Teens Camp Registration Form:

As an alternative, paper form applications can be printed, filled out and submitted to Sunday School Office or Max Basaraba with cash or check payment.

ATTENDEE INFORMATION:

Please upload attendee picture:

Upload (8MB)

Name:

Address:

Birth Date:

Email:

This address will receive a confirmation email

Shirt Size:

GUARDIAN INFORMATION:

Parent 1 Name:

Phone:

Parent 2 Name:

Phone:

Does teen know how to swim?

Yes No

EMERGENCY CONTACT:

Name:

Phone:

Relationship:

MEDICAL HISTORY:

Does attendee have any allergies?

Yes No

If yes, please list all allergies:

Does attendee has medication specific allergies?

Yes No

If yes, please list medications:

INSURANCE & TREATMENT AUTHORIZATION:

Please print and fill out the medical treatment authorization for a minor and submit it to the Sunday School Office or Max Basaraba.
Medical Treatment Authorization for a Minor

Please upload copy of the medical insurance card:

Upload (8MB)

Medical Insurance Company:

Policy Number:

CAMP RULES:

1. Staff have permission to take all electronics away
2. Camp is not responsible for lost items
3. Child must bring appropriate clothing’s
4. For Emergency, parents are responsible for all costs
5. If, for any reason, parents wish to take the child home, notify director
6. In case of non-obedience of the child, parents are obligated to pick up child

I read and agree with above listed teen camp rules.

Yes

LIABILITY WAIVER:

I accept the fact that the New Life Missionary Church or any of the officers at the Camp Wa-Ri-Ki, or individual members, will not be held responsible or liable for any accident or injuries to my child.

I agree

The camp assumes legal custody for the child or children throughout the camp. In addition, both parents and child agree that the child will comply with the rules of the duration of camp, as well as, the staff of the camp. Parents and children should understand that this is a Christian camp and is based on Christian values and Biblical teachings.

I agree

CAMP FEE:

Payment: $130

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

June 25-28, 2025

Teens will head back to Camp Wa-Ri-Ki this summer along the scenic Washougal River.

When: June 25th-28th
Where: 17051 Washougal River Rd. Washougal, WA 98671 - 7115
Ages: 13-16
Cost: $130 per camper
Deadline: May 18th

This 18-acre property offers private river access and ample space for fun activities and games.
Without cell service at camp, teens can disconnect from their screens and focus on the simple pleasures often overlooked in our modern world.
NLMC provides a teen summer camp grounded in Christian principles.
Each morning, our excellent staff guides campers in Bible study with their small groups. In the evenings, everyone gathers for worship and discussions to nurture a genuine relationship with Christ.

Our committed activities team ensures campers have a great time by organizing creative and enjoyable activities: swimming, competition relays, dunk tank, slippery kickball, cornhole championship, sports and much more!

Our team is thrilled about this year’s camp and invites you to join us at NLMC!

For more information, contact:
Max Basaraba 503-961-3571
Moses Ivanov 503-348-9481

Teens Camp Registration Form:

Description

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