DISCOUNTS AND SCHOLARSHIPS AVAILABLE

Church discounts and scholarships: Ask your church leaders if your home church supports PVCC through our partnership program. If so, they can provide you with a partner church discount code for 50% off to enter at payment on the registration form below. Your church may also offer need-based camp scholarships; ask your church leaders how to apply.

50% PVCC scholarship: If you need help paying for camp and your church does not offer a discount or scholarship, please go to www.pleasantvalleycamp.org/scholarships to apply for a 50% scholarship. If your application is approved, you will receive a coupon code for 50% off to enter at payment on the registration form below.

Please fill out and submit both this registration form and the embedded child medical form. Your child is not registered until you have submitted your payment and received confirmation emails for both the child medical form and the registration form.

Camper Information

Parent/Guardian Information

Emergency Contact Information

Medical and Emergency Information

Please fill in your child's medical and emergency information in the embedded medical form below (start by clicking "NEXT"). After you submit the embedded medical form, please continue to the bottom of the registration form to enter your payment information and to submit your registration. Your child is not registered until you have entered your payment information below and submitted the registration form.

Informed Consent and Acknowledgement

As the parent and/or legal guardian of the registered participant, I am fully aware of inherent hazards. I voluntarily allow my child to participate at Pleasant Valley Christian Camp. I assume responsibility for all risks of loss, damage, injury, or death.

GENERAL RELEASE AND WAIVER
Pleasant Valley Christian Camp activities may include (but are not limited to): basketball, baseball, soccer, volleyball, field games, hiking, swimming, archery, campfires, arts and crafts, drama; music; playground, limited transportation on and off the grounds, etc. As the parent or legal guardian of the registered participant, I agree that my child is physically able to participate in all camp activities based on a physician’s examination.

The parent or legal guardian and personal representatives, assigns, heirs, and next of kin of the registered participant hereby release, hold harmless, indemnify and defend Pleasant Valley Christian Camp (including its agents, employees, and representatives) from any and all liability for injury or damages including, but not limited to, death, bodily injury, personal injury, emotional injury, or property damage which may result from any person using the above-described property and participation in any activities.

IMAGE RELEASE AND WAIVER.
I give permission to Pleasant Valley Christian Camp to use any photographs, videos, and/or audio recordings of the registered participant for printed and online promotional materials, including website and social media, without expectation of compensation, including, but not limited to, any royalties, proceeds, and/or other benefits derived from such photographs, videos, or audio recordings.

Medical Release and Authorization

As the parent and/or legal guardian of the registered participant, I authorize diagnosis and treatment by qualified and licensed medical professionals 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 registered participant’s life, physical disfigurement, physical impairment, or other undue pain, suffering, or discomfort, if delayed.

I give permission to the attending medical professional to proceed with any medical or surgical treatment and x-ray examination for the registered participant. In the event of an emergency arising out of serious illness, the need for major surgery, or accidental injury, I understand that every attempt will be made by the attending medical professional to contact me as quickly as possible and that this authorization is granted only after a reasonable effort has been made to contact me.

I grant permission to Pleasant Valley Christian Camp and its affiliates including program staff and camp staff to provide any needed emergency treatment prior to the registered participant’s admission to a medical facility.

This release is authorized for the dates and/or duration of the registered program.

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 registered participant, in my absence.

Confirmation

BY SUBMITTING THIS REGISTRATION, 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.

Please stay on this page until it shows that your submission has been received. Check your email inbox for a confirmation message. If you do not receive a confirmation email, check your junk/spam mail folder. Please email us at office@pleasantvalleycamp.org or call us at 360-492-3451 if you do not receive a confirmation email.

Please add office@pleasantvalleycamp.org to your email contacts to make sure you don't miss any messages from us.