Registration $210 ($195 if before November 4, 2024 at 12:01 AM)

Your home congregation will be invoiced for the registration fee. Please work with your congregational leaders to arrange for camp payment.

I will attend Fall Fandango 2024*

Camper
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Adult Sponsor
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Young Adult Group
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Attendee Name

Attendee Gender

Male
Female

T-Shirt Size

Mailing Address

My Home Congregation is

Attendee Phone Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Attendee Email

Parent/ Guardian Name (Adult Sponsors, please enter your name again.)

Parent Phone Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Parent Email

Attendee Date of Birth

Attendee is

FIRST Emergency Contact including name any phone numbers and emails

Second Emergency Contact Information including phones and email

Very Important Medical Information

Please understand that ALL medications (even over-the-counter medications) must be given by Regional Staff while at camp.

Describe any current medical conditions and any current medications which will be sent to camp.

Please indicate the camper's allergies (including medical and food)(Be sure to list any dietary restrictions here.):

Please list any disease exposure, including Chicken Pox, Mumps, Measles, COVID-19 etc.:

Please list any restricted activites, e.g., swimming:

Date of last Tetanus Shot

Attendee is fully vaccinated for COVID-19

Attendee is current on all required vaccinations

The following medications may be dispensed by adult sponsors of Fall Fandango if needed:

Acetaminophen

Ibuprofen

Pepto Bismol

Skin creams

Physician's Name

Physician's Phone Number

Medical Insurance Carrier

Group Number

Policy Number

Claim Approval Hotline:

Camper Profile

To aid our staff in caring for your child during these overnight, away-from-home events, please complete this “CAMPER PROFILE.” Also, please commit to praying for both the spiritual growth and physical safety of all of the children attending this GRR youth event.

Please share your camper’s expectations for camp. Please share whether this is your child’s first time at camp.

Please describe your camper’s personality:

Please share your camper’s likes & dislikes.

Please share your camper's interests and talents:

Please share how your camper is best consoled when upset:

Please review the list below and indicate any areas which cause you concern for your child. Please elaborate on such concern.

Hyperactivity or short attention span

Demanding or agressive behaviors

Sleeping issues ie. bedwetting, sleepwalking, insomnia, night terrors

Personal Hygiene

Other things we should know

Terms, Conditions, and Waivers

Parent/Guardian PERMISSION TO ORDER MEDICAL PROCEDURES

I give the adult leader(s) for this event permission to order any necessary medical procedures for the youth participant.
I understand that Event insurance (paid by GRR) is secondary coverage only. Primary responsibility for medical treatment belongs to me and to my health insurance provider. I agree not too hold liable for any uninsured medical expenses the Great River Region, its employees and agents.

I have read and agree to the terms above.

Parent/Guardian PERMISSION FOR YOUTH TO PARTICIPATE

I do hereby give permission for my child to participate in the above referenced event, including other locations connected with the event and transportation to/from those locations.
I furthermore agree to immediately pick up my child from the event should my child be found to possess alcohol, controlled substances or tobacco; verbally, physically or sexually assault another; engage in illegal activity; or blatantly disregard other event guidelines or instructions from event leaders; or is running a temperature above 100.4 degrees and/or shows signs of having a contagious infection. I am in full agreement with the intent of this event, i.e., to assist my child in developing a deeper relationship with Jesus Christ and growing into the person God has called my child to become.

I have read and agree to the terms above.

Youth Covenant of Conduct

“As a youth participant, I agree to follow all rules and instructions set forward by the adult leadership of this event. I agree to follow all instructions and guidelines given to me by my virtual sponsor. I agree to have a good attitude throughout this event and to behave in a manner consistent with my Christian faith. I understand that if I break event rules, I can be removed from the event.

I have read and agree to the terms above.

By typing my name, I give permission for the GRR to publish photos or videos of my camper from any Great River Region Sponsored Youth Event. TYPE NO TO WITHHOLD CONSENT

REGISTRATION FEE PAYMENT

Early Bird Registration is $195.00

November 4, 2024, at 12:01 AM, the Registration fee will increase to $210.00

Please arrange to pay the registration fee or request a scholarship with your local congregation.

All congregations will be invoiced for the registration fees.

You may be invoiced for the registration fee if a congregation does remit payment.