2026 Grange Camp Registration

July 5-11, 2026

Eastern 4H Center, Columbia, NC

Grange Camp Registration Details:

Spots for Grange Camp are filled on a first-come, first-serve basis, so we recommend getting registered as early as possible.
Registration includes optional bus transportation to and from camp, which you can sign up for below.
The camp health form must also be completed for each camper. Following the submission of this online form, you will receive an email with a link to the camp health forms. Please complete the health forms and submit them with a physical to jenniegentry@ncgrange.com. The camper's reservation is not complete until all forms are received.
Registration Deadline: May 15, 2026
Deadline for Full Payment and Health Forms: June 1, 2026

Camper Name*

First NameLast Name

MaleFemale

Birth date*

MonthDayYear

JUNIORS ARE FULL, your Junior will be put on a waiting list. Junior (ages 8-13)/Rising 3rd Grade to rising 8th gradeYouth (ages 14-20 / 9th grade and up)

Age at camp*

Grade This Fall*

Camper E-mail

Camper Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Camper Cell Phone*

Area CodePhone Number

Grange (if a member)

Guardian's Name*

First NameLast Name

Guardian's E-mail*

Guardian's Cell Phone*

Area CodePhone Number

Guardian Home Phone

Area CodePhone Number

Other emergency contact*

First NameLast Name

Other emergency contact phone*

Area CodePhone Number

YesNo

StatesvilleRaleigh

BUS TRANSPORTATION WAIVER AND RELEASE

I, the undersigned, give my consent for my child to be transported to and from Grange Camp by the bus which is chartered by NC State Grange and will assume all liability for my child’s participation in riding the bus and any injury that may result during transport to and from Grange Camp.

Parent/Guardian Name

Parent/Guardian Signature (use finger or mouse to sign)

PROGRAM AGREEMENT:

Please read carefully. Each camper and his or her parent / guardian must sign before attending camp.

I understand that my participation in the Grange Camp program is voluntary. During all activities, I will choose my level of participation. I understand that the Grange Staff consists of volunteers. I understand that the 4H staff is trained to work with and protect the physical safety of each camper in all activities and that staff will be present in all activities. I understand there are certain risks in participating and I elect to participate regardless of these risks. Therefore, I assume all responsibility in the event of injury and release the NC State Grange, its staff and counselors from all liability, damages, costs and expenses arising out of injury, loss of life or damage to personal property that may occur as a result of participating in this program.

Camper Name

Camper Signature (use finger or mouse to sign)

Parent/Guardian Name

Parent/Guardian Signature (use finger or mouse to sign)

CONSENT AND RELEASE:

I grant the NC State Grange the right to use and / or distribute photographs and video footage of my child for promotional use only. I understand that pictures from Grange Camp are used to promote its Youth and Junior Programs via newspaper, website, brochures, social media, newsletter, etc.. I give my consent to the NC State Grange to use such items for promotional purposes only, including press releases to local newspapers on awards my child may receive at camp.

Parent / Guardian Signature

Camper Signature if 18 or older

Printed Name (Parent or camper depending on age)

Camper/Guardian Signature (use finger or mouse to sign)

PLEASE READ PRIOR TO SELECTING YOUR PAYMENT BELOW!

IMPORTANT: When selecting a payment option below under My Products, please only select ONE option. The form will not go through if you select more than one option.

Paying Online: If you choose to pay online (one of the first 3 options below), after clicking “submit,” you will immediately be redirected to PayPal to make your payment. You do not have to have a PayPal account to use this feature. Simply click the link to pay with a debit or credit card.

Payment Options: Please select only ONE of these options below.

Member Rate: Select if you are a current Grange member.
First Year Camper: Select if you are attending Grange Camp for the first time. (A camper can attend their first time without being a member.)
Returning Non-Member Camper: Select if you have previously attended camp and are NOT a Grange member. (This pays your $20 dues with your camp fee. Campers are required to be members after their first year.)
Pay By Check: Select if you prefer to pay with a check instead of paying online. (You may mail your check to: NC Grange, 1734 Wilkesboro Hwy, Statesville, NC 28625).
My Grange is Paying: Select if your Grange is paying for you to attend camp.
Other: Select if you would like to make a partial payment online, then fill the box under this option with the amount you would like to pay online. A PayPal Invoice will be emailed to you for the amount.

The total camp fee must be paid by June 1, 2025.

Cancellation and Refund Policy: A full refund can be issued if cancellation is made by June 26, 2026. Cancellations after that date will not be refunded.

Please Note: After submitting your registration, if you do not immediately receive an automatic confirmation email with the health form link, then your camp registration did not go through. If this happens, please re-register or contact jenniegentry@ncgrange.com or EHartsell@ncgrange.com with any questions. Thank you!

My Products*

Member Rate (must be a current member)$310.00

First Year Camper (non-member)$310.00

2nd Year Non-member Camper$330.00

Pay by check$ Free

My Grange is paying$ Free

Youth Team/Ambassador$ Free

Other$ Free

If you would like to make a partial payment online, please select "other" above and fill in the amount here. We will email you an online invoice for the amount.