YTH 1 - Student Registration 2026

YTH CAMP 1 - Student Registration

June 1-5, 2026
Church*
*Only check Independent if your church is not coming to this camp
Your church has not signed up for camp yet.

The MAIN CONTACT from your church must fill out the below form.

Church Registration Form
Student Information
This is my first student (full form required)I already registered one student (skip repeated info)I am only registering one student
First Name*
Last Name*
Birthday*

MonthDayYear
Date
Age*
Grade Next Fall*
MaleFemale

Parent/Guardian Information - Main Contact
Parent/Guardian Name*

First NameLast Name
Main Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Other Phone
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
Emergency Contact - Secondary Contact
Name*

First NameLast Name
Relationship to Camper*
Main Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Other Phone
Please enter a valid phone number.Format: (000) 000-0000.

Student Consent Form
After reading this entire form, along with the Camp Policies and Procedures, I hereby give permission for my child to attend Nebraska NxtGen Ministries Camp in 2026.

I certify that the medical information provided is accurate to the best of my knowledge. In the event of an emergency, every reasonable effort will be made to contact me and/or my listed emergency contact. However, if I cannot be reached, I hereby authorize Nebraska NxtGen Ministries, the Nebraska Ministry Network, and their respective agents, employees, and volunteers to secure and authorize emergency medical treatment for my child, including but not limited to transportation, hospitalization, medical treatment, surgery, and/or medications, as deemed necessary by licensed medical professionals for the health and well-being of my child.

I understand that participation in camp activities involves inherent risks. I give permission for my child to participate in all camp activities, including but not limited to: playground activities, field games (including splash kickball, soccer, and flag football), dodgeball, basketball, indoor swimming pool, go-carts, gyro, and sand volleyball.

I voluntarily assume all risks associated with my child’s participation and agree to release, waive, and hold harmless Nebraska NxtGen Ministries, the Nebraska Ministry Network, The Crossing Retreat Center, and their respective directors, officers, employees, agents, and volunteers from any and all liability, claims, demands, or causes of action arising out of or related to any injury, illness, loss, or damage incurred during participation in camp activities, except in cases of gross negligence.

I understand that participants at The Crossing Retreat Center are responsible for any damage caused intentionally or through misconduct. Any such damage will be billed directly to the participant and their legal guardian.

I have reviewed the camp dress policies with my child and understand that adherence is required.

DRESS POLICY:
Only appropriate and modest clothing is permitted. Clothing displaying indecent, suggestive, or profane writing, images, or slogans is not allowed. Shirts must not expose the midriff or sides of the torso (for both males and females).
Ladies: Bra straps and bralettes must be covered. Leggings must be worn with tops that extend to mid-thigh. Shorts and skirts must be at least mid-thigh length.
Camp staff reserve the right to require a camper or leader to change attire if deemed inappropriate.

I understand that every effort will be made to house church groups together; however, due to facility limitations and bed availability, this cannot be guaranteed.

I grant permission for Nebraska NxtGen Ministries and the Nebraska Ministry Network to use photographs, video, and audio recordings of my child for promotional, educational, and ministry purposes in any medium, without compensation.
Parent/Guardian Signature*

Credentialed Parent Name*

First NameLast Name
Credentialed Parent Minister ID Number*
Payment
Large Family Discount - $30.00
Applies if 3+ students from the same household attend any of the NxtGen summer camps.PK Discount - $35.00
Applies to students that have a parent who is a NEAG Credentialed Minister.AIM Discount - $50.00
Applies to students that are registered for AIM Trip.None apply

Camp T-Shirt - $25.00
Discounts
Merch
Total Due
EDIT REGISTRATION PRICE HERE
Card Fee
Total w/ Card Fee

PAYMENT MUST BE SUBMITTED TO YOUR CHURCH
$50 of a student's registration fee is non-refundable.

If you are unable to attend Camp a partial refund may be requested. All refunds must be requested at least 1 week prior to the start date of an the week of camp they were attending in order to be valid. If a refund is requested less than 1 week prior to the start date of Camp, no refund is available. Valid refunds will be paid in the same form that the original payment was made.

You can transfer the full amount of registration to another attendee instead of requesting a refund. Please contact us at 308.384.1234 to make this transfer.
Should be Empty:

Rows	First Name	Last Name	Birthday	Camp Attending
Student 1
Student 2
Student 3

Registration	$	287.00
Discounts	-$	{totalDue67}.00
Merchandise	$	{Merch68}.00

TOTAL DUE	$	{totalDue}.00

Registration	$	287.00
Discounts	-$	{totalDue67}.00
Merchandise	$	{Merch68}.00
Credit Card Fee	$	{cardfee71}

TOTAL DUE	$	{totalwcardFee}

YTH CAMP 1 - Student Registration

Student Information

Parent/Guardian Information - Main Contact

Emergency Contact - Secondary Contact

Student Medical Information

Insurance Information

Student Consent Form

Payment

Credit Card