Camp Session Selection

Registration deadline for all camps is 14 days prior to start date.

Please provide the information below.  If the address is the same as above for your camper, there is no need to input that information again.  We do need an emergency phone number for the primary parent/guardian.

New - please provide the information below if there is anyone in addition to the Parent/Guardian with Legal Custody that may pick up the camper.  Only the Parent/Guardian with Legal Custody and Approved Alternate Contacts will be allowed to pick up a camper. If no name is added here, the Parent/Guardian with Legal Custody will be the ONLY allowed pickup person.

If your camper requires medical treatment while at camp, your family's or camper's health insurance information will be used at the clinic or hospital.  Please provide that information below. 

This section helps our volunteer staff and medical personnel know about this camper's medical needs including:

• Any medications your camper will take during camp
• Over the counter medications allowed or not allowed to your camper
• Allergies, diet, nutrition, and vaccinations
• General health questions and any restrictions
• Social & Emotional Health

Allergies: Camp attendees with chronic allergies are encouraged to start allergy medications in the weeks leading up to the start of camp and should send allergy medication with their attendees to the event.

Additional Medical History Information may be given and can be in addition to the above check marks - for example, frequent nosebleeds does not mean the camper is not generally healthy.

If your explanation about this camper's health exceeded the space(s) above, please use this section to provide additional information that you think is important or that may affect the camper’s ability to fully participate in the camp program, or contact the Northern Lights Regional Office at [email protected] / 253-893-7202 ext. 1.

The undersigned person represents that they are the custodial parent/legal guardian of the above identified participant.
The camper has my/our permission to attend the indicated camping program sponsored by the Northern Lights Region of the Christian Church (Disciples of Christ) as scheduled during the month of July 2025.

• In case of medical emergency, I/we understand that every effort will be made to contact a parent or guardian of the camper. In the event I/we cannot be reached, I/we hereby grant permission to the camp staff to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for the child while attending camp. I/we further release the camp directors, volunteer counselors, onsite staff, and the Christian Church (Disciples of Christ) in the Northern Lights Region from responsibility and liability for any accidents or illnesses occurring during camp. I/we also authorize the camp director or medical supervisor to dispense non-prescription drugs (i.e. Tylenol; ibuprofen) if the situation warrants, unless otherwise stated.
   
• I/we understand that the camping experience grows in intensity as the week progresses. I/we recognize that missing any part of the week compromises my child’s experience of intentional Christian community and affects both my individual child and the camp community as a whole. I/we know that the demands outside this camp event may be in conflict with the commitment to spend a week apart in Christian camping, and I/we have chosen to have my child spend a week at camp uninterrupted. Thus, I/we agree to not text or call my child/youth during the week of camp.  I/we acknowledge that I/we will be personally responsible for picking up my youth from the event if they violate any part of the covenant below.
   
• NEW - No camper cell phones/electronic communication devices are allowed at Disciples camps held at GWINWOOD RETREAT CENTER:
  I/we understand that Northern Lights Region camps at Gwinwood Retreat Center aim to create an immersive and spiritually enriching experience, and that a no-cell phone (and other electronic communication devices) policy ensures full engagement in real-life activities, builds meaningful connections, allows a child/youth's brain to rest and reset, and embraces the beauty of God's creation and natural surroundings. Thus, I/we agree to leave all electronic communication devices at home. I/we understand that campers who fail to adhere to this and bring devices to camp must voluntarily turn them over at check-in, and that they will be securely stored until the end of the week. Repeated failure to follow the no-device policy will result in a child/youth being sent home from camp without refund.
  *An exception to the policy is phones used for medical/medication alerts. In this case, campers are required to turn over devices at check-in; camp staff will support timely medication administration. 
  In times of emergency or appropriate need, provisions will be made to address situations effectively. In case of a genuine emergency where a camper needs to contact family, they will be granted permission to use a phone under the supervision of a staff member. Campers may approach a staff member to request use of a phone. Staff will assess each situation and provide assistance accordingly.
  I/we accept this no-device policy and will adhere to its guidelines.  
   
  *Camps at Cane Ridge West may have assigned periods of quiet time when phone use for music is allowed.
   
