2026 Canoe Trip Registration Form

Canoe Trip 2026 Registration Form

(New Conference young folks will be given priority and those from other fellowships will be considered on an individual basis as camp capacity permits.)
Camper's Name*

First NameLast Name
Birthday*

MonthDayYear
Date
Age at camp*
Gender:*

MaleFemale
Email*
example@example.com

Camp Information and Rules
Camp Rules:
1. Abide by the curfew rules.
  - 11:30 pm - go to the cabins
  - 12:30 am - in cabins / lights out
2. Stay on the camp grounds at all times
3. Wear a life jacket during canoeing.
4. Guys and girls stay in their respective cabins
5. NO Fireworks, alcohol, or tabacco
6. Abide by the dress code for the entire canoe trip.
7. The cell phone compound and tower are off limits - NO EXCEPTIONS
Dress Code:
- Modesty is a part of godly behavior for both men and women. All young men are to wear long pants or jeans and shirts with sleeves. All young ladies are to wear dresses or skirts that come below the knees at all times (even if wearing leggings) and blouses/shirts that are not sleeveless, tight or low-cut.
Parents:
- We ask your assistance in upholding this dress code.
*

I have reviewed the expectations of campers and will abide by all that is asked.
Camper's Name that agrees to follow the camp rules

First NameLast Name
Parent's Name (Only needed if camper is under 18) who has reviewed the camp rules with your son/daughter and agrees to the Canoe Trip Standards.

First NameLast Name
Parent's Phone: (in the event a chaperone needs to speak with you during camp)
Please enter a valid phone number.Format: (000) 000-0000.

Medical Consent Form

2026
Camper's Name*

First NameLast Name
Do you have any allergies?*

YesNo
If allergic, to what?
Current Medications: blank Time: blank
Last Tetanus shot:

MonthDayYear
Date
Medical Conditions:
Emergency Contact Name*

First NameLast Name
Emergency Contact Number*
Please enter a valid phone number.Format: (000) 000-0000.
Permission is granted for medical treatment while participating in camp activities June 19 - 21st*

YesNo
Camper Signature:*
Parent's Name (if camper is under 18)

First NameLast Name
Parent's Signature (if camper is under 18)

Payment
Make Check Payable to: Rex or Tara Cottrell

$115 per Camper
Please send Check to

Rex & Tara Cottrell

9936 Wetzel Rd

Bradford, OH 45308
After you hit "Submit", you should receive a confirmation email with some additonal information for the weekend.
Should be Empty:

Canoe Trip 2026 Registration Form