Student Life Camp 2026

**This Registration Page Adds Your Student to our Wait List for Camp.**

Student Name

Gender

Male Female

Parent Email

This address will receive a confirmation email

Phone

Address

Birthday

T-Shirt Size

Adult Small Adult Medium Adult Large Adult XL Adult XXL Adult XXXL

Grade Completed

6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

Preferred Roommate(s)?

Allergies?

Medications

Insurance Company

Policy Number

Emergency Contact (Parent Name & Number)

Permission to Attend

Yes

Release of Liability

Yes

I permit my child(ren) to be transported on the van, bus, and/or volunteer drivers of Immanuel to and from Student Life Camp from 7/13/26-7/17/26.

Yes

I give permission for photographs and videos (print, electronic, and/or social media use) in which my child(ren) appears to be used for publications and public relations activities by Immanuel Baptist Church.

Yes

Please do not submit a deposit payment since spots are not guaranteed! If we are able to secure a spot for your student, we will reach out and confirm this with you regarding the full payment.

If you would like to submit your deposit payment online, please enter the deposit amount of $75 in the payment section below. However, if you prefer to bring your payment to the church office, please leave the payment section blank.

Final cost of SLC is TBD.

Payment

I acknowledge that I am registering my student to be added to the waiting list for Student Life Camp 2026 and that this registration does not guarantee my student a spot for camp unless more space becomes available.

Yes

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Student Life Camp 2026

Description

Please Fix the Following