Online Camper Registration

What name does your child prefer to be called?

Camper's Last Name

Camper's First Name

Camper's Middle Name

Date of Birth

Gender

Male

Female

Age at Camp

Address

City

State/Province

Zip/Postal

T-Shirt Size

Guardian #1 Name

Phone

Guardian #2 Name

Phone

Emergency Contact #1

Relation to Camper

Emergency Contact #2

Relation to Camper

Emergency Contact #3

Relation to Camper

Medical History

Medications (All Medications must be in original containers and clearly marked with dosage instructions)

Medication Allergies (If none type none)

Environmental / Food Allergies and Reaction Type (if none type none)

Authorized Pickup #1 (ID will be checked)

Authorized Pickup #2 (ID will be checked)

Authorized Pickup #3 (ID will be checked)

Authorized Pickup #4 (ID will be checked)

Parent or Guardian's ID Front

Maximum file size: 1610.61MB

Parent or Guardian's ID Back

Maximum file size: 1610.61MB

Camper's Insurance Card Front

Maximum file size: 516MB

Camper's Insurance Card Back

Maximum file size: 516MB

As Parent or Guardian I do hereby authorize adult volunteers of Ararat Bible Camp and Antioch Baptist Church as agents for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or surgeon in an approved emergency clinic or hospital. I gurther release from any liability Ararat Bible Camp and Antioch Baptist Church, any of it's ministries, leaders, or volunteers in the event of an accident during the course of camp. I agree to the use of photos and videos taken of my child by the camp for promotion or other uses (including internet postings) without compensation.

Clear

I, affirm that I am the parent or legal guardian of the above registered Camper.

Clear

Camp Registration 2026

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