Camp Firebird Apprentice Track

Camp Firebird Apprentice Track

(Entering Grades 11-12)
Camper Information
Name*

First NameLast Name
Desired Name Tag
T-Shirt Size*
Gender*
Pronouns
Date of Birth*

MonthDayYear
Camper (or a member of Camper's family) has been to Camp Firebird before
Grade for 2026-2027 School Year*

Church Affiliation
Are you or your family affiliated with an Episcopal Church in the Diocese of Missouri? *
Which one?

Apprentice Track Questionnaire
The following questions are for your camper to answer. They will help us place them in roles that best fit their gifts and skills.
Tell us about three of your interests, hobbies, skills, or gifts. *
Why do you want to be an Apprentice? *
How do you experience your faith?*
Do. you have a favorite camp memory? If this is your first time, why do you want to come to camp? *

Parent/Guardian Information
Parent/Guardian's Name*

First NameLast Name
Contact Phone Number*
Format: (000) 000-0000.
Email Address*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Format: (000) 000-0000.
Emergency Contact Email*
Relationship to Camper(s)*
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Format: (000) 000-0000.
Emergency Contact Email*
Relationship to Camper(s)*

Releases
The health and safety of our campers and staff are of the utmost importance to us. Camp MoVal's nurse has the special responsibility of providing medical care and attention. The nurse treats all campers, dispenses all required medications and is available to deal with illnesses and emergencies during the entirety of the session. All campers are required to visit the nurse’s table at check-in.

Signing this form confirms that you have entered in accurate medical information about your camper, that you understand our policies listed here and on our website, and that you agree to be bound by them.
Medical Release*

I hereby give permission to the medical personnel selected by the camp director to provide routine health care; to administer medications; to order X-rays, routine tests, treatment and to release any records necessary for insurance purposes. In the event I cannot be available in an emergency, I hereby give permission to the physician selected by the camp director to secure and administer treatment, including hospitalization. I understand that I, the parent/guardian, am responsible for any fees incurred related to necessary off-site medical cares.I authorize Camp Firebird to provide or authorize any transportation or emergency medical treatment that may be necessary for my child(ren), if any should appear necessary. I understand the risks inherent in such transportation and treatment and intend the above waiver to apply equally to such transportation and treatment.All the information I have provided in this form is accurate to the best of my knowledge.
Photo, Media, and Social Media Release*

I release Camp Firebird to record—via still photo, video, audio, or other methods—likenesses of my child(ren) for use in promotional materials to be used by Camp Firebird and the Episcopal Diocese of Missouri. I understand these recordings may be edited at the discretion of Camp Firebird and the Diocese of Missouri and may be published in promotional videos, brochures, websites, newspapers, and other media. I hereby waive all rights to compensation for the use of these recordings.Please do not use the likeness of my child(ren) in promotional materials
Signature*

Cost and Scholarships
Apprentices receive a discounted rate of $300.

Scholarships No camper will be excluded becasue of the cost of camp. We have a scholarship fund available just for Campers! If you would like to request a full or partial scholarship, please choose "scholsarship" in the dropdown box below. We will send you a simple form to complete.
Please make a selection*

Apprentice Track: $300Scholarship
Will a church be covering all or part of the registration fee?*

YesNoI don't know
If yes, which church?
Please specify the name and city of the church.
If you know how much they are contributing, please enter it here.
Should be Empty:

Camp Firebird Apprentice Track

Camper Information

Church Affiliation

Apprentice Track Questionnaire

Parent/Guardian Information

Emergency Contact Information

Health Information

Medication

Medical Insurance

Immunization History

General Health History

Mental, Emotional, and Social Health

Health-Care Providers

Releases

Cost and Scholarships