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Camp Meribah Registration
Register for Camp Meribah Below!
Camper*
Email Address*
Address*
City*
State*
Zip*
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Male
Female
Gender*
Age*
Last Grade Completed*
Phone*
Other Phone*
Parent Or Guardian Name*
Home Congregation*
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Adult
Youth
Adult or Youth T-Shirt*
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XS
S
M
L
XL
T-Shirt Size*
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Yes
No
Requesting Scholarship?*
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Yes
No
Has the Camper been to Camp Meribah Before?*
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$50
$75
$100
$125
$150
Requesting Scholarship Amount
Camp Week*
Day Camp
Mini-Meribah
Youth Week
Teen Week
Amount Due Today*
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Yes
No
Pay All Camp Fees Now*
Note
May Camp Meribah use the camper's photo on social media, camp videos and other promotional purposes?*
Yes
No
I, the undersigned parent or guardian of the above mentioned, a minor, do hereby authorize the Centerville Church of Christ/Camp Meribah Staff to consent to any examination, treatment, and hospital care which is deemed advisable by a physician in the exercise of their best judgment and release Camp Meribah and its staff from all liability. I also understand that summer camp attendance presents a risk of injury or illness due to activities, transportation, and housing with other campers, including COVID-19. By signing below and allowing my child to attend camp, I acknowledge such risks and release Camp Meribah and its staff from liability. I also acknowledge that Camp Meribah is a Christian Camp that operates on Christian characters and values and that my child may be dismissed without refund for any behavior not in accordance with the values of Camp Meribah.
Electronic Signature*
Sign Date*