Camp Registration First Name * Last Name * Payment Method ** PayPal Check - Mailed Cash or Check - in person Sponsorship Please select your preferred payment method. Sponsoring Congregation or Person * Bayside Church of Christ Cameron Avenue Church of Christ Denbigh Church of Christ Glen Allen Church of Christ Norfolk Church of Christ OtherOther Address * City * State * Zip Code * Phone * Alt Phone Email * Gender * Male Female Age * 4567891011121314151617181920 Camp Week * Little (K-3) Elementary (3-6) All Ages (3-12) High (9-12) Home Church Optional Baptized? * Yes No Consent for Baptism * Yes No N/A T-Shirt Size * (C) Small(C) Medium(C) Large(A) Small(A) Medium(A) Large(A) X-Large Insurance Company Policy Number Policy Holder Name Cabin Mates We will attempt to accommodate requests but do not guarantee specific cabin mates. Notes Add any additional information concerning the camper. Are you registering another camper? * Yes No Consent Statement * Yes No I authorize the camp director to secure medical treatment as recommended by a physician for the camper's well-being. The camp nurse may administer any necessary treatment for minor injuries or illnesses that may arise. I agree that fees paid in advance will not be refunded for any reason other than illness and no more than HALF the original amount paid. Upon submission, the parent guardian agree to the terms set forth by this release and Camp Idlewild. Disregard for any rules/policies will result in the camper being sent home. Parent/Guardian Name * Date * Captcha If you are human, leave this field blank. Δ
