Redemption Youth Camp 2025 CAMPER Application

REDEMPTION YOUTH CAMP 2025
Alabama Church of God Youth & Discipleship
High School, Middle School, Kids, & Junior Camp Registration Form

DATES
High School Camp | June 9-13 | Grades 9-12
Middle School Camp | June 16-20 | Grades 6-8
Kids Camp | June 23-27 | Grades 4-5
Junior Camp | June 30- July 3 | Grades 1-3

*NOTE: Grade level marked is for the UPCOMING school year.*
However, campers in transition years between camps have the option to stay "down" a camp before moving "up" to the next camp or they can attend both. For ex: an upcoming 9th grader can attend Middle School, High School, or both if desired.

*ALL CAMPS: 2pm Check In first day; 9am Dismissal last day

RATES
Early Bird Registration Fee (Ends April 14, 2025): $125.00
Standard Registration Fee (April 15-May 26, 2025): $145.00
Late Registration Fee (After May 26, 2025): $165.00

*Full payment due upon submission of your registration form*

*All registrations are charged a $4 merchant fee*

*Note: $75 of your full payment is non-transferable and non-refundable. All partial refund requests must be submitted by email to youthsec@alacoghq.org within 20 days from the start date of students specific camp. If your student checks in at registration, NO refund will be made.
CAMPER INFO

Please fill out your child's information.
Please Select Your Camp*
Student's Age*
Student's Name*

First NameLast Name
Select One*

MaleFemale
Date of Birth*

MonthDayYear
Date
Upcoming Grade Level*
Father/Guardian Full Name*

First NameLast Name
Mother/Guardian Full Name*

First NameLast Name
Parent/Guardian Phone Number*

Area CodePhone Number
Alternative Phone Number*

Area CodePhone Number
Parent/Guardian Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

CHURCH INFORMATION

Please fill out your church information.
Do you currently attend a local Church of God?*
Name of local church you attend*
Pastor's Name*

First NameLast Name
Student Leader's Name*

First NameLast Name
Student Leader's Email*
example@example.com

ROOMMATE PREFERENCES

We cannot guarantee your roommate preference, however we will do our best to accommodate requests that are submitted at least 14 days prior to the start of your selected camp.
Room with MY Church?

YesNo
Roommate Preference
Cabin Leader Preference
CAMPER AGREEMENT
As a camper of the Church of God Youth Camp, I agree to abide by the rules and policies of the camp during my stay at camp. I understand that any deliberate breach of conduct or disregard of camp rules will necessitate disciplinary action, even to the extent of being asked to leave the camp. I understand that the Alabama Church of God Youth Camp is a private Church and Christian camp. I agree to conduct myself according to the principles and biblical beliefs of the Church of God during my participation at the camp. Any conduct which violates these principles and beliefs may be grounds for my dismissal from the camp, the transportation and other costs of which will be my responsibility. The camp administration retains full and sole discretion to dismiss me from the camp, for any reason it deems necessary.
Camper's Name

First NameLast Name
Camper's Signature*

CAMP VIDEO OPTIONS
Pre-Order Camp Video (Digital Download)*
Video will be emailed to email address provided on this registration after camp is concluded.

Camp Electives
Select an elective for High School Camp*
Select an elective for Middle School Camp*
Select an elective for Kids' Camp*
Select an elective for Junior Camp*

Payment Page

*Note full payment due upon submission of this form* -Canteen cards are available for purchase at KIDS & JUNIOR CAMP ONLY. -Digital Camp Video sales will be available at all camps for $10 or you can pre-order on this application.

My Products*

Youth Camp Standard Registration Fee$149.00

$145 Registration Fee + $4 Merchant Fee

KIDS Camp - CANTEEN/CASH CARD $10.00

Quantity
Item subtotal:$0.00

JUNIOR Camp - CANTEEN/CASH CARD$10.00

Quantity
Item subtotal:$0.00

Camp Video - Digital Download$10.00

Enter coupon

Total $0.00

Should be Empty:

CAMPER INFO

CHURCH INFORMATION

ROOMMATE PREFERENCES

CAMPER AGREEMENT

Medical Information

A parent/guardian must complete this section.

INSURANCE INFORMATION

Parent / Guardian must complete this section

CAMP VIDEO OPTIONS

Camp Electives

Payment Page