Pursue Youth Camp

Youth Camp Information & Registration

Name *

First

Last

Age *

Are you a camper or volunteer? *

Camper
Volunteer

Sending Church *

Phone *

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Confirm Email

T-Shirt Size

Are you coming as: *

An individual registration
As part of a church registration

I (print name) *

Parent/Guardian/Applicant Full Name

being the Parent/Guardian *

/or am over 18 of the above person hereby acknowledge that the above information is correct and that I give permission for my son/daughter/ myself to participate in all the activities and abide by the camp rules supplied in the registration pack.

Signature *

Clear Signature

Parent/Gurdian Signature of Youth Camp Registration

Date *

Camp Medical and Permission Form

Please fill out this form. If the camper has a condition that requires a management plan (such as allergies or asthma) we will request this information after this form is submitted.

Emergency Contact 1

Full Name: (Emergency Contact 1. ) *

Relationship with contact 1 *

Address of contact 1

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone number of contact 1 *

Emergency Contact 2

Full Name: (Emergency Contact 2.)

Relationship with contact 2

Phone number of contact 2

Address of contact 2

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

STEP ONE: PAY $50 REGISTRATION FEE

STEP TWO: TO COMPLETE THE FOLLOWING REGISTRATION FORM

Youth Camp Information & Registration

Camp Medical and Permission Form

Media Release Form