2024 GEMS Camp Registration is now Closed!

Registration

GEMS Name

First Name

Last Name

GEM'S Grade

Up to THREE girls that they would like to bunk with:

We will do our best to put them with at least ONE friend they request. If left blank, we will try to put them with a group of sweet girls. :) Please include FIRST and LAST name, if possible!

Church attending with

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Phone

(###)

###

####

Emergency Contact Name/Phone (if different than above)

Important Medical Information

Please list any medications that will be sent to camp (a nurse will help to administer/track), allergies, food sensitivities, car sickness, etc.

Insurance Company & Policy/Group #

Is there anything else we should be aware of?

By typing your name, you sign off on the following

I understand that this trip will be supervised by qualified leaders and I will not hold them or the camp and it's employees responsible in the event of an accident or injury to my daughter. Should illness or accident occur, which in the opinion of the leadership requires immediate medical attention, I give my permission to have my daughter treated by a doctor or hospital secured by the counselor in charge. If you are a parent or guardian of an 8th grader, you are also acknowledging that they have permission to participate in a climbing wall, zip-line, or similar activities which will be supervised by trained staff.

First Name

Last Name

THINGS TO KNOW

LOCATION:

Camp Arroyo; Livermore

https://www.uccr.org/camparroyo

We are excited to returning to Camp Arroyo for our 3rd year in order to spend time growing in our walk with God in the picturesque setting.

camp map

Schedule:

Friday, March 15: Depart your church at 4:15 p.m.

Friday night will be filled with dinner, worship and fun!

Saturday will be filled with rotations… from craft to rec. We will also spend plenty of time eating, singing and getting to know others better.

Sunday, March 17: Arrive back at 12pm for all church locations

Adult/Counselor Release

Name

First Name

Last Name

Church attending with

Do you have a daughter attending camp?

If so, please include her name and if you prefer to BE roomed with her or NOT be roomed with her.

Do you have any health concerns, medications, dietary restrictions, etc. that we should be aware of?

How long will you be staying?

Emergency Contact Name/Phone

Insurance Company Name & Number

By typing your name, you agree to:

I UNDERSTAND THAT THIS TRIP WILL BE SUPERVISED BY QUALIFIED LEADERS AND STAFF MEMBERS OF THIS YEAR'S CAMP/CONFERENCE CENTER. I WILL NOT HOLD THEM RESPONSIBLE IN THE EVENT OF AN ACCIDENT OR INJURY SUSTAINED BY MYSELF. SHOULD AN ILLNESS OR INJURY OCCUR, WHICH, IN THE CAMP NURSE OR DIRECTOR’S OPINION REQUIRES IMMEDIATE MEDICAL ATTENTION, I GIVE MY PERMISSION TO BE TREATED BY A DOCTOR OR HOSPITAL SECURED BY THE CAMP DIRECTOR.

First Name

Last Name