Teens Camp 2025 • Emmanuel Church

Early Bird (GENERAL) 0

Student's Full Name *

Grade Completed *

Gender *

Date of Birth *

Phone Number *

Father's Name *

Father's Phone Number *

Mother's Name *

Mother's Phone Number *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone Number *

Do you give permission for camp staff to give basic over-the-counter meds to your child if necessary? *

Tip: (tylenol, ibuprofin, benedryl, tums, pepto bismol, etc...)

Medical Issues/Allergies

Tip: If you require medication, you will need to give it to the nurse, and go to her to get it when you need

Required Medication *

T-Shirt size (adult sizes) *

Do you attend Teens or are you a member of Emmanuel Church? *

I attend teens

i don't attend teens but we are church members

I graduated 6th grade Sunday School

I don't attend teens and we are not church members

Tip: This registration is for those who attend Teens or are members of Emmanuel Church

This registration is for those who attend Teens or are members of Emmanuel Church *

Do you agree to follow the camp rules? (No phones, no money, appropriate clothing required, bags will be checked, no medication without prior notification) *

I agree to follow the camp rules

Liability Waiver: I am aware that participation in the Emmanuel Teen Camp has some inherent risks and injury can occur. On rare occasions these injuries can be serious. In consideration of my child being allowed to participate in the Emmanuel Teen Camp, I, the parent or guardian, assume the risk of all injury and agree not to sue Emanuel Teen Camp, the camp site, camp directors, coaches, leaders, or volunteers for any and all injuries caused by or resulting from participating in the Emmanuel Teen Camp. By signing this waiver, I also authorize the use of pictures of my child to be posted on the Emmanuel web site or advertising media published by Emmanuel church. I understand that the Camp Insurance Policy provides secondary coverage, and I provide primary coverage for my child.

Do you agree with the statement above?

I agree to the statement above

Anything else we need to know

Early Bird (7th & 8th GRADE BOYS ONLY) 0