Camper Information

This section is required. We have added an area where you can upload a photo of the camper. Please ensure it is a front-facing, photo.

Parents/Guardians Information

Please fill-in area completly.

Others Authorized for Pick Up

We ask that at least one other person is authorized for pick-up in case of an emergency. You are allowed an additional five(5) authorized persons. Remember, your authorized persons MUST have your child's 4-digit pin number every time they pick-up your child.

Insurance Information

This entire section is required. We will not be able to process your application without complete insurance information.

Notify in Case of Emergency

This contact information will only be used in the case of an emergency. You can have up to two(2) persons listed.

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New Mercies Christian Church