Elementor #8528 Posted on January 28, 2023January 28, 2023 by Dakota Baptist Convention Camper Application Camp Registration Fee Early Bird Price (Before March 1) - 230 USDRegular Price (After March 1) - 250 USD Youth Camp - Camper Application 2023 Step 1 of 3 33% Camper InformationCamper's Name* First Last Church Attending With Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birthdate* MM slash DD slash YYYY Gender* Male Female PhoneEmail T-shirt size*All shirts are adult sizes S M L XL 2XL 3XL Responsible Party InformationParent/Guardian Name* First Last Parent/Guardian Phone*Parent/Guardian Email* Please use the same email address when applying and paying for camper registration. Secondary Emergency Contact Name First Last Secondary Emergency Contact Phone The Campers Covenant The Campers Covenant The Campers Covenant “Let no one despise you for your youth, but set the believers an example in speech, in conduct, in love, in faith, in purity.” 1 Timothy 4:12 As a camper at DBC Youth Camp 2023 I commit to set an example by following these camp rules. 1. Campers are expected to be present, on time, and at the appropriate places for all scheduled events. Campers will be in their cabin with lights out according to the schedule. Should a camper become ill, at any time, they should immediately inform their Cabin Leader/Staff Member and seek assistance from the Camp Nurse. 2. No one may leave the campgrounds without permission of the camp director. No camper may leave at any time without an adult staff member or cabin group leader. 3. Cabins and grounds are to be kept clean at all times. The church or individual causing any kind of damage is responsible to pay for the damage. All campers and leaders will participate in the daily camp clean-up times. 4. The camp nurse must administer any medications, prescription or over-the-counter. Cabin Group Leaders may not give any camper any kind medication. 5. Campers, staff, and cabin group leaders are expected to eat at every meal. Water needs to be consumed daily. Politeness and manners will be expected of each camper at every meal. 6. No personal electronic devices are to be brought to camp (this includes radios, CD players, I-pods, games, headsets, and CELL PHONES etc…). No fireworks of any kind will be tolerated at camp. Absolutely no form of tobacco, alcohol, drugs, drug paraphernalia or weapons of any kind (this includes pocket knives) will be permitted. *** Cell phones must be turned into camp administrators at registration. If parents need to keep in contact with their kids please let administration know at check in and arrangements will be made. Let’s keep camp as distraction free as possible. 7. Attire should be modest and appropriate. Shorts above arms length, crop tops, tank tops, and shirts with offensive language or graphics and underclothes showing are inappropriate at all times. Campers will be asked to change their clothing by camp staff if deemed unacceptable. Girl’s swimsuits will be a modest one-piece OR covered with a t-shirt/wet-shirt. Boy’s swimsuits are to be surfer board type only and must include a t-shirt/wet-shirt (no Speedos!). 8. Visitors of the opposite sex are not permitted inside of the cabins at any time. There will be no public displays of affections. 9. Use of inappropriate language or behavior will not be tolerated. 10. All campers will be treated with appropriate respect. However, camp staff reserves the right to search a camper’s belongings if a report of rule infringement has been made or to protect the safety of campers. Consent* I, as the camper listed on this form, agree to abide by the campers covenant. Medical Release InformationPlease list all allergies (food, seasonal, medication, etc.)Medications needed during camp (please include dosage and when taken)All medications will be turned into the camp nurse and distributed from the nursing station. Prescribed medications must be brought in its original packaging (from the pharmacy) and clearly labeled with the child's name, prescriber's name, and instructions.Consent to treat minor*I give permission/power to staff members and adult volunteers of the Dakota Baptist Convention (DBC) youth camp for all emergency treatment and medical care of my child that is necessary or desirable by the child's attending physician. I give permission to the staff at the DBC youth camp to treat minor injuries and dispense medicine. A registered nurse will be on duty at all times during the week of camp. I permit my child to attend the camp and participate in its activities. I agree that the DBC, its officers, staff, employees and volunteers will not be liable for injuries, death, damage or loss to my child. I, as parent/guardian of the camper, have read and understand the terms to consent to treat.Copy of Health Insurance CardPlease attach a copy of your Health Insurance Card with policy numberMax. file size: 100 MB.Electronic SignaturesParent/Guardian Electronic Signature*By typing in my name below, I am legally signing this form electronically. I agree that all information contained in this form is accurate to the best of my knowledge. Camper Electronic Signature*By typing in my name below, I am legally signing this form electronically. I agree that all information contained in this form is accurate to the best of my knowledge and agree to abide by "The Campers Covenant." Are you a real person?What is 2 multiplied by three?
