Registration | Equipministriesusa

This form is necessary for EVERY camper, of any age, who attends an EQUIP Ministries USA Retreat. Please make sure it is filled out by the adult who oversees the camper's well being. A 50% deposit is required to guarantee a bed for each camper. You will receive information about final payments, registration and closing times, directions, etc. from us well before the start of camp.

Adult first name

Adult last name

Camper's first name

Camper's last name

Phone

Address

City

State

Zip Code

PLEASE FOLLOW THIS STEP

Please read CONSENT FORM here and check box when completed

Check Here to Accept Agreement

Please fill out as much relevant information as you have available

Insurance Company

Policy/Member ID

Group Number

Primary Insured

Relationship to Participant

Insurance Company Phone

The Parent/Guardian understands that EQUIP does not provide medical insurance for Participants unless expressly stated otherwise in writing.

The Parent/Guardian is responsible for ensuring that the Participant has appropriate insurance coverage or otherwise accepts responsibility for medical expenses.

Allergies

Dietary Restrictions

The Parent/Guardian understands that failure to disclose relevant medical information may increase risk to the Participant.

Retreat Date and Time Requested

Link

Please read this AV RELEASE FORM and check box when completed

Check here to accept A/V Release Form