Youth Registration
(You will need your filled out Permission Forms and a Payment Method to complete this Registration Form)
Camp Yeshua 2018
What's your first name? *

Hey {{answer_KgpiE8fkyQvv}}, nice to meet you.
What's your last name? *

What year were you born, {{answer_KgpiE8fkyQvv}}? *

What is your gender, {{answer_KgpiE8fkyQvv}}? *

Have you been to Camp Yeshua before, {{answer_KgpiE8fkyQvv}}? *

What is the name of the congregation you attend?

Please provide the name of your congregation's leader as well.
Is anyone coming to camp with you?

Friends, parents/guardians, siblings, relatives
Preferred Roommates

Camp leaders will take your requests into consideration when assigning dorms.
Where do you live? *

While we try to avoid snail mail, if the need arises, where should we send mail?
Please provide your full postal address, including ZIP code.
Home Phone *

If you don't have a dedicated house phone, please provide your parent's phone number.
Your Phone *

You do have a cell phone, right?
Parental Contacts

What is your first contact's name? *

How is {{answer_68714861}} related to you, {{answer_KgpiE8fkyQvv}}? *

What is the best number to contact {{answer_68714861}} at? *

What is your second contact's name? *

How is {{answer_68737031}} related to you, {{answer_KgpiE8fkyQvv}}? *

What is the best number to contact {{answer_68737031}} at? *

Who should we contact in case of an emergency? *

And what number would work best for contacting {{answer_68747816}}in an emergency? *

Medical Survey

This information is requested by our Staff to keep you healthy and safe.
Are you allergic to anything? *

Foods (like nuts, dairy, gluten, etc.), Plants, Animals, Drugs
Please list your allergies and the severity of your reactions *

The more detailed information you provide, the better our medical staff will be able to help you in the event you are exposed to an allergen.
Okay, {{answer_KgpiE8fkyQvv}}, do you have any ongoing medical conditions? *

{{answer_KgpiE8fkyQvv}}, please provide details on your current medical condition(s) *

The more detailed information you provide, the better our medical staff will be able to help you in the event you need assistance.
Are you taking any prescribed medication, {{answer_KgpiE8fkyQvv}}? *

Please list your prescriptions for our medical staff *

Dosage, interval, and complications
Have you had any serious injuries, illnesses, or surgery in the past year? *

Please provide details for our medical staff *

Give as much detail as you feel comfortable sharing with our medical staff
If needed, can our medical staff administer over-the-counter medicine to you? *

Alright, {{answer_KgpiE8fkyQvv}}, what size should your included Camp Yeshua T-shirt be? *

Sizes are based on Adult Unisex T-shirts

Insurance Policies

Which insurance policies are you covered under? *

Which company provides your accident policy? *

What is your accident policy number? *

What is the phone number associated with your accident policy? *

Which company provides your health insurance policy? *

What is your health insurance policy number? *

What is the phone number associated with your health insurance policy? *

Please upload a photo of your health insurance card *

Which company provides your hospitalization policy? *

What is your hospitalization policy number? *

What is the phone number associated with your hospitalization policy? *

Legal Stuff *

You need to read, understand, sign, and return the Youth contract...
You will not hold Lion and Lamb Ministries liable for any damages incurred while attending Camp Yeshua.
Lion and Lamb Ministries reserves the right to deny any registration.
Please attach your signed Parental Permission form *

Please attach your signed Youth Contract *

Please attach the signed Oakridge Minor Release *

How much of your registration cost will you cover at this time? *

{{var_price}} (choices are cumulative)

CY Registration Payment {{var_price}} *

Please enter your Credit or Debit Card number: *

The CVC number: *

(3 or 4 digit security number on the back of your card)
The name on your card: *

Your card's expiry month: *

Your card's expiry year: *

Thank you for submitting your registration for Camp Yeshua.  Please check your email over the next week or so for a Confirmation email.  You are not confirmed until you receive that email.  The confirmation email will be sent once all documents are confirmed to be completely filled out.  Please also make sure to check out the other payment deadlines to make sure you are paid up.

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