Family Camper Form

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Family Camp Registration + Emergency Medical Form

FAMILY CAMP REGISTRATION FORM

A separate Medical Emergency Form must be completed for each applicant listed below.

FAMILY CAMP AGES:
Adults who are 18 years of age and up and children who are newborn through 6 years of age (Note: Children who are 6 years old may register as a Jr. Camper. If they choose to register in Jr. Camp, you will need to obtain the appropriate Junior Camp Registration Form - DO NOT use this form.)

FAMILY CAMPER'S PERSONAL INFORMATION:

LIST SPOUSE AND CHILDREN (only newborn through 6 years of age) IF THEY ARE FAMILY CAMPERS WHO ARE LODGING WITH YOU:
(Note: All other family members must fill out a separate form for the appropriate camp they are registering with.):

(If applicable)
(newborn through 6 years of age, if applicable)
(newborn through 6 years of age, if applicable)
(newborn through 6 years of age, if applicable)
(newborn through 6 years of age, if applicable)
U.P.C.I. PASTOR'S INFORMATION:

LENGTH OF STAY:

What Nights Will You Be Staying?

EMERGENCY MEDICAL FORM

A separate Medical Emergency Form must be completed for each family camper.

Do You Have Insurance Coverage *
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