Camp2019 Register


- Please complete the registration form completely and accurately as possible
- More Info? Camp2019 Information
- Questions? FAQ or

Camp2019 registrations are officially closed!
We will only consider applicants on a case-by-case basis. If you are still interested in participating in Camp2019, you can sign-up for the wait-list by reaching out to


Youth · Grades 8-12

August 11 (Sun) - August 17 (Sat)
$380 per camper


Elementary · Grades 2-7

August 18 (Sun) - August 23 (Fri)
$369 per camper

SECTION 1: General Information

Week of Camp *

Camper Information

First Name *

Last Name *

Gender *

Birthdate *

Grade (in Sept) *

Contact Information

E-Mail *

Address *

City *

State *

Zip/Postal Code *

Primary Phone *

Emergency Phone *

(Camper) Cell Phone

Other Information

Transportation TO Camp *

Transportation FROM Camp *

Fluent in English *

Shirt Size *

SECTION 2: Health Insurance & Medical Information

Parent/Guardian's Name *

Do you have health insurance? *

Please be reminded that you and your family must take full responsibility over any accidents or physical incidents that must be medically addressed while at the Camp, regardless of whether or not you are insured.

**If you have selected "YES", please complete the fields denoted below.

** Insurance Company

** Policy Number

Health Notes *
* Are there any physical or health limitations (e.g. allergies) we should be aware of?
* Are there any behavioral considerations we should be aware of?
* Medical Conditions/ Medications taken?

SECTION 3: Miscellaneous


How did you find out about Camp?


SECTION 4: Terms of Registration

To complete your registration, you must read and certify to the statement below:

You acknowledge that, as a parent/guardian of the registered child, you are accepting full responsibility for sending your child to Camp2019 (sponsored by Pioneers For Christ, Core Team). You are agreeing to take responsibility for accident/health/injury-related incidents while your child is at Camp2019; Pioneers For Christ, Core Team will not be held liable for any accident/health/injury incidents throughout the duration of the Program. You are agreeing to submit to the authority of Pioneers For Christ, Core Team's leadership decisions with respect to your child. If you have any questions regarding this registration process, please contact us at