Labor Day '26 Adult Registration
September 4th-7th | Where: Camp Hemlock, WV
When: 9/4-7
Cost: $200
Theme: "Here I Am"
Speaker: Reed Berger
Registration Information
Name
*
Contact Email
*
This address will receive a confirmation email
Phone
*
Expected Role at Labor Day
*
Please select one option.
Counselor
Kitchen
Work Crew
Other
Select Option
Counselor
Kitchen
Work Crew
Other
Church
*
Please select one option.
Bowie Reformed
Good Hope
Mount Airy
New Covenant
Wallace
Other
Select Option
Bowie Reformed
Good Hope
Mount Airy
New Covenant
Wallace
Other
Are you coming directly from your church with your youth group or are you coming in some other way? Either write "with church" or write a description of the other way.
*
T-Shirt Size
*
Please select one option.
XS
S
M
L
XL
XXL
Select Option
XS
S
M
L
XL
XXL
Background Check
Have you completed a background check recently?
*
Please select one option.
Yes
No
Select Option
Yes
No
If Yes, please upload proof of clean background check.
Upload (8MB)
If No, please provide an email address so we can send a link to complete a background check.
*
Medical Information
Date of Birth
*
Current Weight
*
Known Medical Conditions (for example, Asthma, Migraines, ADHD) (write N/A if not applicable)
*
Who will be in charge of medication?
*
Please select one option.
Teen
Counselor
Camp Nurse
N/A
Select Option
Teen
Counselor
Camp Nurse
N/A
Emergency Contact Name
*
Emergency Contact Phone
*
Emergency Contact Email
*
Insurance Company & Policy #
*
By completing this form, you are also giving CONSENT & MEDICAL RELEASE for this trip and any other youth activities from August 1, 2025 to August 1, 2026 for all the churches involved in the Labor Day Camp. As the undersigned, I give my consent for myself to participate in all Youth activities sponsored by Wallace Presbyterian Church, Good Hope Presbyterian Church, Mt. Airy Presbyterian Church, New Covenant Presbyterian Church, Christ Reformed Presbyterian Church, Bowie Reformed Presbyterian Church (whichever church I came with, hereinafter the “Church”). I understand that there are inherent risks involved in any ministry or athletic event, and I hereby release the Church, its pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my involvement in Youth activities. In the event that I am injured and require medical attention, I consent to emergency medical treatment prescribed by a licensed physician, and any first aid treatment the Church, its pastors, employees, agents, or volunteer workers deem necessary until a licensed physician or emergency medical personnel assume control of my care. This care may be given under whatever conditions necessary to preserve the life, limb, or well-being of myself. In the event treatment is required from a physician and/or emergency personnel designated by the Church, I agree to hold the Church and any such person free and harmless of any claims, demands, or suits for damages arising from the provision of that medical care. I acknowledge that I am responsible for the cost of any medical care should the cost of that medical care not be reimbursed by a health insurance provider. I affirm that the health insurance information provided below is accurate to the best of my knowledge. In the event I become ill or injured, I authorize the camp nurse to render aid and/or administer over-the-counter medication, i.e., acetaminophen, ibuprofen, antibiotic ointment. In the event of an EMERGENCY, the counselor or camp nurse will call the emergency contact at the contact number listed below. If no one can be reached, I hereby give my permission to the physician selected by the counselor or camp nurse to secure proper treatment for myself. To the fullest extent permitted by law, I release Camp Hemlock, its trustees, officers, directors, employees, agents, and representatives from injury, harm, damage, or death which may occur to myself while participating in the activity and agree to save and hold harmless all the churches and Camp Hemlock's trustees, officers, directors, employees, agents, and representatives from any claims arising out of my participation in the activity. Electronic Signature
*
Date of Electronic Signature
*
Submit
Description
September 4th-7th
Where: Camp Hemlock, WV
When: 9/4-7
Cost: $200
Theme: "Here I Am"
Speaker: Reed Berger
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