1. One registration form with payment will be required per camper. Fill in all applicable spaces on the registration form using the "Tab" key to move through the form. Use the "Enter" key to submit the registration form.
2. Registration will need to be completed to the end of all steps before the next camper can be registered.
3. On line registration can only be completed with full payment for a week of camp.
There will be no capability to use a credit card on site on the day of registration.
Fill in all applicable spaces on the registration form.
If the “I Agree” button at the bottom of the registration page is not marked then the camper will not be registered and the registration will not be completed until a signed paper application is received at Camp Hope.
First Name
Last Name
Address
City
State
Zip Code
Date of Birth
Female Male Age as of 9/1 of current year
Grade Entering
Parent/Guardian Name
Home Phone Number
Father'sWork Number
Mother's Work Number
Father's Cell Number
Mother's Cell Number
Personal E-Mail Address
Home Church Camper Attends
Home Church Address
Home Church City
Home Church State
Home Church Zip Code
Home Church Phone Number
Home Church Contact Name
Camper Friend Request (Requests will be considered if campers are in the same age group & this request must be made on the registration form by both campers for each other. Friend requests are not guaranteed.)
Emergency Contact Name
Emergency Home Phone Number
Emergency Work Phone Number
Relationship
Medical Insurance Company
Insurance Policy Number
Pre-Admission Telephone Number
Camper Name
Note: Each camper must be immunized against the following:
Polio, Measles, Mumps, Rubella, Diphtheria, Whooping Cough, Tetanus
Date Last Tetanus vaccine
Check if camper has any of the following:
Seizures Asthma Ear Trouble Heart Trouble Bleeding Disorders Hay Fever Diabetes
Does camper have allergic tendencies? (ie. bee sting, penicillin, poison ivy, food, etc.) If there are no allergic tendencies enter "None".
Has camper been under medical care within the past 3 months? Yes or No
If so, what for?
Date of Last Health Exam
Does camper have trouble with Enuresis? (Bed-wetting) Check one.
Yes If yes, please send sheets, not sleeping bag. No
Does camper have any medical or physical disorders that will be a handicap in camper activities? If there are no items to enter please put "None".
Is there any other information which you feel we should have about this camper? If there is no other information please enter "None".
I understand a brief health screening will be conducted prior to registration.
If this is your first time to Camp Hope, how did you hear about us?
Friend Parent Expo Parent Magazine Web Atlanta Christian Magazine
Church
1. Conduct Code: Camper conduct should adhere to sound moral principles & all camp rules and policies. The presence, use, or display of tobacco, alcoholic beverages, drugs, improper clothing or expressions of profanity or vulgarity will not be permitted. Any camper who violates camp rules, is disruptive or is not cooperative with the camp program or others in attendance is subject to dismissal and forfeiture of fees.
2. General and Emergency Medical Authorizations: I hereby give permission to the first aid personnel selected by camp personnel to determine and provide standard first aid care and administer over the counter medications and medications sent for camper and, in case of emergency, to determine and select outside medical personnel and facilities, and I grant permission to such to order x-ray, make routine test, hospitalize, secure proper treatment for and to order injection and/or anesthesia and/or surgery for this camper.
3. Camper has my permission to attend Camp Hope and engage in all activities except as noted.
4. I accept full responsibility for any damages my camper may cause.
5. Clothing & other personal articles are the responsibility of the campers. No liability is assumed for personal articles left on premises. Lost & found will be donated to a worthy organization two weeks after the closing of each week of camp. For information on Lost & Found, contact Austin Meadows at 678.316.9536.
6. No cell phones, radios, CD/tape players, TV’s, skateboards. These items will be collected to minimize distraction from the spiritual goals of camp and returned at the end of camp.
I have read the content in the attached Camp Hope brochure and camper is knowledgeable of the content and conduct code. The information recorded on the application form is accurate and complete.
Please remember to click one of the buttons below. If the “I Agree” button is not marked then the camper will not be registered and the registration will not be completed until a signed paper application is received at Camp Hope.
I Agree I Do Not Agree
