Senior Camper Form

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Senior Camp Registration + Emergency Medical Form

SENIOR CAMP REGISTRATION FORM

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

SENIOR CAMP AGES:
Unmarried young people 12-18 years of age (Note: 12 year olds may register in Sr. Camp or Jr. Camp. If you already graduated from high school, you may register in Sr. Camp or Hyphen Camp. If you choose to register in Jr. Camp or Hyphen Camp, you will need to obtain the appropriate Registration Form - DO NOT use this form.

BED ASSIGNMENT: All Sr. Campers will be assigned a bed in the designated Sr. Camp cabins/dorms only. The only exceptions that will be made are for medical conditions or disabilities that require a young person to have parental/guardian assistance.

SENIOR CAMPER'S PERSONAL INFORMATION:

PARENT/GUARDIAN INFORMATION (IF CAMPER IS UNDER 18 YEARS OF AGE)

(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 Senior camper.

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

BREAKOUT SESSIONS

Check One Box *

MISCELLANEOUS INFORMATION

(If Applicable)
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