Junior & Teen Camp

Longview Junior & Teen Camp Registration

Junior: Grades 3 - 6; Teen: Grades 7-12
Teen Camp for BOYS is full! You may still register to be put on a waiting list. If a spot does not open, you will be refunded in full.
Camper Information
Which event is your child attending?*

Junior Camp 1 - July 7-12Junior Camp 2 - July 14-19Teen Camp - July 21-26
Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade in Fall*
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Church/City
Cabin Mate Request
Name of Friend
Parent/Guardian Information
Name*

First NameLast Name
Relationship*
Father, Mother, Grandparent, etc.
E-mail
Home Number*

Area CodePhone Number
Cell Number

Area CodePhone Number
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship
Phone Number*

Area CodePhone Number
Second Emergency Contact's Name*

First NameLast Name
Relationship
Alt. Phone Number*

Area CodePhone Number
Participations, Release, and Medical Agreement

While we make every effort to provide a safe and pleasant environment for each camper who attends Longview, we do require that this participation agreement be read, filled out, signed, and dated by all campers (or their parent/guardian if under the age of 18) who wish to participate in activities at Longview.

With full knowledge, I accept full responsibility for any injury or accident that may occur to myself, my spouse, or my child while participating in Longview activities. I give permission for my child to participate in activities that occur at Longview. These activities may include, but are not limited to, archery, riflery, boating, hiking, campfire activities, and active competition games.

Although Longview has taken reasonable steps to provide equipment and skilled employees so yourself, your spouse, or your child can participate in activities for which he/she may not be skilled in, we do remind you that these activities are not without risk. Certain risks cannot be eliminated due to the unique character of those activities. The same elements that contribute to the character of these activities can be cause of loss or damage to your property, accidental injury or illness or, in exteme cases, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for these activities, but we do think it is important for you to be informed and know in advance about inherent risks.

For promotional or marketing purposes, Longview reserves the right to use any audio, video, and/or photography of guests or campers participating at Longview facilities.

I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless Longview, its officers, board, agents or employees, for any and all claims for injuries, causes of action, or liability related to my child's participation in any activity occurring at Longview. This release does not apply to intentional and/or willful acts of misconduct by Longview or any of its officers, board, agents or employees.

Should Longview, or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold Longview harmless for all such fees and cost.

By signing this document, I acknowledge that if anyone is hurt or property damaged during my or my child's participation in these activities, I and/or my child may be found by court of law to have waived any right to maintain a lawsuit against Longview on the basis of any claim which has been released herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and agree to be bound to its terms.
Health or Behavioral Conditions:
Drug Allergies or Other Allergic Reactions:
Dietary Needs or Restrictions:
Medication Taken Regularly:
Activity Restrictions:
I give permission for myself or my child to attend camp at Longview. I understand that my personal insurance will provide primary coverage for medical aid and that Longview will provide excess coverage. I also understand that if myself or my child must be sent home because of disciplinary or other problems, I will assume the additional transportation cost. IN CASE OF MEDICAL EMERGENCY, I hereby give permission to the physician selected by the camp director or his agent to hospitalize, secure proper treament for, and order injection, x-ray, anesthesia, or surgery for myself or my child as named previously.

Myself or my child is immunized against the following according to H.E.W standards: Polio, Measles, Mumps, Rubella, Diphtheria, Tetanus, and Whooping Cough. (Please notify the camp if this child has been exposed to any communicable disease during the two weeks prior to camp attendance.)
Immunizations*

No, my child is not immunized.Yes, my child is immunized
Insurance Company:
Enter "None" if camper does not have insurance
Policy Number:
May camp personnel apply insect repellent if needed?*

YesNo
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature*

Clear
Any questions or comments about your registration:
Payment
You may choose to pay below with credit card through Paypal (no account needed) or you can mail in a check with at least your registration fee. You may choose to pay the full $325 camp fee ($295 if registering by April 21) or just pay the $50 registration fee now and finish paying on arrival.

* Registration fees are non-refundable, but partially transferable
All Boy spots are FULL for both JR Camps and Teen Camp!

If you would like to be put on a waiting list for Jr or Teen Boys, please complete the registration process. Your registration fee will be applied to your child's camp fee if a space becomes available. If there is no availability, you will be refunded, in full, during the week of camp.
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Registration Fee$50.00

Registration Fee

Junior or Teen Camp$325.00
If registering after April 21st

Mailing Check for $50 or other amount$ Free

Total $0.00
You will receieve a confirmation email. If you do not see it in your inbox, please check your spam folder.
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Longview Junior & Teen Camp Registration

Teen Camp for BOYS is full! You may still register to be put on a waiting list. If a spot does not open, you will be refunded in full.

Participations, Release, and Medical Agreement

Payment

All Boy spots are FULL for both JR Camps and Teen Camp!