Check which Camp you plan to attend *

High School

Discipleship

Jr. High

Elementary

Name of Student *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Home Address *

Address, City, State, Zip

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Name *

First Name

Last Name

Contact *

(###)

###

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I understand and acknowledge that my child must use a soft duffle bag with a 30lb weight limit for travel *

First Name

Last Name

I understand and acknowledge that the camp planes cannot transport passengers that weigh more than 300lbs *

First Name

Last Name

I hereby authorize KHBC to obtain medical services for my child, should such services become necessary. I hereby release KHBC and its staff of any liability for accidents that may occur at camp or during travel to and from camp. In signing this, I give permission for my child’s belongings to be searched for articles or substances that are illegal or could be dangerous to him/her or other persons at camp. I also give permission for photos/videos of my child to be used for various promotions, brochures, and on the camp website or Facebook page. *

First Name

Last Name