Koinonia Nature Camp Registration

Thank you for registering your child for Koinonia Nature Camp 2024! We are excited to start an amazing summer experience for your family.

Below you will find much of the information that we need to complete the registration process. Once this online portion is submitted, we will forward a few more documents that must be signed by you and sent back to us:

  • Signed Medical Release Form (one per child)
  • Health History Form (one per child)
  • Behavior Policy
  • Swimming/Boating Consent Form
  • TO/S/R Consent Form (sunscreen and insect repellent)
  • Photo Release Form
  • Staff Transportation Consent Form
  • Inclement Weather Policy
  • Bible Stories Consent Form

Please note that no participant will be accepted into the program until all information is completed and given to our office.

Questions? Contact our Executive Director, Kathleen Ruen at program@koinoniany.org




Please CLICK HERE to read the Koinonia Nature Camp Policies and Payment Options.

Parent/Guardian Information










 










 

Child Information





 





 





Emergency Contact Information

The following are names of people other than the parents/guardians listed above who can be contacted IN CASE OF AN EMERGENCY, AND/OR MAY PICK UP MY ILL CHILD if I cannot be reached. You must list someone in addition to yourself or your spouse.






Unless otherwise specified here, only the above listed parents/guardians will be allowed to pick up their child. If there are any specifications about custodial rights or pick-up rights, they must be submitted IN WRITING to Koinonia. Your child will not be allowed to be picked up by anyone other than the above listed parents/guardians unless the contact information is provided here and your signed approval is received prior to the start of camp. This will be strictly enforced. The following people have permission to pick up my child/children at the end of the camp day:







Medical Contact Information






Session Information

Please indicate which session(s) you are registering for:*

Session 1 (limited) – July 1-3
Standard Day
Extended Day

Session 2 – July 1-3
Standard Day
Extended Day

Session 3 – July 1-3
Standard Day
Extended Day

Session 4 – July 1-3
Standard Day
Extended Day

Session 5 – July 1-3
Standard Day
Extended Day

Session 6 – July 1-3
Standard Day
Extended Day

Session 7 – July 1-3
Standard Day
Extended Day

Session 8 – July 1-3
Standard Day
Extended Day