• I/we confirm that the participant has no physical or mental disabilities that would impair their participation except as noted above. I/we understand that the information provided on this form will be kept confidential and shared only as necessary to provide care of the participant.
    

Photograph, Video Recordings, and/or Livestream Permission

With your permission, the Region's program staff and our volunteer camp staff (counselors and directors) may photograph or video record your child for the express purpose of promoting the Region's Summer Camp program or the Youth and Children's Ministries program through print media, digital media, and/or internet platforms.  With your permission, livestream technologies such as Zoom or Facebook Live may be used to connect programming at camp sessions running concurrently in different locations, during which time your child may be in view of the camera. Further, the staff of the facilities the Region rents for the Summer Camp program (Gwinwood Retreat Center and Cane Ridge West Conference and Retreat Center) have your permission to photograph or video record your child for the express purpose of promoting their facilities and ministry of hospitality through print media, digital media, and/or internet platforms. Below you can choose to NOT give your permission.

Community Covenant

Our camp, retreat, education and mission trip experiences depend on a commitment to living in intentional Christian community by the participants and the adult volunteers. To do so, we agree to a covenant that helps manage our relationships with one another, our behavior within community, and as a community.
We require all participants to read and agree to our Community Covenant below.

Camp, retreats, mission trips, or education trips are an opportunity to come to know God while living in intentional Christian community. To ensure every person’s worth as a child of God and each person’s safety, all participants (youth, children, and adults) follow this Community Covenant:

• I will participate fully in all activities.
• I will be respectful to all persons and the camp environment at all times.
• I understand that the adults are present for my safety, for my questions about life and faith, and that they are responsible to uphold the Region’s policies and boundaries as well as that of the camp facilities. I will respect and trust the adults.
• I will not wander away from the camp, small group, cabin group, or the total group without permission from a counselor. The Region practices “Two-Deep Leadership” to ensure the safety of all participants. This means that at least two adults are present when children and youth are present.
• I will respect the personal items of other participants (children, youth, and adults) and respect the personal space physical autonomy of other persons.
• I will not bring food to camp unless authorized by the Regional Minister due to my health requirements.
• Accidents happen. I understand that my family could be held financially responsible for any repairs needed to property as a result of my actions.

I understand and accept that if I am found with or participate in any of the following, that I could be sent home from a camp, retreat, education trip, or mission trip experience at my family's expense. I also understand that being sent home may limit or disqualify my participation in camp, retreats, education, or mission trips in the future.

• I will not bring weaponry of any sort (knives, firearms, etc.) to camp.
• I will not bring or consume illegal drugs, alcohol, or tobacco of any sort.
• I will not steal anything from anyone.
• I will not physically harm another camper or adult.
• I will not participate in sexual activity of any kind.
• I will behave consistently in a way that respects the adults, other campers, and the facility that reflects the grace and love that is expected of persons who claim Christian faith. 
• I will adhere to the new no-device policy beginning Summer 2025 (above) and will leave all electronic communications devices at home.

I look forward to spending time in community with those who share my interest in exploring Christian faith and the practice of Christianity as we play, pray, study, worship, and serve one another following the example of Jesus.

Cancellation and Refund Policy

Our refund policy is built on the money that has already been spent in the preparation for a camp.

• Cancel 21 days (3 weeks) or more prior to the beginning of your camp to receive a full refund of fees paid minus $20 administration fee.
• Refunds will not be issued for cancellations made less than three weeks before camp (communicable illness exception below).

Communicable Illness Exception
If the camper or a family member have been diagnosed with, have experienced symptoms of, or have been exposed to someone who has been diagnosed with any communicable illness (cold, flu, COVID-19, norovirus, etc.) within one week prior to camp starting, you are asked to cancel the camper's registration and a full refund will be issued without question.
Other health reasons such as lice, bed bugs, or other similar issues also fall under this category. 
Contact the Regional Office at [email protected] or 253-893-7202 ext. 1 to cancel.

If you discover an error or change needing to be made after submitting this registration, please contact the Regional Office ([email protected] / 253-893-7202 x1) to get the corrections made. Do not submit a new registration form.