• Kids Camp Full Registration

    Register and pay by June 15th. Full registration filled out after May 15th may not be eligible to receive the free Kids Camp T-Shirt.
  • Register as...*

  • Please visit www.thekidscamp.org/qualifications for more details on which role to select.

  • REGISTRATION INSTRUCTIONS (Camper)
    The Parent/Guardian of the Camper must fill out this form and must electronically sign the form in the Parent/Guardian Agreement & Release section.

    The Camper must also review the Agreement section with his or her Parent/Guardian and sign the Camper Agreement section.

    Payment must be sent separately. Completing this form does not constitute payment.

    Medication: All Medicine brought to camp must be in original containers from pharmacy. All medicine must be turned in to the camp nurse upon arrival at camp.

    Swimming: Campers have the opportunity each day to swim in a full-size swimming pool. There is a life-guard on-duty at all times, and there are always at least two counselors in the pool area while campers are swimming. If the camper is unable to swim without assistance, please send wear-able flotation devices for your camper.

  • REGISTRATION INSTRUCTIONS (Shepherd Counselor)
    The Parent/Guardian of the Under 18 Assistant Counselor must fill out this form and must electronically sign the form in the Parent/Guardian Agreement & Release section.

    The Under 18 Assistant Counselor must also review the Agreement section with his or her Parent/Guardian and sign the Counselor Agreement section.

    Payment must be sent separately. Completing this form does not constitute payment.

    All Medicine brought to camp must be in original containers from pharmacy. All medicine must be turned in to the camp nurse upon arrival at camp.

  • REGISTRATION INSTRUCTIONS (Cabin Counselor, 18+)
    The Counselor, 18+ must fill out this form and must electronically sign the form in the Counselor/Volunteer Agreement & Release section.

    Payment must be sent separately. Completing this form does not constitute payment.

  • REGISTRATION INSTRUCTIONS (Support Worker, 18+)
    The Support Worker, 18+ must fill out this form and must electronically sign the form in the Counselor/Support Worker Agreement & Release section.

    For those planning to come with small children, each child must be listed on this form and each one must also be registered separately. If you are a Support Worker attending with your children, you will be asked to help at camp with some task as you are able. The reason for this is to give you some sense of purpose for being at camp and some idea of what you should do with your time while you are there. We understand that if you are caring for very young children, you may only be available on a very limited basis. This is not a problem, but we still would like to give you something to do while you are there.

    Payment must be sent separately. Completing this form does not constitute payment.

  • Will you attend camp with small children who will be in your care during camp?*

  • Personal Information

    Name / Address / Phone
  • Gender*
  • Date of Birth*
     - -

  • The address and phone numbers below should be for {parentguardianName}.

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

  • Note: Please list the names of each child or grandchild whom you are bringing to camp and for whom you will be entirely responsible for at camp. 

    A separate registration form must be filled out for each child or grandchild. Please do not list children or grandchildren who will not be sleeping in a cabin with you at camp.

  • Miscellaneous

  • T-Shirt

    Size & Color
  • Date
     - -

  • For registrations received after 11:59 P.M. on May 15th, T-shirt size/color selected below may not be honored, but we will try to give everyone their size/color of choice.

  • Does {name120} want a T-shirt*

  • Note: One T-shirt may be included at no charge to each person attending camp if "Yes" is selected above. To order additional T-shirts, contact Daniel Healy (314-696-3306 or GodsKidsCamp@gmail.com)

  • T-Shirt Size (Adult)*
  • T-Shirt Size (Youth)*
  • T-Shirt Color*
  • Image field 26

  • Parent/Guardian Notice

  • Important Information for {parentguardianName}:

    We request that you not call {name120} at camp except in cases of emergency. Campers are not allowed to call home unless it is an emergency. Letters from home, however, are very important and encouraged. Send mail early to be certain that {name120} receives it before the morning of the last day.

    ---

    The mailing address for letters and postcards is:

    {name120}

    Lake Springfield Baptist Camp

    PO Box 556

    Chatham, IL 62629

    ---

    The mailing address for packages (UPS, Fedex, etc.) is:

    {name120}

    Lake Springfield Baptist Camp

    5878 Iron Bridge Rd

    Chatham, IL 62629

     

  • Health Information

    Physician / Insurance / Medicine / Health Concerns
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Has {name120} had a Tetanus booster in the past 10 years?*
  • Last Tetanus Booster Date*
     - -
  • May the camp staff administer Tylenol or Ibuprofen (Advil) for headaches, minor pain, fever, or menstrual cramps to {name120}?*
  • May the camp staff administer Benadryl for cough or allergies to {name120}?*
  • May the camp staff administer Loratidine (Claritin) for allergies to {name120}?*
  • Does {parentguardianName} want to be notified if medication other than {name120}'s prescribed medication is administered?*

  • Note: {parentguardianName} will be notified if {name120} has a fever greater than 100 oF, or if {name120} sustains any injury or illness greater than a minor cold or small cut or bruise.

  • Does {name120} have a primary care physician?*
  • Format: (000) 000-0000.
  • Does {name120} have Health Insurance?*
  • Is {primarySubscribers} the Parent/Guardian of {name120}*
  • Format: (000) 000-0000.
  • Will {name120} bring any medications (Prescription or Over-the-Counter) to camp?*

  • Please list every medication (including over-the-counter medication) that will be brought to camp. All medications must be turned in to the camp staff except for medications that must be kept close at hand for emergencies (such as inhalers). Any non-prescription medications must be accompanied by a doctor's note. All medications must be in original containers. Your pharmacy should be able to provide empty, labeled medication containers.

  • Is {name120} allergic to any medicine, foods, bee-stings, or anything else?*
  • Does {name120} use an EpiPen?*

  • Camper Agreement

  • {name120} must review the agreement below with their parent or guardian and {name120} must place their electronic signature at the bottom of this page using their finger or mouse.

    It is very important that all campers feel free to have fun and are free to hear God's voice to them during camp. For this reason, a lot of patience and gentleness will be given to campers who fail to meet these guidelines. It is our expectation that most campers will make mistakes but that the counselors will be able to have reasonable conversations with them to help them continue meeting these guidelines.

    On rare occassions, however, there are campers who do not feel they want to or can keep the guidelines listed below. In these cases, they will be sent home so it is important that the parent or guardian of the camper not sign the form on the campers' behalf.

  • Because camp is supposed to be a fun time,

    1. I agree to do my best to have fun at camp, and
    2. I agree to help others have fun by being a good sport, and being respectful of the wishes of others and the rules of the camp.

    Because camp is also supposed to be a place where anyone can hear God's voice,

    1. I agree not to bring with me to camp the following distractions:
      • Cell phones (Cell phones found in the cabins will be held until the end of camp)
      • Video games
      • CDs, DVDs, and MP3 players
      • Comic books
      • Gum, candy
    2. I agree to abide by the camp schedule each day including changes that are made to the schedule by my counselors after camp begins

    Note: A few staff members will carry cell phones with permission to be used for emergencies or other important communication related to camp. Counselors may also use cell phones for an alarm in the cabin.

    Because camp is also meant to be a place where interactions between people are always peaceful,

    1. I agree not to argue or fight with my fellow campers or with adults at camp, and
    2. I agree to cooperate in the activities that are scheduled and un-scheduled in which my cabin or group is participating at the direction of my counselors, and
    3. I agree to express my dissatisfaction in a respectful way to the adult or adults in charge which means:
      • I will not react to them by raising my voice (i.e. yelling, screaming, etc.)
      • I will not abuse them physically (i.e. hitting, kicking, etc.)
      • I will speak kindly and agreeably when speaking or responding to them

    Because camp is supposed to be a safe place for everyone,

    1. I agree to stay with my group and not to go anywhere without at least two adults with me because this ensures my own protection against harm, and it ensures the protection of others against harm.
    2. I agree to stay on the side of the campground assigned to my gender at all times which means:
      • Female campers will not cross over to the boys' side of the campground from the girls' side of the campground after group activities have ended for the day, and
      • Male campers will not cross over to the girls' side of the campground after group activities have ended for the day.
      • Neither males nor females will enter into a cabin assigned to the opposite sex at any time. All campers and counselors must be confident in privacy from the opposite sex in their private areas.
    3. I agree not to act inappropriately toward the opposite sex which means:
      • Girls and boys will not grab each other, hold on to each other, or hang on each other at any time or for any reason.
      • Girls and boys will not touch each other except for handshakes, high fives or things like it.

  • {name120} Agreement Signature

  • By my signature above I, {name120}, agree to the following: 1) I have read and discussed this agreement with {parentguardianName}, and I understand the items listed on this page; and 2) I will make every effort - by the grace of God - to honor and uphold these very important camp rules and policies.

  • {name120} Signature Date

  • {name120} Signature Date
     - -
     :

  • Shepherd Counselor Agreement

  • To participate in camp, {name120} must review this free-will, voluntary agreement below with their parent or guardian and {name120} must place their electronic signature at the bottom of this page using their finger or mouse to signify that they will choose to abide by these camp policies to the best of their ability and by the grace of God.

    It is important that {name120} honestly agrees to abide by and follow the rules written below. They are not the perfect rules, but they are important in order for Kids Camp to be a place where Kids and Adults alike can hear God's voice. {name120} is free to discuss any and all of these rules with the Kids Camp leadership to gain a better understanding of the reasoning and to suggest improvements. If you, the parent/guardian for {name120} have any concerns, you are also welcome to bring those up with the Kids Camp leadership for discussion.

    To be clear, by signing this agreement, {name120} is not asserting that they like or agree with these rules - only that they agree to sincerely and honestly keep them. The Kids Camp leadership recognizes that disagreement is normal, and requests that {name120} or their parent/guardian discuss it with them in humility and love. This is welcome and desired at Kids Camp.

    Please continue with the registration process only if {name120} truly agrees to keep these guidelines to the best of their ability. If it becomes apparent at camp that {name120} does not intend to follow these guidelines, they will be asked to leave. This is an attempt to make expectations as clear as possible to avoid this kind of conflict at camp.

     

  • Because camp is supposed to be a fun time (Trust in the living God who has given us richly all things to enjoy; 1 Tim 6:17),

    1. I agree to do my best to have fun at camp, and
    2. I agree to help others have fun by being a good example of sportsmanship to the campers, and being respectful of the adult counselors’ instructions and the rules of the camp.

    Because camp is also supposed to be a place where anyone can hear God's voice (My sheep listen to my voice; and they follow me. John 10:27),

    1. I agree not to bring with me to camp the following distractions that might present a temptation to disregard my assigned duties of shepherding:
      • Cell phones (Cell phones found in the cabins will be held until the end of camp)
      • Video games
      • CDs, DVDs, and MP3 players
      • Comic books
      • Gum, candy
    2. I agree to abide by the camp schedule each day including changes that are made to the schedule by the camp leaders and counselors after camp begins.
    3. I agree to cooperate with the planned and unplanned activities which means:
      • When another counselor or shepherd counselor is trying to communicate in a serious way with someone, I will be available to help ensure that joking, playing and loud conversations are kept separated from the serious conversation occurring in order to help prevent distractions,
      • I will not have conversations with other counselors at the expense of being with the children to whom I am assigned except on my free time, and
      • I will pay attention to the person in charge of the current activity and will be engaged in the activities with my cabin to the extent to which I am physically able.

    Note: A few staff members will carry cell phones with permission to be used for emergencies or other important communication related to camp. Counselors may also use cell phones for an alarm in the cabin.

    Because camp is also meant to be a place where interactions between people are always peaceful (My peace I give unto you; not as the world gives, give I unto you. John 14:27),

    1. I agree not to publically discuss personal matters that pertain to the campers in ways that would embarrass them or needlessly expose them;
    2. I agree to cooperate in the activities that are scheduled and un-scheduled in which my cabin or group is participating at the direction of my adult counselors, and
    3. I agree to express any disagreement with my adult counselor in a respectful way and to willingly be subject to the decision made regarding the disagreement.

    Because camp is supposed to be a safe place for anyone to be (The name of the Lord is a strong tower; the righteous runs into it and is safe. Proverbs 18:10),

    1. I agree to stay with my group to which I am assigned and not to leave my post without asking those who are in charge of the activity I am participating in.
    2. I agree to stay on the side of the campground assigned to my campers at all times which means:
      • Female shepherd counselors will not cross over to the boys' side of the campground from the girls' side of the campground after group activities have ended for the day, and
      • Male shepherd counselors will not cross over to the girls' side of the campground after group activities have ended for the day.
      • Neither males nor females will enter into a cabin assigned to the opposite sex at any time. All campers and counselors must be confident in privacy from the opposite sex in their private areas.
    3. I will not act inappropriately toward the opposite sex, whether they are a camper or another counselor, which means:
      • Girls and boys will not grab each other, hold on to each other, or hang on each other at any time or for any reason
      • Girls and boys will not touch each other except for handshakes, high fives or things like it

  • By my signature above I, {name120}, agree to the following: 1) I have read and discussed this agreement with {parentguardianName}, and I understand the items listed on this page; and 2) I will make every effort - by the grace of God - to honor and uphold these very important camp rules and policies.

  • {name120} Signature Date
     - -
     :

  • Counselor/Support Worker Agreement & Release

  • To participate in camp, you must review this free-will, voluntary agreement below and place your electronic signature at the bottom of this page using your finger or mouse to signify that you will choose to abide by these camp policies to the best of your ability and by the grace of God.

    It is important that you honestly agree to abide by and follow the rules written below. They are not the perfect rules, but they are important in order for Kids Camp to be a place where Kids and Adults alike can hear God's voice. You are free to discuss any and all of these rules with the Kids Camp leadership to gain a better understanding of the reasoning and to suggest improvements.

    To be clear, by signing this agreement, you are not asserting that you like or agree with these rules - only that you agree to sincerely and honestly keep them. The Kids Camp leadership recognizes that disagreement is normal, and requests that you bring it up with them in humility and love. This is welcome and desired at Kids Camp.

    Please continue with the registration process only if you truly agree to keep these guidelines to the best of your ability. If it becomes apparent at camp that you do not intend to follow these guidelines, you will be asked to leave. This is not the desired result, and this is an attempt to make expectations as clear as possible to avoid this kind of conflict at camp.

     

  • Because camp is supposed to be a fun time (Trust in the living God who has given us richly all things to enjoy; 1 Tim 6:17),

    1. I agree to do my best to have fun at camp, and
    2. I agree to help others have fun by being a good example of sportsmanship to the campers, and being kind and respectful to fellow counselors and campers.

    Because camp is also supposed to be a place where anyone can hear God's voice (My sheep listen to my voice; and they follow me. John 10:27),

    1. I agree not to use my cell phone for personal use or for photos during camp except when on my free time so as not to be distracted and not to distract others from hearing God's voice.
    2. I agree to cooperate with the planned and unplanned activities which means:
      • When another counselor or shepherd counselor is trying to communicate in a serious way with someone, I will be available to help ensure that joking, playing and loud conversations are kept separated from the serious conversation occurring in order to help prevent distractions,
      • I will not have conversations with other counselors at the expense of being with the children to whom I am assigned except on my free time, and
      • I will pay attention to the person in charge of the current activity and will be engaged in the activities with my cabin to the extent to which I am physically able.

