Youth Name
*
First Name
Last Name
Address
*
Email Address
*
Congregation (Include City)
*
Gender
*
Current Grade
*
Choose One
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
List the name of the adult accompanying you
Camp Covenant
*
• I will come to camp expecting to grow in my faith and in relationship with others, becoming a special part of the camp community. In order to do this, I covenant to follow all the rules and guidelines set by the Christian Church in Alabama Northwest Florida and any others set for this event. With this, I commit myself to the following: To be on time, attend and be attentive for all camp/conference activities and participate in them fully
• Have fun and make sure everyone else has a great time
• To respect each other regardless of age and to respect others’ feelings and thoughts
• I will not go from adult to adult until I get the answer I want
• Be myself and open to making new friends
• Be inclusive at all times
• Cooperate with the counselors, keynoter, director and other staff members at all times
• Be respectful of God’s beauty in this special place and only leave footprints behind
• To take all that I learn about God and share it with my friends, family and church.
Do you have any health problems?
*
If yes, please explain
Are you currently under the care of a physician or psychologist?
*
Do you expect to have any difficulty with normal event activities?
*
Do you have any food or other allergies?
*
If yes, please list below
Do you take any prescription medication?
*
If Yes, please list medication below
Should your child be allowed appropriate over-the-counter medications to be given as needed?
*
Photo Permission
*
I hereby give permission for my child to be included in candid shots or group photos which may appear in flyers or on the Region's website.
Parent/Guardian's Name
*
First Name
Last Name
Parent/Guardian Email Address
Parent/Guardian Number
*
(###)
###
####
Emergency Contact Number
*
(###)
###
####
Insurance Information
*
Insurance Information
*
Youth Name
*
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Date
*
MM
DD
YYYY
Payment Options
*
$130 per youth/adult
