2026 Adult, Jr. Sponsor, and Volunteer Registration Form

Name

First NameLast Name

Gender

Age

Date of Birth

Date

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Adult Sponsors/Volunteers: I have provided my legal and correct information above - and consent to a search of the National Sex Offender Public.

Is this the first time volunteering for our Youth Camp?

Church you attend?

Students you will be responsible for during camp?

If you don't know all the names, provide the name of the church.

Do you have any special skills or knowledge which can be used to enhance the camp experience for the students?

I am available to serve and help with:

Emergency Contact Info

Physician's Name and Contact Info

If you have no family doctor, please indicate by "None".

Insurance Provider and Policy Number

If none, please indicate such.

Medications: Please list all - with dosages and frequency of taking

Allergies: Food, Drug, and Natural

Health issues and concerns: Please list all

Breathing Sinusitis Bronchitis Epilepsy Diabetes Heart Dizziness Hay fever Kidneys Ears Hearing Sleep walking C-Pap Upset stomach

Any other information you want to share with the Camp Nurse / Camp Director?

Official Background Check done within the past 3 years. You can provide a copy during Monday registration if you can't upload one here.

As an Adult Sponsor, Jr. Sponsor, and/or Volunteer - I agree to download the Youth Camp Pack, read all the Camp Rules and Policies, and adhere to all the Rules and Policies without exception. I also agree to sign the Camp's Code of Conduct agreement on the first day of camp. As well, I understand I will need to complete a Vehicle Registration form if I have a vehicle on the campus and file that with the Camp Director on the first day of camp.

Camp Fee: $180 per participant.

If you are not part of a church group, the camp fee can be paid by cash or check payable to RCBA Youth Camp on the first day of camp. Churches may scholarship their students or collect the camp fee prior to registration.

If you need assistance with this form or with the camp fees, please contact us as early as possible. If the form does not submit - please use print (save to pdf) and then send that pdf to us at smbayouthcamp@gmail.com. Thanks!

Signature:

2026 Adult, Jr. Sponsor, and Volunteer Registration Form

Medical Information

Waivers