2026 Zion Hill Youth Camp Registration
August 2 - 8, 2026 (Ages 13-Grade 12) $320
Camper Information
Camper Name
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Date of Birth
*
-
Year
-
Month
Day
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Desired Roomate
Home Church (if applicable)
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Medical Information and Emergency Contacts
Health Card #
*
Family Physician and Phone Number
I give permission for the medications outlined on the registration form to be administration to my child by the first aid attendant of Zion Hill Youth Camp. I consent to my son/daughter as necessary.
*
Please Select
Yes, I give permission for my child to receive first aid.
No, I do not give permission for my child to receive first aid.
In the case of medical emergency, I understand that effort will be made to contact the primary contact or the emergency contact. In the event they cannot be reached, I hereby give permission for the camp director/designate to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant.
*
Yes
No
Other
Persons Authorized to pick up campers:
*
Current Problems
*
None
Bowel Problems
Stomach Aches
Headaches
Nightmares
Sore Throats
Ear Infections
Bedwetting
Homesickness
Sleepwalking
Frequent Colds
Sinus infections
Other
Medications/Creams
*
Medical Conditions
*
None
ADD/ADHD
Behavioural disorder
Convulsions
Asthma
Hearing Problems
Seizures
Diabetes
Other
Does your child have allergies?
*
No
Yes, Please fill in details below
Allergies
*
Will your child have medications at Zion Hill?
*
No
Yes, Please fill in details below
Medications
*
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Registration and Swag
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Camp Registration
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Camp Registration
Youth Camp Registration Fee
Overnight Camp: August 2, 2026 - August 8, 2026
$
320.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
Swag
Camp Shirt
Must be ordered no later July 1st
$
17.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
Size
XS
S
M
L
XL
XXL
XXXL
Camp Bucket Hat
$
30.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
Color
Sky blue
Cotton Candy Pink
Navy
Preferred Method of Payment
*
Cash
Cheques (made payable: Zion Hill Youth Camp)
Electronic Fund Transfer (Payments@ZionHillCamp.com)
Other
Payment Email
example@example.com
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Consent and Authorization
I consent to the taking and reasonable use of videos and photography of my child named above during Zion Hill Camp. I hereby authorize that these may be only used for the following purposes (select all that apply):
*
This year we will be swimming at a local beach (to be determined). A certified lifeguard will be on duty. Please indicate whether or not your child requires the use of a life jacket. Our lifeguards will be conducting a swim test to ensure that campers are able to swim independently.
*
Yes, my child requires a life jacket
No, my child does not require a life jacket
Special Instructions and Other pertinent information
Please outline any special instructions concerning care, medication, diet, allergies, custody, etc.
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Signature
*
Submit
Should be Empty: