2026 Youth Camp

2026 Youth Camp Registration
CAMPER INFORMATION
Full Name

First NameLast Name
Gender:
Date of Birth:

MonthDayYear
Date
Age:
Is this your first camp?
Are you baptized in Jesus' name?
Do you have the Holy Ghost?
T-Shirt Size:

Other
Are you required to take medication?
If so, please list medications, please also list if nurse needs to administer medication:
Please list any allergies:
By checking this bubble, I agree to abide by the District Camp Rules, Schedule, and Dress Code.
Parent/Guardian or Emergency Contact
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Relationship to Camper:
By checking the bubble, I, the camper, grant my permission to the camp staff to administer the necessary medical treatment deemed necessary for my well-being. I also agree to be held responsible for the cost of any and all damage created by me, the camper. If under 18 the parent/guardian will be responsible for any damages created by the camper.
Photo/Video Release Statement:

The district creative team will be taking pictures and video throughout our camp.
Do you give the camp media team permission to post pictures and/or videos of you without your name on our social media platforms?
Please be advised that these photos and videos, including our camp photo, will be posted on our social media platforms, without names. Campers do hold the right to tag themselves and repost these images on their personal platforms.
Pastor Information
Pastor's Name:
Church City:
As the campers Pastor, I give them permission and my blessing to attend this camp. I have made them aware of the rules and their obligation to abide by these rules. I have also ensured for them to be taken and picked up from the campground.
Form of Payment
I will pay using:
Should be Empty:

2026 Youth Camp Registration

CAMPER INFORMATION

Parent/Guardian or Emergency Contact

Photo/Video Release Statement:

Pastor Information

Form of Payment