top of page

     Sharing Christ with Others

Camper Registration Form

Multi-line address
Birthday
Month
Day
Year
Gender
Male
Female
T-Shirt Size
YS
YM
YL
AS
AM
AL
XL
2XL
3XL

Camper's Medical History

Camp Insurance is Secondary to Personal Insurance

Does your child suffer from any medical, physical, mental, or behavioral conditions that may affect their safety at camp? (vertigo, asthma, heart problems, diabetes, epilepsy, etc.)
Yes
No
Is the camper currently undergoing any kind of medical or psychological treatment, including medications?
Yes
No
If yes, are any daily medications required?
Yes
No
Will the camper be bringing any medications with them?
Yes
No

If yes, please fill out the Medication Form listing medications and dosing schedules. This must be filled out and turned in at registration or mailed in with the form packet.

Is the camper allergic to any kind of food, medication, or sting?
Yes
No

Consent and Medical Release

Camper Declaration

As a camper, I agree to participate fully in all planned activities of the camp, and agree to abide by all rules of camp. I also understand that if I am not following the dress code I will be asked to change clothes by a cabin leader or staff member.


Campers will be asked to change if they are wearing any of the following:

  • Spaghetti straps

  • Halter tops

  • Bare midriff

  • Fishnet skirt

  • Miniskirts

  • Vulgar, obscene, or suggestive working or images of any kind

  • Caps during classes

  • Sagging pants/shorts

  • Cutoffs

  • Undergarments shown at any time

  • Shorts should be no more than 4 inches from the top of the knee

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Parental Release

I agree that my child may attend Sharing Christ with Others Youth Camp and agree to him or her taking part in all activities described below. I acknowledge that these activities involve the risk of serious injury or death. I acknowledge the need for responsible behavior and obedience on my child's part.


The activities may include: water activities (such as water balloons and playing in the creek), sporting activities, camp games, team sports, and mingling with other individuals and groups. Specific activities may be excluded or added. Please contact the camp director with any questions.

I give permission for staff to give my child the following:

Acetaminophen - Tylenol or Generic
Yes
No
Ibuprofen - Advil or Generic
Yes
No
Cough Suppressant - Robitussin
Yes
No
Hydrocortisone Ointment
Yes
No
Antacid - TUMS or Generic
Yes
No
Aspirin
Yes
No
Antihistamine - Benadryl or Generic
Yes
No
Decongestant - Sudafed or Generic
Yes
No
Antibiotic Ointment
Yes
No

Media and Emergency Transportation Permission:

I give permission for photos of my child to be taken and understand that these photos may be posted on social media for information purposes. I also give permission for my child to be transported by ambulance to the nearest medical center in the even of an emergency and first aid be administered to my child in the event of a minor accident.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Cost of Camp:

PreK and Kindergarten - $45

1st - 4th - $55 pre-registration - $65 if registering after June 1st

5th - 12th - $85 pre-registration - $95 if registering after June 1st

Payment Options
Pay at Check-in
Congregation Pays
Venmo - (@scwo-lynchburg)
Mail Check to: SCWO, PO Box 8192, Lynchburg TN 37352

Make Checks Payable to "Sharing Christ with Others Youth Camp"

bottom of page