Junior Camper Form

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Junior Camp Registration + Emergency Medical Form

JUNIOR CAMP REGISTRATION FORM

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

JUNIOR CAMP AGES:
Children 6-12 years of age (Note: 6 year olds may register in Jr. Camp or Family Camp, if your 6yr old is not able to groom or dress themselves they will be required to stay in their parents/guardians cabin every night and can report back to their assigned counselor in the morning for daily activities, and 12 year olds may register in Jr. Camp or Sr. Camp. If you choose to register your child in Family Camp or Sr. Camp, you will need to obtain the appropriate Registration Form - DO NOT use this form.
BED ASSIGNMENT: All Jr. Campers will be assigned a bed in the designated Jr. Camp cabins/dorms only. The only exceptions that will be made are for medical conditions or disabilities that require a child to have parental/guardian assistance.

JUNIOR CAMPER'S PERSONAL INFORMATION:

PARENT/GUARDIAN INFORMATION

(If Applicable)
(If Applicable)
(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 Junior camper.

Do You Have Insurance Coverage *
(If Applicable)
(If Applicable)

MISCELLANEOUS INFORMATION

(If Applicable)
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