Family Camp 2020 Registration
2020 Family Camp will be at Windy Gap on April 3rd-5th. To reserve your family a spot, please register on this page and then go to the following site to pay a $20 per person deposit: https://payments.younglife.org/triplink.cfm?TripId=JG4GKW6R66VS or mail a check to the office at PO Box 2612 Burlington, NC 27216.

Cost...
Adults (12+): $130
Kids (11-3): $80
Kids (2 & under): Free
 
Take advantage of our early sign-up discount of $120 for adults and $70 for kids (11-3).  These prices are good through
December 31st 2019.

Please call the YL office with any questions at 336.513.5300.  
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Name
T-Shirt Size
Spouse
T-Shirt Size
Kid Name and Age
T-Shirt Size
Kid Name and Age
T-Shirt Size
Kid Name and Age
T-Shirt Size
Kid Name and Age
T-Shirt Size
Kid Name and Age
T-Shirt Size
Address
Insurance Company
Policy Number
Insurance Company Address
Explanation of any reported loss of consciousness, convulsion, or concussions.
Any medically-prescribed meal plan or dietary restrictions?
Any medication/treatment to be continued at camp?
Authorization for Treatment:This health history is correct to the best of my knowledge, and family members have permission to engage in all camp activities except as noted. I herby give my permission to medical personnel selected by the camp director to treat and to maintain and/or release any medical records necessary for insurance purposes as outlined under the HIPAA regulations; and to provide transportation for me or my child. In an emergency, I hereby give my permission and authorize the physician selected by Young Life to secure or administer emergency medical treatment. I authorize the physician to call in any necessary consultants in his/her discretion. It is understood that this consent is given in advance of any specific diagnosis or treatment being required, and is given to encourage the physician to exercise their best judgment as to the requirements of such diagnosis or medical treatment.
Acknowledgement of Inherent Risk: I acknowledge and understand there are inherent risks associated with many camp activities. I will assume the risk associated therewith, whether known or unknown to me at this time. I recognize that my attendance at a young life camp is a privilege and as a consideration for this privilege, I release young life, including its employees, agents, and trustees, from responsibility for my accidental physical injury , including death or illness, and loss of personal property while at camp or during young life sponsored travel to and from camp. This release is also intended to include all claims made by my family, estate, heirs, personal representative or assigns.
A copy of your responses will be emailed to the address you provided.
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