camper registration

Camp Salvation Camper Registration 2022
Before you begin, please ensure that you have the following documents completed and available to upload:
- Statement of Health *: this can be a copy of the campers most recent physical or the linked form, must be within the past 24 months and signed by a health care provider
- Immunization Records * on the required form OR the approved Exemption Certificate
- Medical Administration Form (for camper's bringing prescribed medication, note that this will need signed by a health care provider)
- Allergy Rescue Medication Self Carry Release
- Asthma Rescue Medication Self Carry Release
*These documents or applicable alternatives are required for all campers, per regulations of the CDHS Child Care Licensing Department.

These documents are also avaliable on our website, if the above links are not working. Registrations must be complete to be accepted. All paperwork must be attached in order to submit this registration. Any registration missing documentation will be considered incomplete. You can save your progress at anytime and it is suggested that you do so before submitting.

Because we operate with a volunteer staff, we are only able to accommodate special meals for dietary restrictions and allergies. Our space is limited and we ask that you do not bring food to camp unless it is a medical necessity. Please contact registration staff to be sure that we have the information we need to provide meals for you or your camper.
Camper Information
First Name *
Middle Name *
Last Name *
Likes to be called
Gender *

Male Female
Birth Date *

Month Day Year
Grade entering in the fall *
Address *
City *
State *
Zip *
Home Phone *

Area Code Phone Number
Parent or Legal Guardian Information
Parent/Legal Guardian *
Relation *
Work Phone *

Area Code Phone Number
Cell Phone *

Area Code Phone Number
Parent/Legal Guardian 2
Relation 2
Work Phone 2

Area Code Phone Number
Cell Phone 2

Area Code Phone Number
In addition to those already listed, two more contacts are required by CDHS Child Care Licensing.
Emergency Contact 1 Name (if parent or guardian is not available) *
Contact 1 Number *

Area Code Phone Number
Contact 1 Alternate Number

Area Code Phone Number
Emergency Contact 2 Name (if parent or guardian is not available) *
Contact 2 Number *

Area Code Phone Number
Contact 2 Alternate Number

Area Code Phone Number
Cabin Buddy

List a first and second choice, not all requests are guaranteed.
Cabin Buddy #1
Cabin Buddy #2
Church Information
Church you attend
City/Town
Name of City
Church you are coming with (if any)
Email Confirmation
Parents Email (camper confirmation will be sent by email) *
Camper's Email
if camper would like to receive updates or contact after camp
Other Information
How did you hear about Camp Salvation?
Health Information

A camp nurse is on site at all times.
It is our policy to contact the parent or guardian as soon as possible in the event of a serious accident or injury. If any of the information below has changed on the day of registration please inform the nurse during check-in. If the child will be staying in a cabin with campers, all medication must be turned in to the Camp nurse at check-in. Please bring all medication or vitamins in the ORGIANAL CONTAINER or they cannot be left with the Camp medical personnel. All prescriptions must be in that child's name and the correct dosage.

For the required fields below, if nothing applies, please put "NONE" in the box.
Is camper free from infectious diseases or conditions? *

Yes No
Are immunizations up to date? *

Yes No
Date of last tetanus shot *
Type unknown if not sure
Please list any known allergies and a description of their reactions: *
Please describe any physical or mental condition requiring camps special attention: *
Please list and describe any past illnesses, surgeries, accidents, or chronic health problems: *
Any activity the camper should be restricted from? *
Feel free to include any other helpful information:
List all medications that the camper will be bringing with them. This includes both prescriptions, over the counter, vitamins, and supplements. All medications will be turned into the Camp Nurse. *
In order for the Camp Nurse or first aid responder to administer medications they deem appropriate please check any of these over the counter meds you would approve of: *

Acetaminophen (Tylenol) Ibuprofen (Advil, Motrin) Antibiotic Ointment Tums Maylox Mylanta Benadryl Afrin Nasal Spray Sunscreen Bug Spray None
Will your camper need to cary rescue medication? (example: epipen or inhaler) *

Yes No
Multiple documents can be uploaded for each section if needed. If you do not have a digital copy of a document, you can take a picture and upload that version. Supported File Types include: pdf, doc, dox, png, and jpeg.
*Nonmedical exemptions expire June 30th each year. If a signed exemption cannot be obtained, parents can complete the online module through CDPHE.

Each of these requirements must be met for anyone staying at Camp Salvation, per regulations of the CDHS Childcare Licensing Department.

These documents are also avaliable on our website, if the above links are not working. Registrations must be complete to be accepted. All paperwork must be attached in order to submit this registration. Any registration missing documentation will be considered incomplete.
Please upload a copy of the camper's most recent physical or statement of health, must be within the last 24 months. *

Browse Files

Cancel of
Please upload the Medication Administration form.

