arena (eye protection is worn)

    45 minute Canoe Trip (certified life guards are on trip)

    Springs Trip (certified life guards are on trip as well as a chase boat)

    Archery Range (only trained staff oversee this activity)

    Pellet Gun Range (only trained staff oversee this activity)

    Painting

    Crafts and much more

    **Please note: Activities will be available for sign up after campers arrive. There is no pre-registration for activities.

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  • 22
    If Camper CAN participate in ALL activities, please indicate this as well.
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  • 23

    LIABILITY WAIVER

    Functions and Activities  

    Prior to attendee’s participation in the activities provided by CAI, CAA, I acknowledge that  there are certain risks associated with the activities, including but not limited to, by way of example, physical injury due to activity related accidents, and physical injury due to transportation-related accidents, illness or even death. I give permission for the attendee to be transported in an authorized Camp Anderson, Inc., DBA; Camp Anderson  Anchored (CAI, CAA) vehicle to CAI, CAA activity locations. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware.  

    Release of Liability  

    By signing this Liability Waiver Form, I expressly warrant that the above named attendee is capable of  withstanding both the physical and mental demands of the activities discussed. I also expressly assume all risks of the attendee participating in the activities, whether such risks are known or unknown to me at this time. I  further release CAI, CAA and its leaders, employees, Officers, Directors, volunteers, and agents from any claim that my student may have or that I may have against them as a result of injury or illness incurred during the  course of participation in the activities. This release of liability shall include (without limitation) any claims of  negligence or breach of warranty. This release of liability is also intended to cover all claims that members of the  student’s or my family or estate, heirs, representatives, or assigns may have against this organization or its  leaders, employees, volunteers or agents. I further agree to indemnify and hold harmless CAI, CAA and its leaders,  employees, volunteers, or agents from any and all claims arising from the attendee's participation in its activities  and programs, or as a result of injury or illness of attendee during such activities.  

     First Aid and Emergency Medical Treatment  

    I recognize that there may be occasions where the above named attendee may be in need of first aid or emergency  medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give  permission for agents of this organization to seek and secure any needed medical attention or treatment for the  student named above including hospitalization, if in the agent’s opinion that such need arises. In doing so, I agree  to pay all fees and costs arising from this action to obtain medical treatment.  

    I give permission for camp professional medical staff to give over-the-counter medications as  needed, as well as, attending physician(s) and other medical personnel to administer any needed medical  treatment, including surgery and, again, I agree to pay for the medical treatment. I give permission for my  student to be transported to a medical center in an emergency situation.   

    Release to use Image and Likeness  

    On occasion, the CAI, CAA or its representatives takes photographs or makes an audio or videotape recording  of attendees involved in activities. Such photographs or video records may be used by staff and  participants to remember the activities and participants.  

    Local news organizations may hear of our activities or events, and our organization may invite or allow them to  photograph or record our events for news reporting on special interest features. I consent to the use of any such  audio or visual record of the above named attendee to be used, distributed or displayed as agents of the  organization see fit. This consent includes but is not limited to: photographs, videotape and audio recordings.  Furthermore, I give permission for the attendee to be interviewed by the news media, or for such photographs  and other audio or visual records to be used by the news media.  

    In addition, such photographs and audio/visual recordings may be used in publications or advertising materials  to let others know about our activities. These images may also be used by CAI, CAA or its agents to produce  ministry resources for staff training, Camp or Campus Ministries, or other uses to promote the ministry of CAI,  CAA. CAI, CAA may also make these materials available for sale to the public.  

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    I have read the above Liability Waiver Form and am fully familiar with the contents thereof. I give permission for the above named attendee to participate in the activities of this organization, including any special  events/activities during the time of event. I hereby consent to the Liability Waiver Form, including the Release of Liability above, and agree that this Liability Waiver Form shall be binding upon me, my family, heirs, legal representatives, successors, and assigns.
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  • 25

    REGISTRATION FEE INFORMATION

    Registration fee: $350.00

    Camper Deposit

    Deposits are required for registration to be completed for the camper. The deposit amount due at registration is $100.00. The remainder of the balance is due by April 27, 2026.

    Camper registration ON or AFTER April 27, 2026 requires the balance to be paid in full to complete registration. 

    Camper Registration Paperwork

    Camp Anderson Anchored's registration is digital. We require each camper to complete a Camp Registration Form, have a signed Liability Waiver by their Guardian, and to submit a Camper picture with their registration. 

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  • 26
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  • 27
    You may choose to pay the deposit of $100.00 now or the full amount. Camper balances are to be paid in full by May Camp registration must be paid in full if registering camper after April 27, 2026.
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