Tomahawk Youth Camp Registration
August 30–September 1, 2025
Welcome!
Please complete this form to register your child for our overnight Youth Camp at ReviveNow Church. Campers will stay at ReviveNow Church from August 30 to September 1. This form collects all required information, medical consent, and liability waivers.All information will be kept confidential and used only for camp safety and emergency purposes.
Camper Information Section
Camper First Name
*
Camper Last Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Age on Camp Date
*
Grade (Fall of 2025)
*
Parent/Guardian Information Section
Parent/Guardian 1 Full Name
*
Relationship to Camper
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 2 Full Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Information Section
Emergency Contact Name (Other than Parent/Guardian)
*
Relationship to Camper
*
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pick-Up List
Please list ALL adults authorized to pick up your child at the end of camp. ID will be required.
Authorized Adult #1 Name
*
Authorized Adult #2 Name
“I understand that only these individuals may pick up my child unless I give written notice.” (Type Yes If Understood)
*
Medical Information Section
Does your child have any allergies?
*
Yes
No
If "Yes" Describe Allergies
Does your child have any medical conditions?
*
Yes
No
If "Yes" Describe Medical Conditions
Is your child taking any medications?
*
Yes
No
If "Yes" List Medication, Dosage, Instructions
“I give permission for Tomahawk Youth Camp staff to administer basic first aid if needed.” (Type Yes)
*
“I authorize camp staff to obtain emergency medical care for my child if I cannot be reached.” (Type Yes)
*
“I will turn in all medications in their original containers at check-in.” (Type Yes)
*
Consent & Waivers Section
📄 Please read our full Youth Camp Parent Guide & Policies before submitting this form. By signing below, you confirm you have read and agree to these terms.
Read Youth Camp Parent Guide and Policies Here
https://tinyurl.com/3canjtkv
“I understand that participation in Youth Camp may involve physical activities, overnight stays, and group transportation (if applicable). I release and hold harmless ReviveNow Church, Tomahawk Youth Camp, its staff, and volunteers from liability for accidental injury.” (Type Yes)
*
“I agree to my child following the camp’s behavior code of conduct.” (Type Yes)
*
"I acknowledge that I have read and understand all camp information and policies.” (Type Yes)
*
“I give permission for my child to be photographed/video recorded during camp. I understand these may be used in promotional materials or social media.” (This is optional, please type yes or no as you find fit for your camper and family)
*
Parent/Guardian Signature
*
Today's Date
*
-
Month
-
Day
Year
Date
Code of Conduct Agreement
“All campers are expected to show respect to staff and other campers, follow instructions, stay within camp boundaries, and behave safely. Bullying, fighting, or inappropriate behavior may result in dismissal from camp at the parent’s expense.”
Camper E-Signature
*
File Upload
*If you have any medical files you would like us to have on record for your camper, please upload them here*
File Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Continue
Continue
Should be Empty: