Youth Conference Registration

Applicant Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email Address *

Sex *

Male
Female

Age

Age *

Birth Date *

Birth Date

High School Grade/Graduate (at time of camp) *

Church Location

Church Location *

Church Location (if you chose "Other")

Roommate Request

We will try to place you in a cabin or room with one of your friends (choose up to three friends) if your application is received by June 26.

Accommodations

If you need accommodations either before or after the conference, please indicate which days and contact Mrs. Teresa Kamp at (616) 401-5622.

Emergency Contacts

Emergency Contact #1 *

Phone *

Emergency Contact #2 *

Phone *

Medical Information

Do you have any allergies, allergic reactions to medicine, or other medical concerns?

Conference Rules

• All campers must be age 15 (having completed at least grade 9) – age 22.
• Smoking, tobacco, and e-cigarettes are not permitted.
• Alcoholic beverages are not permitted.
• Young men and women must not enter the vicinity of each other’s cabins for any reason.
• Campers staying for the duration of the conference may not use personal vehicles during the time at camp.
• All young people will carpool from PRTS, 2965 Leonard NE, Grand Rapids, MI 49525
• “Quiet Time” is from 11:00 PM to 6:30 AM.
• Residents of cabins or rooms will be held responsible to pay for any damaged items.
• Camp management’s permission is required for removing furniture, bedding, or equipment from buildings.
• Attendance at all meals, topics, and campfire gatherings is required.
• No fires are permitted except for the evening campfire. No fireworks.
• Each camper will participate in assigned cabin/grounds/kitchen clean-up duties.
• Skirts are not mandatory for topics, but skirts or shorts must come close to the knee (pants are also allowed but no legging w/o something over them).
• One-piece swimwear is required for young women and should only be worn in the swimming area. (Note: tankinis are okay if no midriff shows when standing. If midriff shows, wear a T-shirt over it.)
• Adequate cover-ups over bathing suits (other than towels) are necessary to and from the swimming area.
• Young men may wear pants or shorts to topics. A shirt must be worn at all times outside the swimming area.
• Campers are expected to dress modestly and appropriately at all times.**

NOTE:
* No smoking means no smoking! In addition to being our camp rule, Camp Michawana is a non-smoking campus. If you are a smoker, you must leave your cigarettes behind in order to promote your health and that of other campers. Those who choose to smoke at the conference will be subject to discipline.
** “Appropriately” means dressing in a manner in which you would not be ashamed to come face to face with the Lord Jesus Christ, because in reality God is present at all times. For young women this means tops will cover the shoulder, cleavage, and midriff when raising your hands or bending over. This means no low-cut, see-through, tight-fitting, or too-short tops may be taken to camp. Tight-fitting or “short” skirts, dresses, shorts, and pants are deemed “inappropriate”. For young men this means no sagging pants allowing boxers to show.

Camper Agreement

I agree to participate in the activities of the conference and cooperate with my chaperones and camp directors. I agree to be respectful of other campers, the camp directors, chaperones, and their property. I will not damage or deface the campgrounds. I have read the conference rules above and will conduct myself in accordance with them. I understand that if I break this agreement, I will be subject to discipline, may be sent home immediately, and may not be allowed to attend future conferences.

Camper Signature *

Date *

Parent/Guardian Signature *

I am under 18 years old, my parents will sign below
I am 18 or over (Parent/Guardian Agreement is not necessary)

Campers under 18 years old must have their parents participate in filling out this form to approve this application. For those 18 years and older, Parent/Guardian signature is not necessary.

Parent/Guardian Agreement

1. I approve that the above-named registrant will attend the HRC Youth Conference.
2. The registrant’s health condition is suitable for him/her to participate in camp activities.
3. I understand that all due precautions will be taken. In spite of this, I acknowledge that accidents and illnesses do occur. I will not hold Camp Michiwana, HRC, camp directors, or camp chaperones liable for any accident or illness which occurs during the conference.
4. In case of a medical emergency, I give permission to medical personnel selected by the camp directors to hospitalize and secure proper treatment (including medicine, anesthesia, and/or surgery) for my child. In the event of an emergency, this form may be photocopied and distributed as needed.
5. I will oversee the clothing my child packs for camp and that it will be in conformance with the above guidelines.
6. I have read and agree to the conference rules. If it is deemed necessary by the camp directors that my child be sent home, I will be responsible for the expenses incurred, including transportation.

Parent/Guardian Signature

Parent/Guardian Email

Parent/Guardian Phone Number

Conference Fee

The fee for camp is $175 (US funds only) for those who register by Monday, June 8. The fee is $200 for those who register after June 8. This includes all meals and lodging.

Do you wish to register as a full-time or part-time camper? *

Full Time
Part Time

Day/Part-time Campers Only

Please complete this section by checking which night(s)/meal(s) you will be at camp so we can pay our appropriate fees. Meals cost $10 and each night of lodging is $40.

Tuesday

Dinner – $10.00
Night – $40.00

Wednesday

Breakfast – $10.00
Lunch – $10.00
Dinner – $10.00
Night – $40.00

Thursday

Breakfast – $10.00
Lunch – $10.00
Dinner – $10.00
Night – $40.00

Friday

Breakfast – $10.00
Lunch – $10.00

Full Time Camper

Total

$0.00

Payment *

Card

Name on Card

Payment will appear as squareup.com on your records.

Youth Camp 2026

Applicant Information

Age

Church Location

Roommate Request

Accommodations

Emergency Contacts

Conference Rules

Camper Agreement

Parent/Guardian Agreement

Conference Fee

Day/Part-time Campers Only