LUTHERAN CAMPFORMATION
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 Day of Service Registration Form- Student
    Student Information
    Parent/Guardian Information

    TRANSPORTATION
    Please fill out the Adult Registration Form.

    HEALTH AND MEDICAL INFORMATION

    ALLERGIES

    PHOTO RELEASE STATEMENT
    Lutheran Campformation takes photos and videos with the intent to celebrate the mission of Lutheran Campformation. These pictures and videos MAY be used in social media and website promotion, but will not include any information on the individuals pictured (names, church affiliation, etc.). By submitting this form, you acknowledge this photo release statement and agree. 
    (Any concerns with the photo release statement can be brought to the attention of your church representative.)
    ​
    ​MEDICAL AND LIABILITY RELEASE STATEMENT
    Lutheran Campformation Adult Leadership to provide routine health care and emergency first aid; to release any records necessary for treatment or insurance purposes, and to provide or arrange necessary transportation.  I understand that my insurance information will be given to any healthcare providers, but that I will ultimately be responsible for any medical charges in the case of illness or injury while my youth is participating at Lutheran Campformation or a related event.  In the event I cannot be reached in an emergency, I hereby give the permission to the physician selected by the Lutheran Campformation Leadership to secure and administer treatment, including hospitalization, for the person named above.  

    I understand that participation in this event is not without risk to my child because of the group nature of the event and the unpredictable behavior of any group, even when managed with the greatest amount of care.  I understand that all reasonable safety precautions will be taken at all times by Lutheran Campformation.  I understand the possibility of unforeseen hazards and know the inherent possibility of risk.  I agree to not hold Lutheran Campformation, its leaders, employees, volunteers or your home church liable for damages, losses, diseases, negligence, or injuries, or death incurred by my youth. 
    AGREEMENT - ELECTRONIC SIGNATURE 
    If you are able to transport other participants and will be staying for the service events, please fill out the Day of Service - Adult Registration Form.

    ​Thank you!
Submit
  • Home
    • Welcome!
    • About Lutheran Campformation
    • Counselor Application
  • Camper Registration
  • Counselor Registration
  • Adult Leader Registration
  • Camp Pinerock