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Campers Name *

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Cabinmate request *

Email *

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Parent or Guardian info

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Relationship *

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   Participation, Release, and Medical Agreement

While we make every effort to provide a safe and pleasant environment for every camper who attends Camp Maranatha , we do require that this participation agreement be read, filled out, signed, and dated by all campers parent/guardian who wish to participate in activities.

   With full knowledge, I accept full responsibility for any injury or accident that may occur to myself, my spouse, or my child while participating in Kids Kamp activities. I give permission for my child to participate in activities that occur at Camp Maranatha. These activities may include, but are not limited to, swimming, archery, and strenuous competition games.
   Although Camp Maranatha has taken reasonable steps to provide equipment and skilled employees so yourself, your spouse, or your child can participate in activities for which he/she may not be skilled in, we do remind you that these activities are not without risk. Certain risks cannot be eliminated due to our camp’s rural setting and without destroying the unique character of those activities. The same elements that contribute to the character of these activities can be cause of loss or damage to your property, accidental injury or illness or, in extreme cases, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for these activities, but we do think it is important for you to be informed and know in advance about inherent risks.
For promotional or marketing purposes, Camp Maranatha reserves the right to use any audio, video, and/or photography of guests or campers participating at Camp Maranatha facilities.
I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless Camp Maranatha, its officers, board, agents or employees, for any and all claims for injuries, causes of action, or liability related to my child’s participation in any activity occurring at Camp Maranatha. This release does not apply to intentional and/or willful acts of misconduct by Camp Maranatha or any of its officers, board, agents or employees.

By checking below, I acknowledge that if anyone is hurt or property damaged during my or my child’s participation in these activities, I and/or my child may be found by a court of law to have waived any right to maintain a lawsuit against Camp Maranatha on the basis of any claim which has been released herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and agree to be bound to its terms.

Medical Information

Health or Behavioral Conditions *

Drug Allergies or Other Allergic Reactions *

Dietary Needs and/or Restrictions *

Medication Taken Regularly *

Activity Restrictions *

I give permission for myself or my child to attend camp at Cacmp Maranatha. I understand that my personal insurance will provide primary coverage for medical aid and that Camp Maranatha will provide excess coverage. IN CASE OF MEDICAL EMERGENCY, I hereby give permission to the physician selected by the camp director or his agent to hospitalize, secure proper treatment for, and order injection, x-ray, anesthesia, or surgery for myself or my child as named previously.

Immunization records must be provided for all first time campers.

Date of last tetanus shot *

Insurance company *

Policy number *

Acknowledgement

By checking below, I am acknowledging that I agree with the above Participation, Release, and Medical Agreement and Medical Information. My acknowledgment is equally as binding as signing a paper copy of the agreement.

Name *

First

Last

I agree *

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Payment

Your registration is complete when you submit this completed form. $60 fee for full time campers due at onsite check in.
Day campers $8 per meal.
Men attending lessons only: No charge
Cash, Check, & Venmo are accepted payment types.

Venmo username: @CampMaranatha
Please make checks payable to ACCSC.

Please select which meals you would like to participate in. *

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