Medical Form

The Wilds Christian Camp

Chr1st Fellowship Church Registration
Name
Grade in September 2026
Age in September 2026
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Roommate Request
Guardian's Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physician Name
Physician Phone
Date of Last Tetanus Shot
Medication taken regularly & reason for taking them.
Please provide any allergies to medications, insects, food, etc.: the type of allergic reaction and treatment given.
Medical Conditions
Restricted Activities
Camper Signature
Age: Campers must be 9 years old & going into 4th grade by September 2026, or have been a 2026 graduating senior to attend camp.

Cost: $820/camper. This covers ALL camp-related fees: Wilds fees (with $30 Wilds Bucks), travel meals, lock-in activity, van maintenance, gas, road snacks, etc.

Fundraising: We have several fundraising events scheduled. All campers are welcome to participate in all fundraisers & will receive a portion of profits from each fundraiser they participate in.

Balance Owed: Any balance left after fundraising ends is the responsibility of the camper. All balances are owed by July 19, 2026.

Registration Fee: There is a $50/camper registration fee due upon the submission of this form. The registration fee is deducted from each camper total, making your remaining fundraising amount $770/camper. Your child will not be registered for camp unless this form & registration fee have both been received.

Registration fee can be paid via:

Venmo: @cfcwilds

Zelle: cfcwilds@gmail.com

PayPal: cfcwilds@gmail.com

CashApp: $cfcwilds

By signing below, you understand & agree to everything listed above.
Guardian Signature
Should be Empty:

The Wilds Christian Camp