Clone of Summer Camp 2025 Camper Registration Form
  • Living River Summer Camp 2026- Night Owl, Elementary, or Creative Camp Registration

    Pressing the "back" button of your browser will reload the form, so only use the "back" and "next" buttons at the bottom of the form pages. Once you click "submit" you cannot go back to edit your submission, but the "save" option is great if you need to take a pause in filling out the form. A copy of you submission should be emailed to you once you submit your camper(s) registration. Please contact Living River staff at office@livingriver.org if you have any questions about the registration process. Thank you and we're looking forward to summer camp!
    • Camper/Camper One's Personal Information 
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    • Camper/Camper One's Medical Information

    • Camper/Camper One's Family Information

    • Camper/Camper One's Parent/Guardian Information

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    • Camper/Camper One's Emergency Contact Information

      Please list an emergency contact for your camper in case their primary parent/guardian cannot be reached.
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    • Camper/Camper One's Healthcare Provider

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    • Camper/Camper One's Insurance Information

    • Upload a picture of your camper's insurance.

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  • Camper Two's Personal Information

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  • Camper Two's Medical Information

  • Camper Two's Family Information

    • Copy of Camper One's Family Information 
    • Camper Two's Family Information 
    • Camper Two's Parent/Guardian Information

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    • Camper Two's Emergency Contact Information

      Please list an emergency contact for your camper in case their parent/guardian cannot be reached.
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    • Camper Two's Healthcare Provider

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    • Camper Two's Insurance Information

    • Upload a picture of camper two's insurance.

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  • Camper Three's Personal Information

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  • Camper Three's Medical Information

  • Camper Three's Family Information

    • Copy of Camper One's Family Information 
    • Camper Three's Family Information 
    • Camper Three's Parent/Guardian Information

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    • Camper Three's Emergency Contact Information

      Please list an emergency contact for camper three in case their parent/guardian cannot be reached.
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    • Camper Three's Healthcare Provider

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    • Camper Three's Insurance Information

    • Upload a picture of camper three's insurance.

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  • Camper Four's Personal Information

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  • Camper Four's Medical Information

  • Camper Four's Family Information

    • Copy of Camper One's Family Information 
    • Camper Four's Family Information 
    • Camper Four's Parent/Guardian Information

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    • Camper Four's Emergency Contact Information

      Please list an emergency contact for camper four in case their parent/guardian cannot be reached.
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    • Camper Four's Healthcare Provider

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    • Camper Four's Insurance Information

    • Upload a picture of camper four's insurance.

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  • Camper Five's Personal Information

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  • Camper Five's Medical Information


  • Camper Five's Family Information

    • Copy of Camper One's Family Information 
    • Camper Five's Family Information 
    • Camper Five's Parent/Guardian Information

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    • Camper Five's Emergency Contact Information

      Please list an emergency contact for your camper in case their parent/guardian cannot be reached.
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    • Camper Five's Healthcare Provider

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    • Camper Five's Insurance Information

    • Upload a picture of camper five's insurance.

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  • Camper Consent Agreements

    The consent forms below apply to all children registered on this form. Living River's Medical and Liability Releases are required for participation and for submitting this form. If you have any questions, please email office@livingriver.org.
  • Living River: A Retreat on the Cahaba, Inc. Participant Photo and Media Release

    I understand that photos of my child or me may be used by Living River for publicity purposes in print or on social media. Names will not be printed. If I do not wish photographs of my child to be used in this capacity I will notify staff, in writing, before the beginning of the camp session. 

  • Living River: A Retreat on the Cahaba, Inc. Participant Medical Release

    I, the undersigned, give authorization for Living River's liscenced healthcare providers and staff to address the medical needs of my child according to their training and Living River's policies. I, the undersigned, understand that I will be notified in case of medical or surgical emergency involving my child. However, in the event that I or persons I have designated cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. I understand Living River will not be responsible for medical expenses incurred, but that such expenses will be my responsibility as parent/guardian. I will notify the camp director of any problems or restrictions which would affect participation in normal camp activities prior to the camp period. I also understand that the adult supervisors reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child. I agree to abide by the decisions of the director(s) in the case of sending the camper home due to illness or fails to abide by the camp rules.

  • Living River: A Retreat on the Cahaba, Inc. Participant Release of Liability and Assumption of Risk Agreement

    In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree that: 

    1. The risk of injury from activities involved in this program is significant, including the potential for permanent paralysis and death. 

    2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation. 

    3. I willingly agree to comply with terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately. 

    4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS LIVING RIVER: A RETREAT ON THE CAHABA INC., its officers, officials, agents and/or employees, other participants, volunteers, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any ILLNESS, INJURY, DISABILITY OR DEATH I may suffer, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law. 

    5. I will abide by all local, state, and federal guidelines or laws.

    For Parents/Guardians of Participants(s) of Minor Age (under age 18)- I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law. 

  • Your electronic signature below affirms the validity of the information on this form and is equally as binding as an original, manual signature. Your signature applies the above consent releases to every camper you have registered.

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  • Summer Camp 2026 Payment

  • You may choose:

    • Pay now (either the full amount or the full amount minus the Presbytery of Sheppards and Lapsley scholarship).
    • Be billed your total by Living River after Summer Camp is over (whether you apply for a scholarship or plan to pay the full amount).
    • Bill my chuch if you have made arrangements for your church to cover the cost of Summer Camp.
    • Full scholarship if you are a camper that lives in Wilcox Co.

    Scholarships- The Presbytery of Sheppards and Lapsley offers a limited number of $200 scholarships for any camper ($75 for You & Me campers). There is a limited number of scholarships, and you must complete the Presbytery of Sheppards & Lapsley application to be considered for their scholarship. If you plan to apply for a camp scholarship, please select "yes" below and $200 per camper will be taken off your total. If the Presbytery never receives your application, you will be billed the remaining total after Summer Camp. To complete the scholarship application go to http://pslpcusa.org/summer-camp/ and click the "Apply for Scholarship" button.

    Additional Assistance- If you need additional financial assistance beyond the Presbytery scholarship, please email office@livingriver.org.

    Bring a Friend Discount- If you are inviting new friends to Living River this Summer for the "Bring a Friend Discount," choose to be billed by Living River after Summer Camp so that your total reflects your discount. New friends need to both complete registration and participate in camp.

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