2023 Summer Camp Registration

Summer 2023 Registration

Use this form to sign up for a 2023 camp session. One form per camper; those with multiple campers will need to fill out multiple forms. At the bottom is an opportunity pay before submitting.

Individual Camp Information
Grandparents, parents, pre-k - it's for all! June 4-9 (FULL) or July 9-14

For those families who want to build a faith foundation out at camp together, Family Camp is the perfect option with our fun-filled 48-hours. Families participate in all the activities camp has to offer, from the arts and crafts to the canoeing. Our family campers stay in our retreat cabins up at our Washunga site.
6th/7th - 8th grade; June 18-23

Here at Camp Tomah Shinga, supplement your Confirmation program with a week immersed in the beauty of God’s creation surrounded by all God's children. Confirmation campers grow intensely in their faith through our high ropes courses and our cooperative games designed to build community, and they deepen their relationship further with God through bible studies led by our devoted, high-energy counselors. Bring your youth and teach the vastness of God’s creation and beauty in the rolling Flint Hills at Camp Tomah Shinga! The pastors and youth directors work together from different churches to teach Bible study and lead worships. Students will stay down at The Grove and their leaders will stay in our retreat cabins up at our Washunga site. Note that this is planned by the church leaders to go as a group.
Ages 1st - 3rd grade; June 4-6 (FULL) or July 9-11

Designed for our youngest campers, this short week runs for 48 hours as they explore what it means to be away from home and at camp. This shorter stay allows our campers to get accustomed, as they are introduced to exciting camp activities—bible study, swim-time, team-building games, hiking, arts and crafts, worships, camp songs, and more! Our Explorers stay in the cabins up at our main site, Washunga.
Ages 4th - 6th grade; June 4-9 (FULL), June 11-14, June 25-30

Designed for new and returning campers, our Pathfinders experience is a whole week of camp from Sunday afternoon to Friday around noon. They continue to experience camp activities—bible study, swim, team-building games, arts and crafts, hiking, worship, camp songs—as well as add new ones such as canoeing and high ropes. Our Pathfinders stay in the cabins up at our main site, Washunga.
Fishing Camp; June 18-23

New this year, our Pathfinders have the chance to explore the rivers and lakes in Central Kansas and find what is swimming in them. Each day will be spent at a different location with the opportunity to catch a variety of different fish and learn about the habitats of each. Nights will be spent in the beauty of God’s creation at the Grove or under the stars, with typical worships and Bible studies.
Ages 6th - 8th grade; June 25-30, July 17- 22

For new and returning campers, the Trailblazers kick the camp experience to the next level. Participating in all the camp activities that younger campers experience, the Trailblazers also have the experience of staying at The Grove, as well as enjoying food prepared over an open fire for lunch and supper. Our Trailblazers continue to experience even more fully the beauty of God’s creation. Our Trailblazers stay in our cabins down by the chapel, The Grove.
Night Camp; July 9-14

We will be sleeping through the day, and awake through the night! Night hikes, breakfast at midnight, campfires and hanging out on the stargazing deck are a few camp favorites. Our Trailblazers get to experience camp and God in a new light (or lack thereof), doing all the same fun camp activities in the glow of the night sky.
Fishing Camp; June 18-23

New this year, our Pathfinders have the chance to explore the rivers and lakes in Central Kansas and find what is swimming in them. Each day will be spent at a different location with the opportunity to catch a variety of different fish and learn about the habitats of each. Nights will be spent in the beauty of God’s creation at the Grove or under the stars, with typical worships and Bible studies.
Ages 9th - 12th; June 11-16 or July 16-21

Our Pioneers continue to experience all the amazing activities that camp has to offer, as well as work on activities that encourage a growth into a greater depth of faith. The Pioneers are pushed to consider where God is calling them and how they can work together as a team to glorify Him. Our Pioneers are able to choose where they sleep throughout the week! Their gathering site is generally at our main site, Washunga.
Fishing Camp; June 12-18

New this year, our Pathfinders have the chance to explore the rivers and lakes in Central Kansas and find what is swimming in them. Each day will be spent at a different location with the opportunity to catch a variety of different fish and learn about the habitats of each. Nights will be spent in the beauty of God’s creation at the Grove or under the stars, with typical worships and Bible studies.
June 11-14, high school teams

Does your camper have the tough decision between going to a sports camp or church camp? We present to you Forged Running Camp. This camp is designed for all high school running enthusiasts who want to spend a week training in God’s beauty. With world record holder and Bethany College Head Track/Cross Country Coach, Aaron Yoder, and other great coaches from around the state, you can get great physical training that is centered in faith formation.

Parent/Guardian Information
Primary Parent/Guardian Name:*

First NameLast Name
Primary Parent/Guardian Phone Number:*
Please enter a valid phone number.
Primary Parent/Guardian Email:*
I would like to opt in for monthly newsletters:

yes
Primary Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact if primary is unavailable:

First NameLast Name
Emergency Contact Phone Number:
Please enter a valid phone number.
Emergency Contact Email:

Health Information
Physician Name:*

First NameLast Name
Phone Number:*
Please enter a valid phone number.
Dentist Name:

First NameLast Name
Phone Number:
Please enter a valid phone number.
Is attendee covered by medical insurance?*

YesNo
Insurance Carrier:*
Member Number:*
Carrier Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Carrier Phone Number:*
Please enter a valid phone number.
Name of Insured:*

First NameLast Name
Relation to Attendee:*
Please upload a picture of your insurance card here:

