Form – Camp Areopagus

Participant's Information

Name*

First Last

Address*

Street Address City State ZIP Code

Age*

Grade (Next School Year)*

Date of Birth*

Gender*

Email*

Church Family Attends

Bunking Request (no guarantees)

T-Shirt Size*

Contact Information

Parent / Guardian Name*

First Last

Phone*

Relationship to Child*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Camp Session Information

Your child should be registered for the session that includes the school grade they will be entering the next school term.

Select a session...*

Total

$0.00

CANCELATION POLICY
Camp Areopagus incurs expenses in preparing for each camper regardless of whether the camper attends or not. However, we are able to offer a 50% refund of the registration fee if the camper is unable to attend. There are no exceptions to this policy at this time. Thank you for your understanding.

Asumption of Risk, Accident, Medical & Publicity Release/Indemnity Agreement

I understand the Camp Areopagus’ camp may be physically and emotionally demanding. I recognize and accept the risks involved in Camp Areopagus, and I assume the risks from activities. In consideration of the above, I have and herby assume all the risks of participation in the activities of camp and will hold Camp Areopagus, its employees, agents, trustees, officers, and affiliates harmless from any and all liability, I also understand that my child’s participation in Camp Areopagus’ activities is entirely voluntary. I have provided in written form any physical, mental, or psychological issue my child may be experiencing that could have an impact on his/her well-being during Camp Areopagus’ activities.

Please check both boxes below...*

I authorize photo/digital media release for the purpose of publication, websites and/or displays to promote Camp Areopagus.
I authorize Camp Areopagus staff to seek emergency treatment from a qualified individual for the above applicant.

Does your child have any medical conditions that could affect their ability to participate in camp activities?*

Yes
No

Please explain*

Is your child currently taking any medication?

Yes
No

Medications you child is currently taking...*

Does your child have any allergies, or are there any special instructions or restrictions?*

Yes
No

Please explain*

Please share any other information about your child you feel we need to know to make his/her camp experience successful. This information will only be shared with the child’s camp director and/or counselor.

Parent’s/Guardian’s Signature*

Payment Information

Hidden

Special Pricing Code

Hidden

Pricing Calculation

Total

$0.00

Credit Card

Card Details

Cardholder Name

Developing the Fundamental Four: Faith, Fire, Family, Friends

Prefer to print and mail your application?

Summer Camp Application 2023

Participant's Information

Contact Information

Camp Session Information

Asumption of Risk, Accident, Medical & Publicity Release/Indemnity Agreement

Payment Information