2023 SUMMER CAMP • Redeemer's Church

2023 SUMMER CAMP REGISTRATION FORM

Join us at Camp Pondo for Summer Camp!

Dates: July 31st - August 4th, 2023

Cost: $500 per camper

Location: Camp Pondo

DEPOSIT IS $50 UPON REGISTRATION.

CLICK HERE TO PAY DEPOSIT ONLINE

(REMEMBER TO SELECT THE ACCOUNT "STUDENT MINISTRY SUMMER CAMP" AND ADD STUDENT NAME FOR MEMO/NOTES)

MARCH 17TH 1ST PAYMENT OF $100
APRIL 17TH 2ND PAYMENT OF $100
MAY 17TH 3RD PAYMENT OF $100
JUNE 17TH 4TH PAYMENT OF $100
JULY 17TH REMAINING BALANCE DUE

ALL DEPOSITS/PAYMENTS ARE NONREFUNDABLE.

FUNDRAISING OPPORTUNITIES AVAILABLE:

Calendar Fundraiser (Month of March)
"Good Friday" Dinners (April 7th)
Fireworks Stand (June 28th-July 5th)

Student's Info

First Name *

Last Name *

Gender *

Date of Birth *

Home Address *

Home City *

Home State *

Home Zip Code *

Mobile Number *

Parent/Guardian Info

You will also be listed as the emergency contact for this student.

Parent or Guardian's Name *

Parent or Guardian's Mobile Number *

Parent or Guardian's Email Address *

Alternate Phone Number

Second Emergency Contact

Emergency Contact Full Name *

Mobile Number *

Alternate Phone Number

Medical History

Does the student have any medical conditions? List below.

Does the student have any allergies?

Will the student need to take any medications while at camp?

Yes

List medications student will take at camp below.

List any dietary needs

Does the camper have any special physical, mental, or emotional needs?

Yes

If yes, please list and give details. Please remember this form will be kept in strict confidence.

Medical Release

I, parent/guardian, hereby give approval for my child to attend Redeemer's Church Youth Camp at Camp Pondo and relieve Camp Pondo, Redeemer's Church, and all affiliated staff from any and all liability for sickness, accidents, or injuries, while attending or being transported to/from the camp facilities. In the event of an emergency, and I cannot be contacted, I give my consent to the camp director and camp medical nurse to authorize medical help onsite or at an appropriate medical facility.

By typing your name below, you are agreeing to the terms above electronically. You agree that your electronic signature is the legal equivalent of your manual signature. *

Photo Release

I give permission to the Redeemer's Church staff to use pictures/video of my child for the purposes of promoting a camp experience.

By typing your name below, you are agreeing to the terms above electronically. You agree that your electronic signature is the legal equivalent of your manual signature.

Transportation

Does the student need transportation to camp? *

Yes, my student needs transportation to camp.

No, I will provide transportation for my student to camp