Clone of 2025 Men's Retreat Registration

Family Camp August September 4-7, 2026

$50.00 Per Person or $200.00 Per Family Unit
Family Information

We are looking forward to having you!
How Many Family Members Attending
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Full Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional Minor Campers and Ages, Please List
Lodging

Cabins are available first come, first serve. There are also spaces available for tent and RV camping.
What type of lodging will your family need?
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Does any camper have any allergies (food or otherwise), chronic illness, medical conditions, physical limitations, or physical accommodation's that we need to be aware of? If yes, please list name and allergy or limitaion .
Important note to Parents and Guardians about Food Allergies: We regret that we do not have the facilities or personnel to ensure that any particular meal is free of allergens. Our staff will do our best to accommodate dietary needs but we cannot guarantee allergy-free meals. We will be glad to serve any special foods that you send (for allergies only ,please) but the participant must take personal responsibility for avoiding foods that can cause an allergic reaction.
Medical Release Authorization and Agreement not to Sue

Medical Release

I am representing myself or the Parent and/or Guardian of all named participants, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child or myself, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted in an emergency, to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination for the named participant. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the Mimbres Christian Camp and its affiliates to provide the needed emergency treatment prior to the participant's admission to the medical facility.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

RELEASE OF LIBILITY FOR HARM AND AGREEMENT NOT TO SUE

I understand that camps involve some degree of risk of bodily harm. I also understand that Mimbres Christian Camp will take reasonable measures to provide a safe environment. I understand that I/my child must act all times in a trustworthy, respectful, responsible manner while adhering to all camp rules and expectations. I agree tos stay home or keep my child home if he/she is sick or has had a fever the same week of camp. I understand that Mimbres Christian Camp cannot prevent the spread of sickness of any kind. I understand that the kitchen staff will take proper precautions regarding food allergies. I acknowledge that it is the responsibility of each participant to avoid foods which can cause an allergic reaction. I acknowledge that it is my decision for me to attend or to send my child and that he/she/I attend(s) at his/her/my own risk.

If my child is dismissed from camp, I understand that I am responsible for immediately transporting my child from the event.

The kinds of activities that may be available may include but are not limited to: hiking, running, climbing, swings, active games, campfires, playing in creek, water games, movies, woodworking, crafts, archery, shooting, activities off of camp property, worship services, and Bible studies.

I give my child permission to participate in event activities that may take place on or off of the campground property. My child will be expected to follow all camp rules and expectations in all activities.

I agree, in consideration of the privilege of my/my child’s participation in this event and I confirm that I have read this document in full. I agree I can never bring a lawsuit, sue, or make a claim against Mimbres Christian Camp and I release Mimbres Christian Camp from all liability for negligence, bodily injury, death, property damage, sickness, Covid-19, and economic harm that may happen in connection with this activity. I agree never to sue Mimbres Christian Camp.

I have full authority to sign this Authorization to Participate in Activities and Release of Liability for Harm and Agreement not to sue on behalf of my child and that there is no need of approval by anyone else. I have full authority to consent tomy own/ my child’s participation in this event and to release liability without the need for approval by anyone else.

I agree not to sue, file a lawsuit, or make claims against Mimbres Christian Camp, but if I do, I will pay all of Mimbres Christian Camp’s costs, attorney fees, and all other financial liability in connection with a claim or lawsuit.

“Mimbres Christian Camp” includes its affiliated churches, board members, staff, volunteers, sponsors, agents, and representatives.
Signature
Date

MonthDayYear
Date
Publicity Authorization

Photographs will be taken throughout the week during many events at camp. These photographs may be used for promotional materials, such as brochures, or the camp website. By signing this authorization, you give Mimbres Christian Camp Permission to use these photos for the above media.
Signature
Date

MonthDayYear
Date
Camp Rules and Expectations

At camp we desire camp to be a place where everyone has an opportunity to have fun, be valued, and experience God's love for them.

At Camp We:

1. Respect God: In what we think, say, and do

2. Respect Others: We honor and add value to every individual

3. Respect Time: Participants are expected to be prompt with camp schedule

4. Respect Property: Participants are expected to keep camp facilities in a clean and functioning order

Not Permitted at Camp:

-Tobacco Use

-Alcohol

-Marajuana

-Illegal Substances

-Pets

- Unmarried Couples Lodging Together

- Fires Outside of Designated Fire Pit

-Minors Outside of Camp Boundaries, or Using Firepit without Adult Supervision
Agreement to Camp Rules and Expections and Appropriate Camp Conduct

I/ I, the parent/guardian and my child (the participant), have read the camp rules and, expectations. We understand what is expected of participants and agree to abide by all rules and expections. If the participants do not abide by camp rules or is a risk to other campers and has to be dismissed from camp, I agree that I am responsible for immediately exiting the camp property.
Adult Signature
Date

MonthDayYear
Date
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, 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.
Should be Empty:

Family Camp August September 4-7, 2026

Family Information

Lodging

Publicity Authorization