2026 Summer Camp Registration

(6th graders may choose to attend either camp session)

$100.00 deposit is required to hold each camper's spot.

The FULL balance is due one month before the camp session begins.

Scholarships and Financial Aid are available. Please notate if such aid is needed on the payment page and a financial aid form will be sent to you.

Camper's Information
Camper Name
Nickname (name for nametag)
Age
Date of Birth

MonthDayYear
Gender
What Grade will the camper complete in May 2026
T-Shirt Size
Camper or Family Home Email
example@example.com
Camper's home church name and city
Camper's home church and city, if not on the list above :
Which Camp are you registering for?
Please provide any information that you think is important or may affect the camper's ability to fully participate in the camp program.

Emergency Contacts

List the name of two persons who can be contacted in the event of an emergency or illness and the parents cannot be reached. Any person listed should be able to assist in contacting the parents/guardians.
Emergency Contact #1
Full Name

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Relationship to Child
Emergency Contact #2
Full Name

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Relationship to Child

Release of Liability, Statement of Understanding, and Code of Behavior

YOU MUST SCROLL THROUGH EACH ITEM AND THEN MARK AS READ!
Type first and last name of Parent below to acknowledge consent
Type first and last name above to consent
Type first and last name of Camper below to acknowledge consent
Type first and last name above to consent
Date Signed

MonthDayYear
Date

MEDICINES AND MEDICAL RELEASE
If you will be sending any medication with your child, please note it must be turned in to the nurse at check-in. All medication must be in the original prescription container, or if it is over-the-counter medicine, it must be in bottle/box and labeled.

Once you have submitted the application, you will receive a Thank You page message which will offer a link to fill out and print the Medical Release. This should be completed, printed and brought to camp at check in. A copy of the front and back of the Insurance card should also be supplied.

If you are not able to print out the form, you can complete one at check in.

Payment Section
Do you need financial assistance for the camper to attend camp? All families are expected to provide a portion of the camp fee. If you need financial assistance, you will be provided the Summer Camp Scholarship application. Once it is completed and returned, you will be contacted to discuss amounts. Families should request financial assistance from their home church prior to registering. **PLEASE NOTE – THIS REGISTRATION IS PENDING UNTIL THE FINANCIAL AID APPLICATION HAS BEEN SUBMITTED AND APPROVED.**

Camp Quarterman

Deposit

Balance is due two weeks prior to camp

$100.00 Quantity

CQ fee paid in full

$600.00

Camp Quarterman Jr.

Deposit

Balance is due two weeks prior to camp

$100.00 Quantity

CQJR Fee paid in full

$450.00

Total

2026 Camp Registration Form