Camp Registration

Gender

Are You Coming With A Church Group

T-Shirt (Additional $10 For A T-Shirt)

T-Shirt Size

Shirt Size

Does Your Child Fall Out Of Bed Frequently?

Does Your Child Have A History Of Seizures?

Does Your Child Have Dietary Restrictions?

If Needed Which Do You Prefer?

Disclaimer: For the health and safety of all campers, Mt. Zion Baptist Church Camp requests that people with contagious conditions or diseases not be sent to or visit Camp. Furthermore, if any potential Camper has had any illness in the two weeks prior to Camp, we request that they not participate in Camp. We appreciate your cooperation and understanding in this matter of public health. Over the counter medications will be provided by our Health Services Department if needed. Please, do not send medication with the camper unless prescribed by a Doctor. All medications must be in their original labeled containers and in a Ziploc plastic bag labeled with the camper’s name and church name. In case of a medical emergency, I understand that every effort will be made to contact the emergency contacts listed above. In the event they cannot be reached, I hereby give permission to the Physician selected by the Camp Director to hospitalize, secure proper treatment, order injection, anesthetize, or perform surgery deemed necessary for my child. I also confirm that the medical information I provided is complete and accurate.

Agreement: I agree that I and my children will follow all guidelines including standards for conduct and dress set forth by Mt. Zion Baptist Church Camp. I acknowledge and accept the risks of physical injury associated with participation at Camp. The participant (or Parent/ Guardian) accepts personal financial responsibility for any injury regarding Camp and further, will hold harmless Mt. Zion Baptist Church Camp, Penn Grove Retreat, or any of their representatives for any injury or illness related to Camp. This includes any illness or injury due to the current Coronavirus situation. I agree that I am aware of the risks associated with the current Coronavirus situation, and I agree that my children are participating in Camp at our own risk. I understand that Mt. Zion Baptist Church of Brogue, PA, will not participate in any form of “contact tracing.”

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