* Camper's Name
I will Attend
Genesis Camp (K-1st Grade) - June 22-24
Discovery Camp (2nd-3rd Grade) - June 22-24
Junior Camp (4th-5th Grade) - June 18-22
Chi Rho Camp (6-8th Grade) - June 18-22
CYF Conference (9-12th Grade) - June 18-22
* Parent/Guardian's Name
Parent/Guardian Email Address
In order to help us have an idea of where you child may be for our planning, please indicate your child’s basic swim level. YMCA Camp Chandler will require a swim test for ALL campers desiring advanced swim privileges.
* Parent/Guardian Number
Emergency Contact Number
* Emergency Contact Number
• I will come to camp expecting to grow in my faith and in relationship with others, becoming a special part of the camp community. In order to do this, I covenant to follow all the rules and guidelines set by the Christian Church in Alabama Northwest Florida and any others set for this event. With this, I commit myself to the following: To be on time, attend and be attentive for all camp/conference activities and participate in them fully
• Have fun and make sure everyone else has a great time
• To respect each other regardless of age and to respect others’ feelings and thoughts
• I will not go from adult to adult until I get the answer I want
• Be myself and open to making new friends
• Be inclusive at all times
• Cooperate with the counselors, keynoter, director and other staff members at all times
• Be respectful of God’s beauty in this special place and only leave footprints behind
• To take all that I learn about God and share it with my friends, family and church
I also agree to follow all camp policies as listed below:
Summer Camping Program Policies
• Participants are expected to remain for the entire event. No one should expect to arrive late or leave early without prior permission from director. The only visitors will be those invited prior to camp by the director.
• No one, including counselors, will leave the camp without special arrangements with the director.
• All cars will be parked for the duration of the event. Keys will remain in the possession of the director.
• Events for youth in Alabama-Northwest Florida are “smoke free”.
• Possession or use of intoxicating beverages, drugs or marijuana is prohibited. Violators will be sent home.
• Stewardship of camp property is important. Camp must be left in as good or better shape than it was found upon arrival. Repair of damage to property will be paid by the person(s) responsible.
• Food must be kept out of the dorm area. If you have special foods, arrangements can be made with director.
• Dorms are off limits to members of the opposite sex.
• Offensive, insensitive and foul language is not acceptable.
• Cell Phones are not permitted. If you must bring one to camp You must turn in to the director
Yes, the camper agrees to this covenant
Yes, the guardian agrees to this covenant
If Yes, please list medication below
Consent for Treatment
In case of emergency, I hereby give permission to the physician selected by the camp director to hospitalize, order injections, anesthesia or surgery for the child named above in order to secure necessary, proper medical care. I understand that I will be contacted immediately in the event that something unforeseen happens requiring my attention. I release the YMCA-Hargis Retreat staff and management, camp directors and counselors, and the Christian Church (Disciples of Christ) in Alabama-Northwest Florida and its staff, from all responsibilities in case of sickness or accidents causing injury occurring during camp. I have provided proof of insurance to those in charge.