Camper Application – CYC Caribbean

2025 Camper Application Form

for Caribbean Youth Camp

Lowes (Orange Bay) Camping Grounds, Jamaica

Church of God, a Worldwide Association

July 31 - August 4, 2025

GENERAL INSTRUCTIONS:

Camp fee: USD$350 per camper. Please make payments to local camp representative. NOTE: You must also complete the Health History and Examination Form for your application to be complete.

PERSONAL INFORMATION:

Applicant's Name:

Last *

First *

Middle

Last grade completed by June: *

Gender:

Male

Female

Address: *

City/Town *

Parish *

Country *

Birth date: *

Age by end of camp this year: *

Telephone number: *

E-mail:

Do you attend church regularly?

Yes

Parent's E-mail: *

Primary phone number: *

Congregation: *

Pastor's name: *

Child T-shirt Size:

XXL

Adult T-shirt Size:

XXL

Have you attended COG camps before?

Yes

If yes, when and where?

Swimming proficiency:

Can't swim

Beginner

Intermediate

Skilled

Current Lifeguard?

Yes

AND REASON FOR APPLYING:

Do you have any health problems, disabilities, severe allergies or any other condition that may require treatment at camp or that could limit your camp experience and full participation?

Yes

If yes, please explain:

List any on-going medical care or medication you are taking (if none, state "NONE"):

Are you willing to be a FULL PARTICIPANT in camp (except for health limitations noted above)?

Yes

In your own words, explain why you want to attend this camp: *

Parent: Please briefly explain what you hope your son or daughter will learn from his/her experience at camp: *

Are you aware of any special needs of your son/daughter such as facilities, medical attention, supervision or counseling?

Yes

If yes, please describe:

CAMPER PHOTO:

Upload camper photo
The photo should capture the camper's face only & the file must not exceeed 2MB in size.

The uploaded file is too large.

The form may take a few seconds to process.