CCUC Junior Camp Registration Form

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Registration Instructions - Junior Camp 2022

Please complete one registration form for EACH camper
Before proceeding, please note and agree to the following:
 
1. At this time, COVID-19 vaccination will be required for all campers and staff to attend Junior Camp 2022 with limited exception. Proof of vaccination is not required for registration, however all students and staff should ensure that they complete full vaccination by July 15, 2022. A copy of your vaccination card can either be uploaded during registration or emailed to us once completed. We will follow guidelines from health authorities regarding masks during the week of camp.
 
2. Camp fees include all lodging, meals, activities, and a camp t-shirt. Some optional activities are available for an additional fee (see FAQ on our website for more details):
 
Junior Camp Fees 2022
Register before June 1: $310
Register after June 1 (until July 15): $325
 
3. Full payment of camp fees are due at time of registration and will be collected at the end of this form. Fees are to be paid by credit or debit card ONLY (paper checks are no longer accepted). Camp fees (minus $50 processing fee) are refundable if cancellation request is received via email by July 15, 2022.
 
4. No refunds will be applied after July 15 as we will be billed by the camp site for the full amount for each camper, whether or not they come to camp. For the same reason, no refunds will be applied for campers who do not stay for the entire duration of camp.

5. Overnight camp fees are not considered tuition or childcare for tax return purposes per the IRS. If you require financial assistance, please contact the directors.

6. FAQ and director contact info can be found on our website at www.ccucjuniorcamp.com

Acknowledgement *

Registration Availability (please select one)

Age Group - Registration Availability * 🛈
(1 remaining) (3 remaining)
(0 remaining) (0 remaining)
(6 remaining) (1 remaining)
If your child's age group is not available for registration, you may join our wait list by visiting www.tinyurl.com/ccucjrcwaitlist. We will notify you if a spot becomes available.

1. Camper Information

First time at Jr. Camp? *
Gender *
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T-Shirt (adult size) *

Transportation to/from Camp

Transportation to/from camp is provided via bus from CCUC in Chinatown or CCFC in Wilmette. Please select a pick-up and drop-off location:
Bus PICK-UP Location (MONDAY morning) *
 
Bus DROP-OFF Location (SATURDAY afternoon) *
 

2. Parent/Legal Guardian Information

3. Health and Insurance Information

A First Aid counselor will be on site at all times to assist your camper if necessary. We will provide any necessary basic over-the-counter medication (e.g. Benedryl, Tylenol, Ibuprofen, Anti-itch cream, etc). However, if your child requires specific medication, please be sure to pack it with the camper.

ALL PRESCRIPTION medications must be declared. You do not need to declare OTC medication that your child may self-administer (e.g. Claritin, Allegra, Tylenol, etc.).
My child has allergies, dietary restrictions, prescription medication, or physical, mental, or other condition that may require special attention during camp: *

COVID-19 Vaccination (Required)

All participants (staff and students) must complete COVID-19 vaccination to attend Junior Camp 2022. *
Proof of COVID-19 Vaccination
Please upload an image of your completed CDC COVID-19 Vaccination Record Card.

Proof of COVID-19 Vaccination
Please complete vaccination by July 15th and email a copy of your vaccination record card to ccucjuniorcamp@ccuc.net upon completion

Health Insurance Information (Optional)

4. Camper Release

As parent/legal guardian of
(the “Participant”), I grant permission for my child to attend Junior Camp on August 8-13, 2022. I have read the attached information about the activity and understand that my child will be at Phantom Ranch Bible Camp in Mukwonago, Wisconsin under the supervision of the adult staff.

I have read the above information about the trip and understand that my child will be leaving the Chinese Christian Union Church (CCUC) premises.

I acknowledge that participation in the activity described above involves risk to the Participant (and to the Participant’s parents or guardians, if Participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage and financial damage.

In consideration for the opportunity to participate in the activity described above (the “Activity”), the Participant (or parent/guardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the Activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the Activity or during transportation to and from the Activity, as well as for any medical treatment rendered to the Participant that is authorized by the Sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to hereinafter as the “Activity Sponsor”). Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the Activity Sponsor for any injury arising directly or indirectly out of the described Activity or transportation to and from the Activity, whether such injury arises out of the negligence of the Activity Sponsor, the Participant, or otherwise.

I/We also acknowledge that the Activity Sponsor reserves the right to inspect any luggage, including but not limited to suitcases, duffle bags, backpacks, purses, etc., that the Participant may bring to the Activity. Such inspections shall be conducted solely for the purpose of maintaining the safety of all individuals who may be present for the Activity. When such inspections occur, they shall be done in full view of the Participant and all Participants are hereby warned that the Activity Sponsor may have an obligation to contact the proper legal and law enforcement authorities if items of questionable legality are found.

If a dispute over this agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the Participant (or parent/guardian) and the Activity Sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution pursuant to the rules of the American Arbitration Association or other agents designated by the CCUC Deacons Board.

I/We understand that all reasonable safety precautions will be taken at all times by CCUC staff and volunteers during the event and activities. In case of an emergency, I/we authorize any medical treatment by an accredited hospital and/or physician deemed necessary for the subject of the release.
I/We understand the possibility of unforeseen hazards and know the inherent possibility of risk.
Acknowledgement *

Waiver of Liability Relating: Coronavirus/COVID-19

On March 11, 2020, The World Health Organization declared the novel coronavirus, COVID-19, a pandemic. COVID-19 is highly contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people over the past several weeks. Chinese Christian Union Church (the “Ministry”) has put precautions in place to reduce the spread of COVID-19; however, the Ministry cannot guarantee that you or your family, including your child(ren), will not become exposed to or infected with COVID-19. Further, because of the number of individuals involved in Teen Camp and the fact that many infected individuals appear to be asymptomatic, attending this activity could increase your and your child(ren)’s risk of contracting COVID-19.

By signing this waiver, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19. I also acknowledge that by attending Junior Camp, such exposure or infection may result in personal injury, illness, disability, and/or death. I understand that the risk of becoming exposed to or infected by COVID-19 at Junior Camp may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Ministry employees, contractors, volunteers, members, and participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense of any kind that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the Ministry or participation in Junior Camp (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the  Ministry, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Ministry, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any program.

Acknowledgement *

Acknowledgement *
Parent/Legal Guardian Signature *
clear
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5. Payment Information

Camp Registration Fee includes all lodging, meals, activities, and a camp t-shirt.
Optional activities are available at an additional cost (cash only paid at camp).

Please note that payment of CCUC Junior Camp Registration Fee is not considered tuition or childcare for tax return purposes.

Camp Fee *
After you click on "Next," your registration form will be submitted and you will be taken to the payment page. Please do not exit the payment page or the payment will not be completed.
 
Full payment must be made in order to complete the registration process. We use Stripe to process all online payments. Stripe is an industry leader in secure credit card payments. CCUC does not not have access to any of your payment information.