2021 Summer Camp Registration
Thank you for registering your child for summer camp online! For summer 2021, we are having two single week camps for grades K-12. Please complete this form for each child you are sending to camp. You make choose more than one week for each camper.
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Camper's Full Name: *
Camper's Birthdate: *
Grade Completed at the end of the 2020 - 2021 School Year: *
Gender: *
Home Address: *
Would you like a 2021 Camp Living Waters T-Shirt?
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T-Shirt Size:
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Parent/Guardian Information
Parent/Guardian 1 - Full Name: *
Parent/Guardian 1 - Address: *
Parent/Guardian 1 - Phone Number: *
Parent/Guardian 1 - Email Address: *
Parent/Guardian 2 - Full Name:
Parent/Guardian 2 - Address:
Parent/Guardian 2 - Phone Number:
Parent/Guardian 2 - Email Address:
Emergency Contact Information
Please enter two additional adults that can be contacted in case of emergency, not including the parent/guardian listed above.
Emergency Contact 1 - Full Name: *
Emergency Contact 1 - Relationship to Camper: *
Emergency Contact 1 - Phone Number: *
Emergency Contact 2 - Full Name: *
Emergency Contact 2 - Relationship to Camper: *
Emergency Contact 2 - Phone Number: *
Will the parent/guardian(s) be at home during the camp session? *
Camp Information
Summer Camp at Living Waters is the year we "Come Together"! This year we are trying something new by offering two single week camps for grades K-12 children. We will have extra staff and safety measures in place due to COVID-19 regulations.
My child will be attending: *
Cabin Mate Preference:
Payment Information:
My church will be paying the following amount:
Church Name:
Scholarship Amount Requested:
It is not guaranteed that requested amount will be given, scholarships are awarded on a first-come, first-serve basis.
Covenantal Agreement
Please review this and initial for each item.
The named camper has my permission to engage in all camp activities except as noted on their medical form.
Initial below:
I give permission for the named camper to be photographed or electronically recorded for future interpretive and promotional efforts of Living Waters.
Initial below:
I (parent & guardian) understand there is a policy prohibiting campers from having call phones at camp.
Initial below:
I give permission to transport camper off-site with a licensed driver over age 21.
Initial below:
We (parents/guardians & campers) understand policies prohibiting campers from engaging in behavior that is illegal or harmful to themselves or others. We also understand that campers may be sent home for breaking camp rules and there will be no refund of the camp fee.
Initial below:
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