2024 Jr High Summer Camp Registration
When: July 8th-13th
Check In: Monday from 1-2pm (Please eat lunch before arrival) 
Pick Up: Saturday 11am-12pm (We will not eat lunch Saturday)
Where: 390 Mason Rd, Humboldt, TN 38343
Cost: $235/ Participant
Contact us at cornerstonecampingministry@gmail.com
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Email *
T-Shirt Size *
Participant's Name *
Participant's Date of Birth *
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Sex  *
Grade for the 2023-24 school year *
Required
Parent's Name *
Parent's Phone Number *
Emergency Contact Name *
Emergency Contact Phone Number
*
What church do you go to? Please put more than "Cumberland Presbyterian Church". 
Examples: McKenzie CP, Milan CP, Dyer CP
*
Church's Phone Number *
Who would you like to be in your cabin? List up to three student (this does not guarantee that they will be in the same cabin). Answer "no preference" if you don't have someone you would like to room with. *

Medical Information

* Please note that the information on this form is for the sole use of Cornerstone Camping Ministry and is not available to any other individuals or groups. This means that we will not disclose any of the following information to another individual without your permission.

* Any medication should be handed into the camp nurse, and it will be supplied when needed. If the medication needs to be carried by your son/daughter this must be agreed upon with the director and nurse. All information will be kept confidential. We cannot accept responsibility for any information not declared.

Did you read the above?

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Are there any medical conditions (i.e. allergies, epilepsy, asthma, diabetes, etc.) of which we should be aware?

*

Are there any disabilities or special needs we need to know about?

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Is the student on any current medication (e.g. antibiotics)?
*

Does the student have any special dietary needs?

*

Over-the-Counter Medication Permission:

Do you give permission for your child/youth to be given over-the-counter medication as needed and as directed on the label to treat non-emergency medical conditions that do not require a doctor or hospital visit, such as a minor headache, stomachache, or allergic reaction (i.e. Tylenol, Advil, antacids, Benadryl, etc.) while at camp?

*

COVENANT

During any events hosted by Cornerstone Camping Ministry, we will do our best to live together in Christian love and fellowship as brothers and sisters  in Christ. Christian community in the family of God is based on mutual love, respect, trust, support, grace, and an intentional effort to dwell together in peace. Every member of the family is necessary and important. To create and maintain this holy atmosphere in Christian community, we agree to the following:

1.      As campers who come here in Christian fellowship to love God and one another, we will always be respectful and considerate of one another, showing love and grace whenever conflict arises.

2.      As grateful guests of Camp Clark Williamson, we will treat all facilities with respect and appreciation, promising to leave the campground in better condition than we found it. We also agree to abide by all CCW Board rules and regulations, as well as all rules of Cornerstone Camping Ministries and Cornerstone Presbytery.

3.      We will not bring or use any alcoholic beverages or smoking materials of any kind.

4.      Understanding the importance of CCW as a haven and a place of rest and respite, we promise to use any electronics (phones, tablets, etc.) responsibly. This includes abiding by the rules set by the directors of any camping event.

5.      We will not leave the campground for any reason, unless otherwise arranged with the camp directors before the event. If an emergency arises, we will first and foremost communicate with the camp directors and trust their judgment in how to proceed.

I RECOGNIZE THAT I AM JOINING A CHRISTIAN COMMUNITY. I AGREE TO ABIDE BY THIS COVENANT FOR THE DURATION OF MY TIME AT CCW. I UNDERSTAND THAT IF I BREAK THIS COVENANT, I MAY BE SEND HOME AT MY PARENTS’ EXPENSE AND MY CHURCH WILL BE NOTIFIED.

Did you read and agree to follow the covenant above?
*
A copy of your responses will be emailed to the address you provided.
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