    Note: A few staff members will carry cell phones with permission to be used for emergencies or other important communication related to camp. Counselors may also use cell phones for an alarm in the cabin.

    Because camp is also meant to be a place where interactions between people are always peaceful (My peace I give unto you; not as the world gives, give I unto you. John 14:27),

    1. I agree not to publicly discuss personal matters that pertain to the campers in ways that would embarrass them or needlessly expose them.
    2. I agree not to play pranks or practical jokes or encourage others to do so.

    Because camp is supposed to be a safe place for anyone to be (The name of the Lord is a strong tower; the righteous runs into it and is safe. Proverbs 18:10),

    1. I agree to bring up any issues or problems I see with the camp leadership as quickly as possible - whether those issues seem small or large to me.
    2. I agree to stay with my group to which I am assigned and to not leave my post without asking those who are in charge of the current activity and my cabin leader.
    3. I agree to stay on the side of the campground assigned to my campers at all times which means:
      • Female counselors will not cross over to the boys' side of the campground from the girls' side of the campground after group activities have ended for the day, and
      • Male counselors will not cross over to the girls' side of the campground after group activities have ended for the day.
      • Neither males nor females will enter into a cabin assigned to the opposite sex at any time. All campers and counselors must be confident in privacy from the opposite sex in their private areas.

    Note: Counselors may break this rule in cases of emergency - where there is a risk of serious injury to someone that must be prevented. In these cases, counselors agree to announce their actions on their two-way radio to make sure that other counselors are aware of the situation and counselors should do everything in their power to ensure they are keeping the two-counselor rule (see #11 below) under these circumstances.

    1. I agree NEVER to be alone with a camper which means:
      • Another adult can always see me clearly when I am with a camper, and
      • I can always see another adult clearly when I am with a camper.

  • By my signature above I, {name120}, agree to the following: 1) I have read and I understand the items listed on this page; and 2) I will make every effort - by the grace of God - to honor and uphold these very important camp rules and policies; and 3) I agree that I am able to participate in camp programs and activities and that neither the camp nor its staff will be held responsible for accidents or personal injuries arising therefrom. Further, I hereby acknowledge my health to be ready for camp; and 4) I authorize the director and health officer of the camp to secure any medical or emergency treatment deemed necessary if I am unable to make decisions for myself and my emergency contact, {emergencyContact}, cannot be reached.

  • {name120} Signature Date
     - -
     :

  • Parent/Grandparent/Guardian Agreement & Release

  • The Kids Camp leadership is firmly committed to the belief that God has given the parents/grandparents final say and authority in the lives of their campers. None of these rules are intended to go against that. If you as the parent/guardian of {name120} feel that participation in Kids Camp is not best for {name120} for any reason, the Kids Camp leadership is firmly committed to abiding by that decision. The purpose of these rules is help you as a parent to make the decision to let {name120} learn the valuable lessons that young people learn when not under the direct oversight of their parents/guardians while in a very safe and secure environment.

    If you, as the parent/guardian have any questions about what these rules mean, please ask the Kids Camp leadership, and if you feel that it is not in {name120}'s best interest to participate in camp for any reason, then the Kids Camp leadership is in total agreement with that decision. It is our desire that all kids should be allowed to come to camp, but we realize that Kids Camp may not be the best fit for all.

    Because camp is supposed to be a fun time for the kids (Trust in the living God who has given us richly all things to enjoy; 1 Tim 6:17),

      1. I agree to encourage {name120} to have fun at camp, and
      2. I agree to encourage {name120} to demonstrate good sportsmanship and to be kind and respectful to fellow counselors and campers.

