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  • Southwest Indian Ministry Camps (SIMC)Registration

  • 2026 Fall CAMP OPTIONS

  • Which camp are you registering for?*
  • Elementary Camp - September 18-20, 2026 (Ages 9-12) - Registration due before Sept 4, 2026
  • Teen Camp - October 23-25, 2026 (Ages 13-18) - Registration due before Oct 9, 2026
  • Camp Locations:

  • Elementary September Camp: Camp Chapel Rock
  • Teen October Camp: Pinerock Camp & Retreat Center
  • CAMPER INFORMATION

  • Gender:*
  • Date of Birth:*
     - -
  • T-shirt Size (Adult sizes only):*
  • Has camper attended SIMC Camp before?
  • PARENT / GUARDIAN INFORMATION

  • EMERGENCY CONTACT

  • Format: (000) 000-0000.
  • PICK-UP / TRANSPORTATION AUTHORIZATION

  • Transportation to and from camp:

  • Type a question*
  • MEDICAL INFORMATION

    Type N/A if not applicable
  • ALLERGIES

  • Food Allergies?*
  • Medication Allergies?*
  • Bee Sting / Insect Allergies?*
  • Seasonal Allergies?*
  • HEALTH CONDITIONS
  • CURRENT MEDICATIONS

  • (All medications must be turned in at check-in in original containers.)
  • PERMISSION FOR AS-NEEDED MEDICATIONS

  • In addition to the medications listed above, I give permission for SIMC staff to give the following medications that I have marked to my child as needed, according to the appropriate age/weight dosing:
  • Medications
  • CAMP EXPECTATIONS

  • I understand campers are expected to:
    • Participate respectfully in chapel, lessons, and activities
    • Follow staff instructions
    • Stay with their assigned group
    • Treat others kindly
    • Respect camp property
    • Avoid bullying, threats, or inappropriate behavior
    • Keep electronics away during scheduled activities
  • Date:*
     - -
  • PARENT / GUARDIAN AUTHORIZATION & RELEASE

  • I, the undersigned parent or legal guardian of the participant listed above, understand and agree to the following:
  • 1. Permission to Participate

  • I give permission for my child to participate in camps, retreats, travel, recreation, games, sports, swimming, hiking, field trips, classes, worship services, challenge courses, ropes courses, climbing walls, zip lines, archery, paintball, kayaking, outdoor activities, and related supervised activities operated by or in cooperation with:
    • Southwest Indian Ministry Camps (SIMC)
    • World Gospel Mission (WGM)
    • Arizona Nazarene Youth International (AZNYI)
    • Camp Pinerock
    • Chapel Rock Camp
    • affiliated churches, ministries, volunteers, and partner organizations
  • 2. Assumption of Risk

  • I understand participation may involve risks including, but not limited to, slips, falls, collisions, weather exposure, transportation incidents, illness, allergic reactions, emotional stress, equipment failure, actions of other participants, serious injury, disability, or death.
  • I knowingly and voluntarily assume the ordinary and inherent risks of participation on behalf of myself and my child.
  • 3. Release of Liability

  • To the fullest extent permitted by Arizona law, I release, waive, discharge, and agree not to sue the organizations listed above, together with their officers, directors, churches, districts, missionaries, employees, staff, volunteers, agents, representatives, and property owners ("Released Parties"), for claims arising out of participation in activities, except for conduct prohibited by law.
  • I further agree to indemnify and hold harmless the Released Parties from claims brought on behalf of the participant arising from participation.
  • 4. Rules and Conduct

  • I understand participants are expected to follow camp rules, safety instructions, and behavioral standards.
  • Camp leadership may restrict activities, contact parents, or dismiss a participant early if necessary for safety, discipline, health, or program integrity. If early pickup is required, transportation home is the responsibility of the parent/guardian unless otherwise arranged.
  • 5. Medical Authorization

  • I authorize camp leadership, staff, and designated adult leaders to provide routine first aid.
  • If illness or injury occurs and I cannot be reached promptly, I authorize licensed medical professionals to provide emergency medical, dental, surgical, diagnostic, ambulance, anesthesia, hospital, or related care deemed reasonably necessary.
  • I understand reasonable efforts will be made to contact me.
  • 6. Insurance / Financial Responsibility

  • I understand I am responsible for medical costs not covered by insurance, AHCCCS, tribal health services, Indian Health Service, or other benefit programs.
  • 7. Medication Permission

  • If my child brings medication, I understand it must be turned in according to camp policy unless otherwise directed. Prescription medication must be in the original labeled container and will be administered according to instructions and camp procedures.
  • 8. Transportation Permission

  • I give permission for my child to be transported for camp-related purposes by approved drivers, staff, church vans, buses, rental vehicles, or authorized private vehicles.
  • 9. Media Release

  • I grant permission for the participant's first name, image, voice, testimony, artwork, or likeness to appear in photographs, videos, livestreams, newsletters, websites, printed materials, and social media for ministry, educational, or promotional purposes without compensation.
  • 10. Governing Law

  • This agreement shall be governed by the laws of the State of Arizona. Any legal proceeding shall be brought in a court of competent jurisdiction in Arizona unless otherwise required by law.
  • 11. Certification

  • I certify that I am the legal parent or guardian of the participant, the information provided is accurate to the best of my knowledge, I have read and understand this document, and I sign voluntarily intending to be legally bound.
  • PAYMENT INFORMATION

  • SIMC Camps is a ministry of World Gospel Mission. Camp costs are covered through a combination of donations and camper fees.
  • The actual cost of a weekend camp is approximately $250 per camper, but thanks to generous supporters, we ask each camper to contribute just $60 to help offset expenses.
  • We never want finances to prevent a child from attending camp. If your family is unable to pay the full $60, we invite you to give a donation that fits your situation—every bit helps.
  • If you're able and would like to sponsor another camper, you're welcome to give more than the suggested amount.
  • Thank you for your understanding and support!
  • To make a payment, visit www.SIMcamps.com/camp and click the Pay Online button under your camp.
    or you can send a check payable to WGM to SIMC Camp, 14202 N 73rd Ave., Peoria, AZ 85381
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  • Chapel Rock Participant Information and Release of Liability Form

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