Camp Form | calvary

CBC Ministries / Calvary Children’s Learning Center

Camp Camino Youth Overnight Camp Application & Permission Form

*Ages 10 and Up

Camper's Information

Camper's Full Name

Preferred Name (If Any)

Date of Birth

Month

Day

Year

Age

Grade

Gender

Home Address

Home Church/Congregation (If Any)

T-Shirt Size (YOUTH/ADULT)

Preferred Name for Nametag

Parent/Guardian Information

Parent/Guardian #1 Full Name

Parent/Guardian #2 Full Name

Primary Phone

Secondary Phone

Best way to reach you during camp

EMERGENCY CONTACT

Emergency Contact Phone Number

Medical, Allergy, & Physical Information

Please provide accurate and complete information so we can care well for your child.

Allergies (food, medication, environmental):

Current medications (name, dosage, schedule):

Ongoing medical conditions (asthma, diabetes, seizures, etc.):

Physical restrictions or limitations (especially related to horseback riding, outdoor activities, or strenuous exercise):

Doctor/Practice Name and Phone (optional):

Health Insurance Provider & Policy # (optional):

Swimming & Activity Permissions

Camp activities will include an outdoor pool (with certified lifeguards on duty), horseback riding, and a petting zoo/animal therapy at Camp Camino. Please complete the permissions below.

Swimming Ability (check one):

Non-Swimmer

Beginner

Intermediate

Advanced

Can your child swim independently in water over 4 feet deep?

Yes

Unsure

I give permission for my child to participate in swimming activities at the outdoor pool with lifeguards present.

Yes

Horseback Riding Permission: I give permission for my child to participate in supervised horseback riding activities at Camp Camino.

Yes

Petting Zoo / Animal Therapy Permission: I give permission for my child to participate in the petting zoo/animal therapy activities, which may include close contact with farm animals.

Yes

Petting Zoo / Animal Therapy Permission: I give permission for my child to participate in the petting zoo/animal therapy activities, which may include close contact with farm animals.

Yes

Morning Workouts with Reverend Gabe

Each morning, Reverend Gabe will lead optional, faith-based workouts which may include stretching, jogging, body-weight exercises, and other forms of STRENUOUS physical activity. These workouts are designed to be encouraging and age-appropriate, but may not be suitable for every child. Please indicate your preference below.

May your child participate in the daily morning workouts?

Yes, my child may participate fully.

Yes, my child may participate with the following limitations:

No, my child should NOT participate in the morning workouts.

Camper Bio ( To help us get to know your child)

Please share a brief bio about your child (interests, hobbies, strengths, personality, any fears or concerns, and how we can best support them spiritually, socially, and emotionally while at camp).

Cost, Payments, and Registration

The total cost for the Camp Camino Youth Overnight Camp is **$300.00 per child for the week**. This includes lodging, meals, and planned camp activities. You may begin making payments now.

Preferred payment method:

Cash

Check (Make payable to Calvary Baptist Church)

Other

Paying by card ? Please click the payment link in the confirmation messsage after submitting the application.

Parent/Guardian Consent & Release

I give permission for my child named on this form to attend and participate in the CBC Ministries/Calvary Children’s Learning Center Youth Overnight Camp at Camp Camino on the dates of July 6th - July 10th. I understand that camp activities may include, but are not limited to, swimming, horseback riding, petting zoo/animal therapy, outdoor games,

and optional morning workouts.

I understand that, as with any physical activity, there are inherent risks of injury. I agree to hold harmless and release CBC Ministries, Calvary Children’s Learning Center, Camp Camino, and their staff and volunteers from liability for any injury or illness that may occur, except in cases of gross negligence. I also give permission for the camp staff to seek emergency medical treatment for my child if necessary, and I agree to be responsible for any associated costs.

Photo/Video Permission (optional):

I understand that photos or videos may be taken during camp activities. These may be used for CBC Ministries/Calvary Children’s Learning Center ministry purposes (newsletters, social media, presentations, etc.).

Yes, I give permission to use my child’s image for ministry purposes.

No, I do NOT give permission to use my child’s image.

Parent/Guardian Signature:

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Date

Printed Name

Parent/Guardian Signature (optional):

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Date

Printed Name