    Because camp is supposed to be a place where anyone can hear God's voice (My sheep listen to my voice; and they follow me. John 10:27),

      1. I agree that I will not to try to seek special treatment or exceptions to the rules of camp for {name120}.
      2. I agree to let {name120}'s cabin counselors and the Kids Camp leadership work with {name120} in the same way that they do with all of the other children at camp - understanding that I can freely discuss concerns with the Kids Camp leadership, and that I have the authority and freedom, as the parent or grandparent, to remove {name120} from Kids Camp if I feel that it is not the best place for them.
      3. I agree to try my best to understand the Kids Camp policies and the reasoning for them from the perspective that Kids Camp is for every child and not only for {name120}.
      4. I agree not to use my cell phone for personal use or for photos during camp except when on my free time so as not to be distracted and not to distract others from hearing God's voice.
      5. I agree to cooperate with the planned and unplanned activities which means:
        • I will decide which activities of camp {name120} should participate in and will do my best to support their growth by allowing {name120} to participate without my help or participation with them in it. (This applies to for parent/grandparents who are physically at camp with their child - unless their child is too young to participate alone in Kids Camp).
        • I will not try to contact {name120} by phone during camp except for cases of emergency. (This applies for parents/grandparents who are NOT physically at camp with their child.)

  • {parentguardianName} Agreement Signature

  • By my signature above I, {parentguardianName}, the Parent/Guardian of {name120}, agree to the following: 1) I have read and I understand the items listed on this page; and 2) I will make every effort - by the grace of God - to honor and uphold these very important camp rules and policies; and 3) I agree that {name120} is able to participate in camp programs and activities and that neither the camp nor its staff will be held responsible or liable for accidents or personal injuries arising therefrom. Further, I hereby acknowledge {name120}'s health to be ready for camp; and 4) I authorize the director and health officer of the camp to secure any medical or emergency treatment deemed necessary for {name120} if neither I nor the emergency contact, {emergencyContact}, can be reached to make decisions regarding medical treatment for {name120}.

  • {parentguardianName} Signature Date
     - -
     :

  • Wrestling Release

  • The boys cabins may hold informal wrestling tournaments inside the cabin with multiple adult supervision. Every effort is made to prevent injuries, however, it is possible that injuries may occur. If you do not want {name120} to participate in these wrestling tournaments, please select "No" for the question below. If you agree to allow {name120} to participate in these wrestling tournaments, please select "Yes" for the question below.

     

    Note: Your answer does not impact {name120}'s eligibility for attending camp.

  • May {name120} participate in wrestling tournaments at camp?

  • May {name120} participate in wrestling tournaments at camp?

  • {parentguardianName} Wrestling Signature

  • By my signature above I, {parentguardianName}, the Parent/Guardian of {name120}, agree to the following: 1) I have read and I fully understand the risks to {name120} for bodily injury associated with his participation in wrestling tournaments at camp; and 2) I agree that {name120} is allowed to participate in wrestling tournaments at camp; and 3) that neither the camp nor its staff will be held responsible for accidents or personal injuries to {name120} arising from his participation in the wrestling tournament.

  • {parentguardianName} Signature Date

  • {parentguardianName} Wrestling Release Form Signature Date
     - -
     :

  • Driving Permission Form

  • Does {parentguardianName} agree to allow {name120} to drive a vehicle to transport themselves to camp and to leave camp when it is time for them to go home?
  • Does {parentguardianName} agree to allow {name120} to leave camp early?

  • Please note: regardless of the answer given above, {name120} will not be allowed to drive a vehicle at any time after they arrive at camp until it is time for {name120} to drive home. This is for their safety.

    If the parent/guardian has not expressly permitted {name120} to drive home early by selecting that option on this form, {name120} will not be allowed to leave campe until the camp ends.

  • By my signature above I, {parentguardianName}, the Parent/Guardian of {name120}, agree to the following: 1) I have read and I fully understand the risks to {name120} associated with my selected choice given on this page; and 2) I agree that {name120} neither the camp nor its staff will be held responsible for injuries arising from my choice; and 3) I want the Kids Camp adult staff to abide by and enforce my choice.

  • {parentguardianName} Driving Permission Form Signature Date
     - -
     :
  •  
  • Should be Empty: