Camp Zorah Registration

Camp Zorah Registration

Calvary Baptist Church -> Week 1 - Ages 7 - 11
Event Attending

Week 1 - Ages 7 - 11 --> July 6-9, 2026 (if you selected the incorrect form, please close this form and access the Week 2 form on the church website.)
Camper Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Adult or Child Tee Shirt?
Please select whether the tee shirt should be adult or child size, then specify the tee shirt size in the next field
Please enter Camper's Tee Shirt Size
Enter camper's Tee Shirt size so we can provide a tee shirt that fits.

Emergency Contact and Health Insurance Information
I understand that my child must be signed in and out of camp each day by the individual dropping him/her off and picking him/her up. Only individuals listed below are authorized to pick up my child. As such, Camp Zorah will not release my child to any other individual. If my child needs to be picked up early for a pre-planned event or appointment, I will provide this information in writing to the Camp Director or Pastor along with the name of the individual who will be picking my child up early.

I authorize the following individuals to pick up my child and understand that these persons may be contacted in the event that I cannot be reached and my child needs to be picked up from Camp Zorah early, due to illness or other unforeseen circumstances.

Contact Name and Phone Number with relationship (for easy reference, please list yourself first):
Emergency Contact 1

First NameLast Name
Relationship To Camper
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 2

First NameLast Name
Relationship To Camper
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 3

First NameLast Name
Relationship To Camper
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Is the camper covered by family/medical insurance?
Insurance Company Name
Insurance Policy Number
Group Number
Insurance Company Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Insurance Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Cardholder Social Security Number
Cardholder Date of Birth

MonthDayYear
Date

Family Physician Information

Please enter family physician information below.
Family Physician Name

First NameLast Name
Family Physician Phone
Please enter a valid phone number.Format: (000) 000-0000.
Family Physician Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Camper Allergies
List all known allergies, reactions, and management treatments. If none, state None.
Medical Conditions
List all known (asthma, diabetes, fainting, etc., and treatments. If none, state None).

Medical Treatment Acknowledgement Form

Please read and fill out the information below:
As the parent or legal guardian of {camperName}, I understand and acknowledge that only basic first aid may be provided to my child while at Camp Zorah. I authorize camp staff to provide this basic treatment. Any treatment beyond what can be provided with a typical first aid kit will not be provided. No medications will be administered while at camp, to include prescription and over-the-counter medications. The parent/legal guardian or emergency contact of ill or otherwise injured campers will be notified of such an occurrence and it will be requested that the child be picked up from Camp Zorah unless an injury or medical event requiring immediate attention occurs. If such an event occurs, I agree that Camp Zorah/Calvary Baptist Church may contact emergency services who will provide care, and authorize them to do so.

Camp Zorah may provide sunscreen and/or bug repellant to campers as campers will allow, and apply these items as you specify below.
Camp Zorah staff may apply sunscreen and/or bug repellant as needed by your camper:
Please list any allergies your camper may have to any components found in sunscreen or bug repellant. If none, please indicate None.
If my child needs to carry and self-administer emergency medication, such as an epi-pen or asthma inhaler, I will inform Camp Zorah of this and agree to complete the Approval for Carrying and Self-Administering Emergency Medication Form, which requires permission from their primary health provider and parent/legal guardian. This form must be completed and submitted to the Camp Director or Pastor on the first day of camp.
I need to access and open the Approval for Carrying and Self-Administering Emergency Medication Form (if Yes, you should access the form on the church website or access below):
Approval for Carrying and Self-Administering Emergency Medication Form
Immunizations

Please respond to the questions related to your child's immunizations below. I agree to inform Camp Zorah and will indicate below if my child has not obtained normal childhood immunizations.
My child has received all childhood immunizations required to attend school.
If not, what immunizations are they lacking?
Lack of completed immunizations will not disqualify your child from attending Camp Zorah unless there is an outbreak of a specific disease of which your child has not been immunized.

