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Ignite Middle School & High School @ Camp Forest Home: Forest Falls, CA
June 1st-5th, 2027

Camper Registration

Registration Options

Ignite Youth Camp ($735.00)
Students entering 6th grade- Seniors in Fall of 2027
*$100 DEPOSIT IS NON-REFUNDABLE, but it will hold your spot!

Camper Name

Student's Phone number

Date of Birth

Age should be 17 or lower as of June 1st, 2027

What grade will your child be in the Fall of 2027

What school does your student currently attend:

Preferred Group Leader - This is not a guarantee, however we will do our best to accommodate preferences:

Name of preferred small group friends. Note, this is not a guarantee and students will be in groups with students of the same gender and similar age. Priority will be given to early registrants.:

Which Central location do you attend?

What Central experience do you attend:

While at camp, is there anyone restricted from seeing your student? If yes, what is their name?

Is your student covered by health insurance?

Does your student have a gluten free diet?

Is your student able to swim unassisted?

Does your student have any food, drug, or environmental allergies?

Does your student have any physical, emotional, mental, or medical conditions? Including ADHD or Autism?

Does your student take any prescription or over the counter medications or treatments?

As Needed Over-The-Counter medication release:

I (Parent/Guardian of this registered camper/Camper), hereby give permission for Central Church staff to administer the following over-the-counter medications during Central Church 2027 Camp if the need arises. We will choose the medication based on the symptoms your child is experiencing and those symptoms listed on the package directions. Please indicate the medications you would like your student to be able to receive, if necessary, and sign below. A parent/guardian will be notified if medication is administered as a result of illness or injury. Dosage will be administered according to what is on the medication packaging. Central Church will provide these over-the-counter medications; you do not need to supply these medications for your student.

I give permission for the following over-the-counter medications as needed (check if you give permission to administer):

Acetaminophen 500mg

Children’s Acetaminophen 160mg

Ibuprofen 200mg

Children’s Ibuprofen 100mg

Calamine Lotion

Benadryl 25mg

Children's Benadryl 12.5mg

Pepto Bismol

Children's Pepto Bismol

Cetirizine 10mg (Daily Allergy)

Parent/Guardian giving permission OR declining permission to administer these as needed over-the-counter medications:

Youth Camp Waivers

Ignite Waivers

CENTRAL WAIVER

The undersigned is the participant or the guardian of the participant whose name is listed below. The undersigned gives permission for the individual to participate in the activities associated with Ignite summer camp. The undersigned recognizes that the activities involve the risk of injury to persons or property. Such injuries may include, but are not limited to cuts, contusions, bruises, sprains, fractures to or death of the child. The undersigned expressly assumes the risk of injury to, or death of this individual, as well as property damage as a result of the activities associated with this Central Christian Church sponsored event. In the event of a medical emergency, the staff of Central Christian Church, or its representative, is hereby authorized to obtain emergency medical care and treatment of the participant, including transportation to a licensed medical facility. The staff of Central Christian Church, or its representative, shall notify the undersigned immediately concerning any such emergency. All costs and expenses resulting from a medical emergency shall be borne exclusively by the undersigned. The undersigned agrees to indemnify and hold the staff of Central Christian Church, or its representative, harmless from any claims, suits, liabilities, or judgments. Settlements, damages, costs and expenses, including reasonable attorney’s fees resulting from the injury, death, or property damage suffered as a result of the below-described activities will be the responsibility of the undersigned. The undersigned understands that the participant whose name is below is responsible to know and abide by all Central Christian Church rules and regulations. It is also understood that the undersigned shall be responsible for any damages caused by the participant during this Central Christian Church sponsored event.

The undersigned also understands that the participant named below may be sent home from this event due to disciplinary reasons at the discretion of the Central Christian Church staff and at the expense of the undersigned.

The undersigned accepts that all personal property brought to camp is the sole responsibility of the participant and that Central Christian Church is not liable for any damage, loss, or theft.

The undersigned also gives consent to the use of any audio or visual record of the participant to be used, distributed, or displayed. This consent includes, but is not limited to photographs, video and audio recordings.

This waiver shall legally include the following entities: Central Christian Church as well as other organizations under contract with Central Christian Church regarding this event

MEDICAL RELEASE

Medical Release & Authorization for Self-Administration of Prescribed Medication Agreement

In the event of a medical emergency, the staff of Central Christian Church, or its representative, is hereby authorized to obtain emergency medical care and treatment of the participant, including transportation to a licensed medical facility. The staff of Central Christian Church, or its representative, shall notify the undersigned immediately concerning any such emergency. All costs and expenses resulting from a medical emergency shall be borne exclusively by the undersigned. The undersigned agrees to indemnify and hold the staff of Central Christian Church, or its representative, harmless from any claims, suits, liabilities, or judgments. Settlements, damages, costs and expenses, including reasonable attorney’s fees resulting from the injury, death, or property damage suffered as a result of the activities associated with the church camp, activity, or event will be the responsibility of the undersigned. The undersigned understands that the participant is responsible to know and abide by all Central Christian Church rules and regulations.

I am aware that there may not be licensed medical personnel or licensed counselors at the church camp, activity or event. I am granting permission for my child to self-administer the indicated medication(s) according to the guidelines provided by a licensed health care provider while participating in a church sponsored camp, activity or event and during transportation to and from the camp, activity or event. I will provide all prescription medications in an appropriately labeled container from the pharmacy which is less than 1 year old. I will provide over-the-counter medications in the original container with instructions for self-administration for my child. I am also authorizing assistance of medication administration by an instructed staff member/volunteer if needed.

I understand that the staff and volunteers of Central Christian Church are immune from liability for any injury to or death of the student as a result of self-administration of the medication or the failure of the student to self-administer the medication.

I, the undersigned, agree to the terms above.

Date of Youth Camp Waiver Agreement:

STOP. Please carefully read below, and complete the external Forest Home waiver before continuing. Thank you!

I Understand:*

Before your registration is complete, a parent or guardian will need to sign a waiver from Camp Forest Home. A link to access this waiver will be provided on the confirmation email/page. Students will not be allowed to attend camp without having this waiver on file.

To complete now, go to: https://form.jotform.com/261667517728166

Parent/Guardian Name

Parent Mobile Phone Number

Yes, it's okay to send me text messages including order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. View our terms of service & privacy policy.

Address

Emergency Contact (other than person above)

Emergency Contact Number

Relationship to camper(s):

Running Total

$0.00

Apply Code

DONATION TO SUMMER CAMP FUNDS

We believe that every kid and student deserves the opportunity to experience the magic of camp and the life-change that God can bring during this time, regardless of financial circumstances. Your generosity can make a difference in the lives of kids and youth who may not have the means to attend. Every little bit helps! Consider making a donation above and beyond your camper's camp costs to help sponsor others and give them the gift of unforgettable memories and life-changing experiences. We sincerely appreciate your support and commitment to making camp a possibility for all kids and students.

Suggested Amounts

$100
$200
$500
Other

Cash or Check Code (to be entered in by Central Staff if you are paying in person with Cash or Check):

CURRENT TOTAL

Total

$0.00

BILLING INFORMATION

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Name

Credit CardSecure Payment

Address

Mobile Phone Number

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Ignite Youth Camp (Entering 6th Grade - Seniors in Fall of 2027)

June 1st - 5th, 2027

Register Today!

CAMPER REGISTRATION

Camper Registration

As Needed Over-The-Counter medication release:

PARENT/GUARDIAN

EMERGENCY CONTACT INFORMATION

DONATION TO SUMMER CAMP FUNDS

CURRENT TOTAL

BILLING INFORMATION