Youth & Children Application


All campers will need to fax, e-mail, or mail a copy of the camper's insurance card.

You can print, fill out, and mail in the "Youth & Children Camp" application OR fill it in electronically below. Online payment is available or you can submit deposit & final payment through your church.

* if camper takes more than one medication, please fax, e-mail, or mail a list of medications (include: name, expiration date, dosage, dates/time to be given, reason, possible reaction) *

Youth: July 24-28 (Completed 7th-12th grade)
Children: Jul 29-Aug 1 (Completed 2nd-6th grade)
Male
Female
/ /
Yes
No
Generic Acetaminophen (Tylenol) for headaches and/or discomfort
Generic Ibuprofen (Advil) for headaches and/or discomfort
Generic Antacid for upset stomach
Epi-Pen (epinephrine injectable) emergency medication in the event of a SEVERE allergic reaction (prescription)
Yes
No

* Required