Register

Register today!

Simply fill out the form below to register for camp. You can register 1 or 2 campers at a time.

Which week of camp/event are you registering for?(Required)

Campers Name(Required)

First Last

Gender(Required)

Male

Female

Camper Date of Birth(Required)

Email Address(Required)

Camper Address

Street Address Address Line 2 City State ZIP Code

Camper Entering Grade(Required)

High School Graduation Year

Camper T-shirt Size

Include Youth or Adult

Is this their first time coming to Deep Valley?

Yes

Medical Information

Health Record / Allergies(Required)

Other/ Notes and Explanation

Please list any medications the registered camper is currently prescribed & dosage information for while they are a camper during their week of camp.

All meds are to be left with & dispersed by the Camp Nurse. All meds must be clearly marked with the camper’s name and in the original container from doctor or pharmacy.

Please mark any medications that you give approval to be administered as needed through the week(Required)

Tylenol

Ibuprofen

Antihistamine/Benadryl

Tums

Robitussin

Other

Notes/Explanations

Allergies(Required)

Eggs

Milk

Gluten

Peanuts

Shellfish

Soy

Tree Nuts

Other

None

If other, what?

If you selected an allergy above, please elaborate so that we may best serve in case of an emergency

Add Another Camper

Yes

Second Camper Information

Which week of camp/event are you registering for?(Required)

Second Campers Name(Required)

First Last

Gender(Required)

Male

Female

Second Camper Date of Birth(Required)

Second Camper Address

Same as previous

Street Address Address Line 2 City State ZIP Code

Second Camper Entering Grade(Required)

High School Graduation Year

Camper T-shirt Size

Include Youth or Adult

Is this their first time coming to Deep Valley?

Yes

Second Camper Medical Information

Second Camper Health Record / Allergies(Required)

Second Camper Other/ Notes and Explanation

Please list any medications the registered camper is currently prescribed & dosage information for while they are a camper during their week of camp.

All meds are to be left with & dispersed by the Camp Nurse. All meds must be clearly marked with the camper’s name and in the original container from doctor or pharmacy.

Please mark any medications that you give approval to be administered as needed through the week

Tylenol

Ibuprofen

Antihistamine/Benadryl

Tums

Robitussin

Other

Second Camper Notes/Explanations

Second Camper Allergies(Required)

Eggs

Milk

Gluten

Peanuts

Shellfish

Soy

Tree Nuts

Other

None

If other, what?

If you selected an allergy above, please elaborate so that we may best serve the camper in an emergency.

Mother/Father/Legal Guardian Information

Mother/Legal Guardians Name

First Last

Mother/Legal Guardians Phone Number

Father/Legal Guardians Name

First Last

Father/Legal Guardians Phone Number

Family Email Address(Required)

Receive updates via email?(Required)

Yes

Church You Attend

City/State

Health Insurance Information

Policy/Group Name(Required)

ID #(Required)

PCP Name(Required)

PCP Phone #(Required)

Heath Insurance Additional Information:

Emergency Contact

Emergency Contact(Required)

First Last

Emergency Contact Phone Number(Required)

Relationship(Required)

Any additional Information

Payment

Church Sponsored Discount

If your church is sponsoring 50% of your camp fees, please reach out to your church or us for their promocode.

Name of Church Paying Tuition

Credit Card

Total

Please bring cash for canteen money for the week

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