High School Camp Registration Form

PARENT/LEGAL GUARDIAN INFORMATION
2026 Camper Registration Form
Camp Session (Please Register Based on Grade Completed in '25/'26 School Year)*
Camper Information

One Form Required Per Camper
Full Legal Name*

First NameLast Name
Sex*

MaleFemale
Preferred Name
School Grade Completed '25-'26*
Birthdate*

MonthDayYear
Date
Age:*
T-Shirt Size (Adult Sizes)*

SmallMediumLargeX-LargeXXLOther
Other Size Information

Primary Guardian Name*

First NameLast Name
Relationship to Camper*
Address*

Street Address

Street Address Line 2

CityState

Postal Code
Home Phone Number
Cell Phone Number*
E-mail*
example@example.com
Would you like to add information for a Secondary Guardian?

YesNo
Secondary Guardian Name*

First NameLast Name
Relationship to Camper
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Home Phone Number
Cell Phone Number*
E-mail*
example@example.com
Do you (there person registering) have legal custody of the child who is being registered?*

YesNo
If no, do you (there person registering) have permission from the person with legal custody to register the child for camp?*

YesNo
Home Church (if applicable)
Emergency Contact (other than the guardian listed above)

In the case that we are unable to reach the legal guardians in an emergency, please provide the name and number of someone we can contact.
Emergency Contact Name*

First NameLast Name
Cell Phone Number*
Work Phone Number
E-mail*
example@example.com
Custody and Restrictions: Are there custody agreements or restrictions? If yes, true and correct and conforming copies of such documentation must be uploaded.*

YesNo
Custody Documentation

Cancelof
Is the Authorized Pick-Up Person different than the Legal Guardian above?
Authorized Pick-Up Person(s)*

First NameLast Name
Relationship to Camper*
Cell Phone Number*
E-mail*
example@example.com
Would you like to add a 2nd Authorized Pick-up Person?
Authorized Pick-Up Person(s)

First NameLast Name
Relationship to Camper
Cell Phone Number
E-mail
example@example.com

Registration Consent - Camper #1
Liability Waiver, Assumption Of Risk, And Medical Authorization and Release
The Refuge at Living Water LLC dba Mountain View Christian Camp (“MVCC”)

ACKNOWLEDGMENT OF RISK
I understand and acknowledge that participation in activities operated, managed, or hosted by The Refuge at Living Water LLC dba Mountain View Christian Camp may include, but not be limited to:
Outdoor recreation and hiking;
Sports and group games;
Campfire activities;
Worship services and group gatherings;
Team-building initiatives;
Transportation on and off camp property; and/or,
Exposure to natural terrain, wildlife, and varying weather conditions.
I also understand and acknowledge that these activities involve inherent risks including, but not limited to, physical injury, illness, allergic reactions, emotional stress, property loss, or, in rare cases, serious injury or death.

ASSUMPTION OF RISK

I knowingly, willingly, and voluntarily assume, without compunction or undue influence, all risks associated with my child’s participation in MVCC activities, whether such risks are known or unknown, foreseeable or unforeseeable.

RELEASE AND WAIVER OF LIABILITY

In consideration for my child’s participation in any MVCC operated, managed, or hosted activities, I hereby release, acquit, waive, discharge, and covenant not to sue:
The Refuge at Living Water LLC dba Mountain View Christian Camp,
its officers, directors, employees, volunteers, contractors, ministry partners, agents, and representatives, from any and all claims, threats of claims, demands, actions, or causes of action arising out of or otherwise related to:
Participation in MVCC camps, programs, or activities;
Use of MVCC facilities or equipment;
Transportation arranged or provided by MVCC; or,
Acts or omissions of other participants.
This release includes claims based on negligence, except where prohibited by law.

MEDICAL AUTHORIZATION

In the event of illness or injury, I authorize MVCC staff or representatives to:
Administer basic first aid;
Obtain emergency medical treatment; or,
Transport my child to a medical facility when reasonably necessary.
I understand that reasonable efforts will be made to contact me as soon as possible.
I accept full financial responsibility for all medical care provided to or for my child by medical providers engaged by MVCC pursuant to this Medical Authorization.

INSURANCE ACKNOWLEDGMENT

I understand that MVCC does not provide medical insurance coverage for campers and that I am responsible for maintaining adequate medical insurance for my child.

SEVERABILITY

If any provision of this agreement is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

GOVERNING LAW

This agreement shall be governed by and construed in accordance with the laws of the state in which MVCC operates, manages, or hosts camps and other such activities hereinabove referenced.
ACKNOWLEDGMENT & SIGNATURE: I certify that I am the parent or legal guardian of the minor listed above. I have read the attached Liability Waiver, Assumption of Risk & Medical Release agreement fully, understand its contents, and voluntarily agree to its terms.*

Agree
Name, Image, and Likeness (“NIL”) Grant of Lawful Use
The Refuge at Living Water LLC dba Mountain View Christian Camp

For and in consideration of your acceptance of my enrollment, attendance, participation in, or acting in association with, any activity operated, managed, or hosted by The Refuge at Living Water LLC, a Texas limited liability company, dba Mountain View Christian Camp (“MVCC”), I do hereby grant to The Refuge at Living Water LLC, a Texas limited liability company, dba Mountain View Christian Camp the right to use any photographic or video images containing my image or likeness which are, were, or which may be, taken at any activity operated, managed, or hosted by MVCC during the calendar months of June & July 2026 for any lawful use, including, but not limited to: publicity, copyright purposes, illustration, advertising, and web content. Once timely created as prescribed or otherwise permitted herein, MVCC may continue to use such photographic or video images containing my name, image, or likeness in any lawful manner in its sole discretion into perpetuity. MVCC warrants and represents to me, however that it will not use publicity, advertising, web content or other marketing materials containing my name, image or likeness which is not or was not created and in existence during the calendar months of June and July of 2026, while attending, participating in, or acting in association with, any activity operated, managed, or hosted by MVCC.

Furthermore, I understand and acknowledge that, other than the consideration stated hereinabove, there shall be no royalty, fee, or other compensation in any form or manner which shall become payable to me by reason of MVCCs exercise of the rights such as I have granted herein.

The provisions of this written grant of lawful use of my name, image, and likeness shall be binding upon and inure to the benefit of the parties hereto, and our respective heirs, successors, executors, administrators, assigns, and legal representatives.
ACKNOWLEDGMENT & SIGNATURE: I certify that I am the parent or legal guardian of the minor listed above. I have read the attached Name, Image, Likeness ("NIL") Grand of Lawful use agreement fully, understand its contents, and voluntarily agree to its terms.*

Agree
Transportation Waiver: I authorize MVCC to transport my camper within or upon camp approved vehicles from time to time as the MVCC camp administration should deem necessary or desirable while my camper is in attendance.*

Agree
Parent/Guardian Name:*

First NameLast Name
Date*

MonthDayYear
Date
Signature

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Registration Payment

Cost is $300.00 per camper, with an early bird registration of $250.00 (before midnight on 3/15/26). This price includes lodging, meals, canteen snacks, and all activities. Full payment is due upon submission.

Early Registration1 Camper

$250.00

Support MVCC Give toward the cost of a camper experience. Contributions help offset camp expenses and support scholarships as needs arise.

$250.00 Quantity

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Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

	Medication Name	Daily AM	Daily PM	As Needed	Medication Administration Instructions
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PARENT/LEGAL GUARDIAN INFORMATION

2026 Camper Registration Form

Camper Information

Camper Medical Information - Camper #1

Emergency Contact (other than the guardian listed above)

Registration Consent - Camper #1

Registration Payment