Browse Files

Cancel of
Please upload the camper's immunization record or exemption certificate. *

Browse Files

Cancel of
Please upload the required Rescue Medication Self Carry Release document(s).

Browse Files

Cancel of
Camper Release
Camper Release (List anyone, including parents or youth group leaders, to whom your camper CAN be released) *
Week Selection

Registrations submitted by May 30th will qualify for the preregistration discount: $10 off. Please use the coupon code CS2022. It is advised that you call for bed availability after that date. If you were Camper of the Week or Runner-Up last year, please contact Kendra England (719 469-5390 or secretary@campsalvation.com) for a discount code. As weeks reach capacity, campers will be placed on a waiting list. It is our desire to serve as many campers as we can. Campers may only register for one week. If your camper is interested in attending a second week, please contact Kendra England to be placed on a waiting list for their second choice. You will be notified a week before if there is availability.

Week Selection *

High School 2 $ 95.00

July 11-16, Ages 14-18, Grades 9th-12th

Junior High 2 $ 90.00

July 18-23, Ages 11-14, Grades 6th-9th

Elementary 2 $ 85.00

July 25-29, Ages 8-11, Leaving 3rd-6th

Enter coupon

Total $ 0.00

Credit Card

Terms of Agreement
Admissions: Rules for acceptance are the same for everyone without regard to race, color, nationality, gender, religion, or disability. Camp Salvation is not a treatment center, and staff, who are all volunteers, are not trained to deal with campers who have severe mental, physical, or emotional difficulties. We do not want to neglect anyone, so we request that an Adult Sponsor be sent to assist special needs campers. This will ensure that neither their needs or the needs of the other campers in their cabin are neglected. If no Adult sponsor is provided for your special needs camper, we reserve the right to refuse admission to our programs; per the General Rules for Child Care Facilities 7.701.14 and 7.702.61c. Please see our website for more information.

Cancellation and Dismissal Policy: Cancellations made more than two weeks before the date registered will be refunded. Any cancellation after that time will only be refunded for medical reasons and must be accompanied by a letter from the attending physician.

Camp Salvation reserves the right to dismiss any camper whom the staff believes presents a safety concern, medical risk, is disruptive, or otherwise conducts themselves in a manner detrimental to the camp community, no refund will be issued for dismissal.

Camp Rules and Expected Behavior: Campers should come to camp with the intention to grow closer to God, meet new people, and have fun. Campers are expected to participate and get the most of every activity at Camp. Phones are not to be a distraction. Don’t bring a bad attitude to Camp or a desire to do wrong. We want you to hear God better while at Camp Salvation.
- Prohibited Items: There is zero toleration for drugs, tobacco, or alcohol. Please leave any “noise” that keeps you from hearing God at Camp, for example: non-Christian music, headphones, and video games. Please leave valuables and weapons at home, this includes pocket knives. The only reason a camper should bring food with them is for medical necessity. This exception should be discussed with Camp Staff prior to registration.
- Clothes: Our dress code goal is modesty. The dress code at Camp is the same for everyone so that we are not a distraction to each other. No sleeveless shirts and all shorts need to be close to the knee.
Parent Permission: I realize there are inherent risks involved in participating in Camp activities. In case of emergency I understand that every effort to contact me will be made. If I cannot be reached, I give my permission to the physician selected by an authorized staff member to hospitalize and give proper treatment to my child if necessary for the safety and well being of my child and other people at Camp Salvation.

By signing below, I acknowledge
- that I will review Camp Salvation's expectations and policies with my camper before arrival at camp.
- that failure to comply with these terms might result in a refusal of admission.
- that if my camper is dismissed for being a safety concern, disruption, or for conducting themselves in a detrimental manner, I will not be refunded.
I give my permission for my camper to *

To participate in all Camp activities except those previously mentioned To allow Camp Salvation to use any pictures my child is in for promotional use. To be transported by staff for supervised off-site activities in staff/Camp vehicles. To be contacted via email, if one has been provided.
By completing the following, I agree that I am are the parent or legal guardian of the above named camper, and am over the age of 18. I understand that the above named camper will only be released to the names listed above, an update may be completed at registration.
Signature *

Clear
Electronic signature, please initial *
Please verify that you are human *
Please do not submit this form until all aspects are complete and required documents are uploaded. Registrations with missing documents will be considered incomplete and campers will not be considered registered until missing paperwork is received. It is recommended that you save your progress until you are ready to submit. If you are having technical difficulties, please contact Kendra England at (719) 469-5390.
Should be Empty:

Camp Salvation Camper Registration 2022

Camper Information

Parent or Legal Guardian Information

Cabin Buddy

Church Information

Email Confirmation

Other Information

Health Information

Camper Release

Week Selection

Credit Card

Terms of Agreement