FAC 2026 REGISTRATION

Registration Form

Grade School / Middle School F.A.C - Faith Adventure Camp Aug. 16-21, 2026
CAMPER INFORMATION

Grade School Camp is for ages 7-11, entering 2nd-5th grade fall 2026. Middle School Camp is for ages 11-14, entering 6th-8th grade fall 2026.
Preferred Name
Legal Name*

First NameLast Name
Birthdate*

MonthDayYear
Gender Identity
Grade (entering fall 2026)*
GUARDIAN INFORMATION
Guardian Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Camper Address*

Street Address

Street Address Line 2

CityState

Zip Code

EMERGENCY CONTACT

Please list a second contact in case the primary guardian cannot be reached.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relation to Camper*
"OTHER" - AUTHORIZED PERSONS

If needed, list 1-2 "other" people that may check-in / check-out or transport your camper. Camp Burton cannot release campers to anyone who is not listed on this registration form.
Name

First NameLast Name
Name

First NameLast Name

ADDITIONAL DETAILS
The camper...*

is new to Faith Adventure Camphas attended Faith Adventure Camp before
How did you hear about our programs?
Shirt Size*
Cabin-Mate Request
We cannot guarantee these requests. Campers must be in the same session and within 18 months of age.

CAMPER INTAKE QUESTIONNAIRE & MEDICAL PERMISSIONS
Does the camper have any dietary needs, allergies or restrictions?
Our kitchen can accommodate and/or provide substitutions for most food allergies. Please be aware that our food may come into contact with common allergens, such as dairy, eggs, wheat, soybeans, tree nuts, peanuts, fish, shellfish or wheat. While we take steps to minimize risk and safely handle the foods that contain potential allergens, please be advised that cross contamination may occur, as factors beyond our reasonable control may alter the formulations of the food we serve, or manufacturers may change their formulations without our knowledge. Camp Burton maintains a "peanut-free" kitchen.
Please list any medical, physical or psychological conditions that we should be aware of. Examples: bedwetting, asthma, recent concussion, anxiety A detailed Health History and Medication Form will be sent after registration is submitted.
Additional health (mental and/or physical) comments, requests, and/or notes.
Guardian Initials*

Powered by Jotform SignClear
What are some of the camper's interests?
Favorite hobbies, activities, shows, music, foods, etc.

PERMISSIONS & RELEASE OF LIABILITY
Camp Burton has permission to video/photograph the camper for:

promotional use - onlinepromotional use - print
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date

Registration Form