Heartland Church Renovate Youth

Heartland Church Renovate Youth
Camp 2026 Registration Form
Youth's Information
Youth Name:
T-Shirt Size:
Parent/Guardian Information
Full Name:
Relationship to Participant:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Emergency Contact Information
Emergency Contact 1 Name:
Emergency Contact 1 Phone:
Format: (000) 000-0000.
Emergency Contact 2 Name:
Emergency Contact 2 Phone:
Format: (000) 000-0000.
Medical Information
Allergies/ Medical Concerns:
Additional Information
Please provide any additional information or requests here:
Permissions and Agreements
I, the parent/guardian, give permission for my child to attend the 2026 Renovate Youth Camp by Heartland Church. I acknowledge inherent risks and release Heartland Church and staff from liability. In emergencies, if unreachable, I authorize medical care. I have provided relevant medical/allergy info. By signing, I agree to this waiver. I understand that photos or videos may be taken during camp activities and used for promotional materials.
Payment Information
A $50 camp registration fee is required. Once registration is submitted, you will be redirected for payment. If you are sponsoring a child please select Renovate Camp sponsorship. If you are paying for your camper please select 2026 renovate summer camp payment! Thank you!
Once you have filled out this registration form it will redirect you to the Payment section!
Parent/Guardian Signature:
Date:

MonthDayYear
Date
Should be Empty:

Camp 2026 Registration Form