New Heights Youth Camp Registration | Updated
Type of Registration
"Youth Registration" is for all youth, coming individually or with a group.
"Adult Registration" is for all adults who will be staying for the camp.
"Group registration" is for youth leaders who need to communicate group details to us. Youth should not use this registration.

Important Notice for Groups

Please complete this group registration so we know your group is attending. We’ll use this information for updates, team placement, and housing assignments.

Each attendee must also submit their own individual registration—please ask your group members to register as soon as possible.

If you’re using paper forms instead of the online form, you can email copies to youthcamp@kmbc.edu to reserve your spot. Bring the original forms with you to camp.

Camper/Leader Info

First Name
Middle
Last Name
Are you attending New Heights with your group?
Address
Address
Street Address
Address Line 2
City
State / Province
ZIP / Postal Code
Country
Note: Background checks are required for all adults working with youth. If you have a background check already completed, please send that to us.
Do not include the dashes
I release KMBC to perform a background check on me. I understand that this background check will be used to inform churches and camps of my fitness to serve.
I understand the information supplied by me must be truthful and falsification with an intent to mislead may result in my prosecution under KRS 523.100. I have provided the basic information necessary to qualify for record processing.

Group Info

If unsure, provide an estimate.
If unsure, provide an estimate.
Are you coming with a group?

Parent/Guardian Info

First
Last
Is parent/guardian emergency contact?

Emergency Contact Info

First
Last

Medical Info

Will your child require any medication to be administered during camp?

Medication

Camper's prescription and over-the-counter medications must be turned in at registration in their original bottles with labels intact. Loose pills in baggies or pill organizers will not be accepted.
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I, the undersigned parent/legal guardian authorize the following non-prescription medication to be administered to my child.
I, the undersigned parent/guardian, hereby consent to my child participating in the New Heights Youth Camp, an event sponsored by Kentucky Mountain Bible College, meeting multiple weeks in the summer. I consent to allow my child to be photographed or recorded during the event for public relations by KMBC and it's employees. I certify that my child is able to participate in the camp activities as listed in the brochure and otherwise. I understand that NHYC is an active camp and may not be suitable for individuals with physical limitations and or emotional/behavioral special needs. I understand that if my child falls into this category that they must be accompanied by a parent or chaperone. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them. In the event of an emergency, I may be reached at the telephone numbers listed above. If I cannot be contacted, I hereby authorize Kentucky Mountain Bible College, its agents or employees to obtain such medical treatment as may be necessary in their judgment to ensure health, safety and well-being of my child. I understand and hereby agree to assume all risks which may be encountered on said activity, including activities preliminary and subsequent there to. I hereby agree to hold Kentucky Mountain Bible College, their agents and employees harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child, property even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities. I expressly agree that this release, waiver and indemnity agreement is intended to be broad and inclusive as permitted by law of the State of Kentucky and that if any portion thereof is held invalid; it is agreed the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and a mere recital. I will disclose and update any changes that may occur to this release before the date of the event. I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understood.
I, the undersigned parent/legal guardian, have read the above statement and agree.
I understand that participation in youth camp activities involves inherent risks, including but not limited to potential exposure to COVID-19, and I accept full responsibility for these risks and release Kentucky Mountain Bible College, its employees, and affiliated parties from liability. In case of an emergency, I hereby authorize Kentucky Mountain Bible College, its agents or employees to obtain such medical treatment as may be necessary in their judgment to ensure health, safety and well-being. I understand and hereby agree to assume all risks which may be encountered on said activity, including activities preliminary and subsequent there to. I hereby agree to hold Kentucky Mountain Bible College, their agents and employees harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to me or property, even injury resulting in death, which I now have or which may arise in the future in connection with the activity or participation in any other associated activities. I understand the risks involved with COVID-19 exposure and otherwise with group camp activities, and incidents related to COVID-19 are expressly included as part of this waiver. I consent to allow myself to be photographed or recorded during the event for public relations by KMBC and it's employees.I expressly agree that this release, waiver and indemnity agreement is intended to be broad and inclusive as permitted by law of the State of Kentucky and that if any portion thereof is held invalid; it is agreed the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and a mere recital. I will disclose and update any changes that may occur to this release before the date of the event. I further state that I have carefully read the foregoing release and know the contents thereof and I sign this release as my own free act. This is a legally binding agreement which I have read and understood.
I, the undersigned, have read the above statement and agree.
Which camp will you be attending?