Camp AN Registration Form

Camp AN - Online Registration

The camper’s registration form must be fully submitted prior to travel. Proof of submission must be presented to the boat captain before departure. Campers who cannot provide proof of a completed registration will not be permitted to board the boat or travel to camp.
Campers Information
Please select the camp week your child will be attending.*

Kids Camp (Ages 9-12) June 15-19Teen Camp (Ages 12-18) June 22-27Both weeks
Campers Full Name*

First NameLast Name
City or Village*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth *

MonthDayYear
Date
Gender*

MaleFemale
How will your child be arriving at camp? *
If you selected other, please explain.
For Teen Camp Only: How will your teen be leaving camp on Sunday night after Family Night? *
If you selected other, please explain.
Please provide detailed information regarding any known medical conditions, allergies, or health concerns for the camper, including all medications that are required during camp. For each medication, include the name, dosage, and frequency of administration. If the camper does not require any medications, please indicate “NONE.”*
Medication Notice

Please be aware: All medications, whether prescription or over-the-counter, must be turned in to the camp nurse upon arrival at camp. Any medications not properly submitted will be confiscated and held by camp medical staff until the conclusion of camp. All medications will be administered by the camp nurse as needed and in accordance with provided instructions.

Parent or Guardian Information

Please complete all sections of this form in full. Parent/guardian information must be provided, including a valid and reachable contact method. Campers will not be permitted to travel to or remain at camp if the required information is incomplete or if parent/guardian contact information is not available.
Parent/Guardian Contact Name*

First NameLast Name
Parent/Guardian Phone Number*
Primary Number we should contact in case of an emergency or any questions. Format: (000) 000-0000.
Emergency Contact (Other than Parent/Guardian)

First NameLast Name
How is emergency Contact related to camper? *
Please list any other contacts that your child or teen may be giving permission to leave camp with? *
Note: Campers will not be allowed to leave camp or with any adult that is not listed, or without prior approval from guardian.
Note: In the event the parent or legal guardian cannot be contacted, the designated emergency contact shall be notified and authorized to make decisions as necessary on behalf of the camper. The camper may be released into the custody of, or transported by, the listed emergency contact.

Parent/Guardian Consent and Signature

By checking the box and providing your signature, you acknowledge and consent to the terms stated.
As the parent or legal guardian of the above-named camper, I hereby authorize Camp Agaiutim Nune (Camp AN), along with its staff, volunteers, and authorized representatives, to secure and/or administer medical treatment for the camper as deemed necessary in their reasonable judgment in the event of illness, injury, or accident. I understand that every reasonable effort will be made to contact the parent/guardian or listed emergency contact; however, I acknowledge that such medical treatment may be provided prior to contact if circumstances require immediate attention. I accept full financial responsibility for any and all medical care, treatment, or related services rendered on behalf of the camper.

I further acknowledge and consent that the camper may be photographed, audio recorded, and/or video recorded during camp activities. I grant permission for such media to be used by Camp AN for promotional, ministry, or informational purposes without compensation or further notice.

I acknowledge and agree that Camp AN, its staff, coaches, volunteers, and affiliates shall not be liable for any loss, theft, or damage to the camper’s personal property. The camper is solely responsible for the care, security, and safekeeping of all personal belongings brought to camp.

As the parent or legal guardian, I understand and agree that if my child is found in possession of any illegal or banned items, or if their behavior is deemed inappropriate or disruptive, camp leadership reserves the right to dismiss the camper. In such instances, the parent/guardian will be required to arrange for and assume responsibility for the camper’s return home. Should camp staff facilitate transportation, the camper will not be allowed to return to camp without the express permission of the camp director.
Signature*

Payment Information

Payment is not required upon submittion of this form.
To Pay Online
If you would like to pay online, please visit the website below to make your payment. In the memo section, please put "Camp AN Registration" with the campers name.

Camp AN Online Payment
To Pay with Cash or Check
If you prefer to pay by check, please make checks payable to the Alaska Ministry Network. Checks may be mailed to the address below or sent with your child to camp. In the memo line of all checks, please write: “Camp AN Registration.”

Cash payments are accepted; however, cash must not be mailed and must be brought with the camper to camp. All payments brought to camp (including registration payments and any spending money for the Moose Canteen) must be presented to camp staff during check-in upon arrival.

Please ensure all cash or checks are placed in a waterproof, sealed bag (such as a ziplock) for protection during travel.

Mailing Address:
Alaska Ministry Network
1048 W. International Airport Road, Ste. 101
Anchorage, AK 99518

If you have any questions, feel free to reach out to us through our website contact page! We are looking forward to seeing God move in the lives of our campers!

Have Questions? Contact us Here.
If you paid online, please save your receipt and upload it here. Or you may send it with your child.

Cancelof
Please verify that you are human*
Should be Empty:

Camp AN - Online Registration

Campers Information

Medication Notice

Parent or Guardian Information

Parent/Guardian Consent and Signature

Payment Information

To Pay Online

To Pay with Cash or Check