Registration Fee Information

Please bring registration payment on the first day of camp. Online payment processing is not set up this year. ***Note: If you are requesting a scholarship, please reach out to Calvary Baptist Church at (207)-341-1561.***
Name of individual completing registration

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Camper Recreation Release and Assumption of Risk Form
I, the undersigned, hereby agree to release, indemnify, discharge and hold harmless from any and all liability, actions, causes of action, debts, claims and demands of every kind and nature whatsoever which I now have or which may arise from, or in connection with my participation in Recreation and/or Participation in all activities, which may include but is not limited to archery, wilderness survival, hiking, group challenges, team sports and games, and other outdoor experiences related thereto conducted by Camp Zorah, its directors, agents, employees, and associates whether paid or volunteer staff . I am doing so on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate, and acknowledge that I am assuming the risks associated with Recreation and/or Participation in any other activities as follows:

I acknowledge that during the Recreation and/or Participation in all activities described in this form and in which I am participating, under the arrangements of Camp Zorah, there are certain risks and dangers present which are inherent in the activity. I also agree that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. I am aware that during the Recreation and/or Participation in all activities in which I am participating under the arrangements of Camp Zorah, that the inherent risks and dangers include but are not limited to: hazards of falling debris, burns, falls or slips while walking, hiking, or climbing on terrain that is not improved, and equipment failure. I also agree that there are unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I also acknowledge that some risks are increased as a result of my own physical condition and that these risks may not be known to Camp Zorah. By its very nature camp is situated on terrain that may include undulations, tree roots, rocks and other characteristics that make mobility more difficult. Camp Zorah therefore strongly suggests that guests take extra care when walking across our campus. Camp Zorah also suggests that sturdy walking shoes be worn. Failure to follow these instructions will increase your risk of injury. Camp Zorah also asks that you share this information with any guests who may be at camp with you.

My participation in this Recreation and/or Participation in all activities is purely voluntary, and I elect to participate in spite of the risks. In consideration of and as part payment for the right to participate in such Recreation and/or Participation in all activities arranged for me by Camp Zorah, I have and do hereby assume all of the above hazards and other related risks which may be encountered on said Recreation and/or Participation in all activities including activities preliminary and subsequent thereto.

I hereby irrevocably consent to and authorize the use and reproduction by Camp Zorah, of any and all photographs which may be taken by Camp Zorah during the Recreation and/or Participation in all activities in which I am participating related thereto, for advertisement or promotional purposes, without further compensation to me. All negatives and positives, together with the prints shall constitute property of Camp Zorah, solely and completely. I further agree to obey and follow all rules, regulations, and instructions of Camp Zorah. This is a legally binding document, which I have read and understand.

I agree that any dispute concerning, relating, arising out of or referring to the subject matter of this Recreation and/or Participation in any other activities shall be resolved exclusively by binding arbitration in Maine, Somerset County, according to the then existing commercial rules of the American Arbitration Association and the substantive laws of Maine unless Camp Zorah, in its sole discretion, selects a different forum. The arbitrator and not any federal, state or local court or agency shall have exclusive authority to resolve any dispute relating to the interpretation, applicability, enforceability, conscionability, or formation of this contract, including but not limited to any claim that all or any part of this contract is void or violable. Each term and provision of this agreement shall be valid and enforceable to the fullest extent permitted by law and any invalid, illegal or unenforceable term or provision shall be deemed replaced by a term or provision that is valid and enforceable and that comes closest to expressing the intention of the invalid, illegal or unenforceable term or provision.
Camper Name

First NameLast Name
Guardian Name

First NameLast Name
Parent/Guardian Signature
Today's Date

MonthDayYear
Date
Should be Empty:

Camp Zorah Registration

Event Attending

Emergency Contact and Health Insurance Information

Family Physician Information

Medical Treatment Acknowledgement Form

Immunizations

Registration Fee Information

Camper Recreation Release and Assumption of Risk Form