Family Camp App

I will be attending as a:*

Name*

First Last

Age*

Please enter a number from 0 to 110.

Date of Birth*

MM slash DD slash YYYY

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Gender*

Phone*

Email*

Local Church

Consent*

I agree to the condition below

ACCOMMODATIONS: No individual family rooms are available at the campground. All sleeping arrangements are clean, comfortable, and air-conditioned male-only and female-only cabins and bunk houses with interior bathrooms/showers and twin beds or bunks.
DRESS CODE: All clothing should be modest with high-enough necklines, low-enough hemlines, and sleeves of a reasonable length past the shoulder. No inappropriate or revealing clothing should be worn, including indecent graphics and slogans, sheer fabrics, shorts and cutoffs, tank tops, or crop tops. Ladies’ dresses and skirts for church services should be at least knee-length. Clothes to cover swim attire should be worn when traveling to/from the pool. Those participating in the baptismal service should wear dark clothing.
NOTE: By signing this application, you agree to the dress code and all other rules set forth by the camp directors and administrators.

Consent*

I agree to the statement below

I will obtain a staff endorsement from my pastor (or state overseer if I am a pastor) by having them complete the form located at (www.tcogtn.org/family-camp)."

Signature*

Date*

MM slash DD slash YYYY

Name of Parent/Guardian*

First Last

Guardian's Phone*

Name of person authorized to pick up camper*

First Last

I give permission for the above-named minor to be baptized in water during camp if they desire.*

Yes

Signature of Parent/Guardian*

Date*

MM slash DD slash YYYY

Health Information

Name*

First Last

Health concerns, allergies and/or limitations*

Please list any prescribed medications*

All medication is to be given to the camp nurse to administer to the camper unless approved by camp administration.

Insurance Information

Name of Insured*

First Last

Insurance Company*

Group Number*

Policy Number*

Medical Consent by Camper (or by Parent/Guardian if under 18)*

I agree to the medical consent below

In case of medical emergency: I understand that an effort will be made to contact parent/guardian of the camper. In the event I cannot be reached, I give permission to the physician selected by the camp administration to hospitalize, secure proper treatment for, and/or to order proper treatment, including injection, anesthesia, or surgery, for the camper named above. I also understand that any accident or sickness for which the camp insurance does not provide, I am responsible for the expense and the camp will not be held liable.

Signature*

Date*

MM slash DD slash YYYY

Emergency Contact*

First Last

Phone*

Relationship*

Please note all staff must be approved by either their Pastor or State Overseer prior to being allowed to work in camp.

Please Check All that Apply*

I am

Saved

Sanctified

Baptized with the Holy Ghost

Earnestly Seeking the Holy Ghost

A Member of The Church of God

I am able to attend International Youth Camp (IYC) if selected to be sponsored*

(Check the main Family Camp web page for more details about IYC)

Yes

Payment Options*

Camper Tuition

Price:

Includes $5.00 Snack Shack card

Staff Tuition

Price:

Processing Fee

Price:

Total

Credit Card*

Card Details

Cardholder Name

Billing Zip Code

ZIP / Postal Code