The Ambush Registration Form

Camper Information

Medical Information

In case of emergency, the camper’s personal health insurance will be used before Camp Selah’s coverage.

Camper Release Information

Michigan state regulations require the name of the person(s) to whom we may release your child in the event of parent/guardian absence. A photo ID must be provided upon request. In the event of an early pick up, parents/guardians must notify the camp director ahead of time.

Parental Agreement

Please read this document carefully. By signing this agreement, you acknowledge that camp activities carry inherent risks and agree to waive certain legal rights.

1. Emergency Medical Authorization & Insurance

• Authorization to Treat: In the event of an illness or injury to my child, I hereby grant permission to the medical staff of Camp Selah to administer first aid, and if necessary, to secure emergency medical care, hospitalization, injection, anesthesia, or surgery.

• Financial Responsibility: I understand that Camp Selah provides secondary medical insurance for campers. I agree that my personal health insurance is the primary coverage, and I assume full financial responsibility for all costs resulting from emergency medical care.

  
  

2. Liability Release & Assumption of Risk

• Activity Acknowledgments: I give permission for my child to fully participate in all scheduled camp activities, which may include outdoor recreation, water sports, team sports, and nature excursions. I understand that these activities involve inherent risks of physical injury.

• Release of Claims: I hereby release, waive, and discharge Camp Selah, its staff, and directors from any and all liability for personal injury, illness, or property loss sustained by my child during their enrollment, except in cases of gross negligence.

  
  

3. Behavioral Expectations & Dismissal Policy

I understand my child will be served by Camp Selah whose mission exalts Jesus Christ through creative programming, a safe and loving atmosphere and gracious hospitality, and a motto which is “Christ Above All.”

• Code of Conduct: I understand that my child must follow all camp safety rules, respect staff directions, and refrain from bullying, violence, or dangerous behavior.

• Dismissal without Refund: I agree that if my child’s behavior compromises the safety or well-being of themselves, other campers, or staff, the camp director reserves the right to dismiss them immediately. I am responsible for picking up my child promptly, and no refund will be issued.

  
  

4. Photo & Media Release

• Image Permission: I grant Camp Selah the right to use photographs or videos of my child taken during camp activities for promotional, brochure, or website usage.

By signing below, I certify that I am the legal parent or guardian of the camper named above, have read this document in its entirety, and agree to all terms and conditions outlined within it.

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Registration Payments