This section should be filled out personally by the camper applicant. Please allow the applicant to complete the following fields before moving on.
Reasons for ApplyingList/number from 1-7 the reasons you are applying (1 being the most important):
I have carefully read the application brochure or application information at www.youngdisciple.org. As the applicant, I agree to abide by all the camp codes and guidelines, and to cooperate fully with the counselors and other staff. I understand that if I fail to do so, I may be sent home at my expense and forfeit all camp fees.
IMPORTANT: Please notify the camp if applicant is exposed to any communicable illness during the three weeks prior to camp.
If parent/guardian cannot be reached, we should contact:
The person(s) authorized to pick up camper after camp:
Informed Consent and Acknowledgement
As parent and/or legal guardian of the applicant, I am in favor of the applicant attending camp and participating in all activities unless otherwise specified in writing. I hereby release the camp and its staff from liability in case of accident or illness, and I understand I am responsible for any charges incurred in treatment of my child's illness. In case of emergency, I understand an attempt will be made to contact me. I hereby give permission to the medical personnel selected by the camp directors to administer natural remedies as deemed appropriate and/or to hospitalize and administer anesthesia and medications as required, or perform surgery on my child. I also give permission for Young Disciple Ministries to use pictures taken of my child during camp for promotional and/or illustrative purposes.
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.
PAYMENT DUE DATES
* This fee will be charged if campers eat reserved GF food.** Add the amount you would like to deposit in the camp bank for store purchases. Balance remaining at the end of camp will be returned to camper.
* If you and your sibling(s) attend camp for one week, you may each subtract $15. If you and your sibling(s) attend two weeks, you may each subtract $30.