Adult Registration Form

  • Adult Registration Form

    For Ages 19 and Older June 28th - July 3rd, 2026 at Laurel Lake Baptist Camp - $150 per person
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Date of Birth*
     - -
  • Have you ever had problems with the government or police?*
  • Have you ever been convicted of a criminal offense involving sexual abuse?*
  • Are you currently under church discipline or receiving any ongoing counseling?*
  • Please select the area(s) in which you would like to participate - All volunteers must select at least one area)*

  • I have read, completely understand, and hereby agree to obey the rules and regulations of participation in Camp Adullam activities and hereby assert that I have accepted Jesus Christ as my personal Lord and Savior and will exemplify a Christ-like character while participating in Camp Adullam. I hereby agree to follow the leadership of the Camp Adullam / Laurel Lake Baptist Camp Directors and Staff.

  • Today's Date*
     - -
  • BY ACKNOWLEDGING AND SIGNING ABOVE, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
  • All medical information will be completed on the next page. Please be sure to submit a copy of your insurance card.

  • Emergency Contact Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Medical Information

  • In case of needed medical attention, permission is given to Camp Adullam/Laurel Lake Baptist Camp and its designee to seek appropriate medical care for the above-referenced participant. 

     

    For this purpose, the following information is given below:

  • Format: (000) 000-0000.

  • I, hereby state that as the above-named Camp Adullam participant, is in good physical condition and has no contagious or infectious disease or symptoms of the same as of this date.

  • Date*
     - -
  • BY ACKNOWLEDGING AND SIGNING ABOVE, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

  • A copy of the insurance card for the adult is required to keep on file in case of medical emergency. Please upload a copy of the front and back of insurance card below. Note: if you are taking a picture of the insurance card, please make sure the picture is clear and the information on the card is easily visible.

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