Bethel Baptist Association

Camper Registration

*Required Information

SUBMIT NO LATER THAN 06/15/2026

Please choose which camp you will be attending *

	Youth Camp (Grade 7-12)
	Childrens Camp (Grade 3-6)
	Kids Day Camp (Grade K-2)

Name *

Date of Birth * mm/dd/yyyy

Gender *

	Male
	Female

Grade Completed *

Sponsoring Church / Association *

You must pay your sponsoring church to be completely registered. Make checks payable to Bethel Baptist Association.

T-Shirt Size *

Parents or Guardians *

Email Address of Parent or Guardian*

Parent or Guardian Phone *

() -

Street Address

City

State

Zip

Camp Policy Regarding Head Lice

A head check will be completed for all campers during camp check-in. If any nits or lice are found, the camper will be sent home with a refund of their registration fee, without the option of returning to camp. No exceptions will be made.

Medical Information for the Camp Nurse

IMPORTANT: List non-food allergies, physical medical concerns and/or mental health concerns. Non-prescription medicines can be listed here. DO NOT LIST PRESCRIPTION MEDICINES HERE: Prescriptions MUST be listed in the separate location on this form.

If needed may Tylenol be given by the Camp Nurse? Check if YES

If needed may Ibuprofen be given by the Camp Nurse? Check if YES

Dietary Needs and Food Allergies

IMPORTANT: Please list all food allergies and dietary requirements.

Message to the Camp Director

Detail any requests directed to the camp director.

Emergency Contact*

Name of Emergency Person to Contact

What is this person‘s relationship to the Camper?

() -
Phone Number

Alternate Emergency Contact*

Name of Emergency Person to Contact

What is this person‘s relationship to the Camper?

() -
Phone Number

Physicians Name

Insurance Company

Insurance Policy Number

LIST OF MEDICINES
In this section, please detail each medicine associated with the Camper. Only necessary PRESCRIBED medicines and ALLERGY medicines should be sent to camp, NOT vitamins and supplements. Be sure the details of the medicine come directly from the prescription label. Select the 'Add Medicine' button to add each medicine.

Church Member?

	Yes
	No

Church Name

Christian?

	Yes
	No

Baptized?

	Yes
	No

Camp Guidelines Agreement *

Mark the checkbox only if you have read and agree to the Camp Information and Camp Guidelines.

1. Camp Information
2. Camp Guidelines

I have read and agree with the Camp Information and Camp Guidelines.

Parent / Guardian Signature *

I (We), the undersigned parent(s) or guardian(s) of the above mentioned minor child, do hereby give consent for any emergency care deemed necessary by Bethel Baptist Association Camp leaders and/or the medical facility(ies) to which he/she is taken. I (We) further agree to release Bethel Baptist Association and its representative from liability for any injury or mishap which may occur at camp, including accident which may occur during transportation to or from camp. I (We) further agree to give consent to post camp pictures of my (our) child(ren) to the Bethel Baptist Association Facebook page, the Bethel Baptist Association website and any related publications, sites or pages. I (We) further agree to voluntarily provide my and/or my child's medical information to camp administrators according to HIPA.

Sign by indicating your name or email address.