Teen and Junior Summer Camp 2026

Register Below

Download The Brochure

Camper Information:

Camper's First Name *

Camper's Last Name *

Gender *

Address *

City *

State *

Postal code *

Age *

Grade in Fall 2026 *

Date of Birth *

Church Group *

Camper T-Shirt Size (Included in registration) *

CAMP WEEK 2026 *

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Roomate Request (honored if possible)

CAMPER AGREEMENT:

I have read the camp information, including the dress code and the 'do not bring' list. I agree to totally cooperate and comply in all areas. I understand that the primary emphasis of camp is spiritual

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Camper Agreement Signature *

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Camper Agreement Date *

PARENT / GUARDIAN INFORMATION:

Parent's First Name *

Parent's Last Name *

Parent's Email *

Parent's Cell Phone *

Parent's Work Phone *

Med. Insurance Co. *

Policy # *

My Child Is Physically Healthy and Able to Participate in the Camp Program Except: *

Is Camper Taking Medications? *

Date of Last Tetanus Shot (If none enter unknown) *

Please Note Any Medications, Health Issues, Behavioral, Emotional Problems (including infectious diseases)

Please List Allergies:

If I cannot be reached in an emergency, I hereby give permission to MPACT YOUTH CAMP to accrue proper treatment for the above name child.

Parent / Guardian Signature *

Clear

Parent / Guardian Signed Date *

Choose Week and Snack Plan Option: *

Junior Summer Camp 2026 (T-shirt Included)

$129

Teen Summer Camp 2026 (T-shirt Included)

$149

*100% secure & safe payments*