Cancelof

Medication
Please list ALL medications, including over-the-counter or nonprescription drugs, taken routinely. Bring enough medication to last the entire time at camp. Medications must be kept in the original packaging/bottle that identifies the prescribing physician (if a prescription), the name of the medication, the dosage and frequency. We are not allowed by law to dispense any prescription drugs without this identification.
This attendee does:*

not take any medications (continue on to the next section)take the following medication(s)
Medication 1: Name, When to be taken, Amount, Topical/Oral
Medication 2: Name, When to be taken, Amount, Topical/Oral
Medication 3: Name, When to be taken, Amount, Topical/Oral
Medication 4: Name, When to be taken, Amount, Topical/Oral
Medication 5: Name, When to be taken, Amount, Topical/Oral
If your attendee takes more than 5 medications, please bring a complete list with the name of medication, time taken, amount/dose, oral or topical.

NOTE: Health Care staff dispense medication to program sites at Breakfast, Lunch, Supper & Bedtime. Please advise the camper of
these times. If there is a major health issue requiring dispensing medication at any other time, please contact the Program Specialist (785-375-0137) a week before the camper is due at camp.

Medical Waiver
IMPORTANT: THIS FORM MUST BE COMPLETED AND SIGNED BY PARENT/CUSTODIAL GUARDIAN FOR ATTENDANCE.

This health history is correct so far as I know, and the person described has permission to engage in all prescribed camp
activities except as noted. AUTHORIZATION FOR TREATMENT: I hereby give permission to the medical personnel selected by
Camp Tomah Shinga to order x-rays, routine tests, treatment and necessary transportation for attendee/camper. In the event
I cannot be reached in an emergency, I hereby give permission to the physician selected by Camp Tomah Shinga to secure
and administer treatment, including hospitalization, for the person named above. This completed form may be photocopied for offsite trips.

I (parent/guardian) give permission for Camp Tomah Shinga to administer over-the-counter medications and provide first aid if
the Health Care staff deems necessary. I understand the Camp Tomah Shinga Health Care staff will administer medications per
instructions and protocols in the Camp Tomah Shinga Health Care Plan, which is approved by a physician, that treatments and medications will be administered according to the directions on the bottle/packages unless a physician directs otherwise, and that the health history form will be reviewed for allergies and parental recommendations prior to that administration.
Signature*

Clear
Date*

MonthDayYear
Date

Ropes and Photo Release
All participants will follow all safety procedures and guidelines as instructed by the facilitators. Participating in this program may involve bending, twisting, lifting, running, jumping, climbing, increased heart or breath rates and physical contact with others. Unexpected strains or jolts to your body can occur.

I understand that this activity could cause serious illness and/or injury, and I assume all risks for any such illness and/or injury. I realize that the Challenge Course/Climbing program might jeopardize my health if I have a history of heart problems or high blood pressure, am pregnant, recovering from broken bones, dislocated joints, sprains, strains, back or neck injuries, have an enlarged organ, am a transplant recipient, or have Down Syndrome. Participants with any of these or other physical concerns should talk with the staff prior to the start of the Challenge Course event.

In the event of illness or injury, I do hereby consent to whatever medical treatment and hospital care may be considered necessary in the best judgment of the attending physician, surgeon, or dentist performed under the supervision of a member of the medical staff of the hospital or facility furnishing medical or dental services.

As a condition of my participation in this activity, I agree to waive all claims against Lutheran Outdoor Ministries Association of Kansas/Nebraska Lutheran Outdoor Ministries and to hold its employees harmless from any and all liability or claims because of any death, bodily injury, personal injury, or illness that may arise out of or in any way be connected with the above-described activity. This waiver shall not apply to any occurrence that may arise solely out of the negligence of its employees or agents.

I am aware that I might be photographed and/or videotaped during my participation and authorize such photographs and/or videotapes to be used in training or promotional materials at any point in the future. I understand that my name will not be used and/or published in any way, and that I will not receive compensation for the use of such photographs and/or videotapes.

By signing below, I am agreeing that I have carefully read and agree to all of the sections above.
Please select from the option

I am fine with my/my child's pictures used as promotional imagesI would not like my/my child's pictures used as promotional images
Signature*

Clear
Date

MonthDayYear
Date

Payment Information
Please choose one:*

I am paying fullMy church is paying fullMy church is paying part and I am paying the restI have spoken with CTS about a campershipI am an MLM camperI am an Angel Tree camper
Church representative:
(if applicable)
If you are signing up more than one camper in your family, you qualify for $30 off each camper.

Sibling 1Sibling 2Sibling 3Sibling 4
*Family camp does not qualify.
Regular
Family Camp: $490
Explorers: $360
Pathfinders: $525
Trailblazers: $525
Pioneers: $525

Special
Confirmation Camp: $525
Fishing Camp: $525
Night Camp: $525
FORGED Running Camp: $465

Should be Empty:

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Summer 2023 Registration

Grandparents, parents, pre-k - it's for all! June 4-9 (FULL) or July 9-14

6th/7th - 8th grade; June 18-23

Ages 1st - 3rd grade; June 4-6 (FULL) or July 9-11

Ages 4th - 6th grade; June 4-9 (FULL), June 11-14, June 25-30

Fishing Camp; June 18-23

Ages 6th - 8th grade; June 25-30, July 17- 22

Night Camp; July 9-14

Fishing Camp; June 18-23

Ages 9th - 12th; June 11-16 or July 16-21

Fishing Camp; June 12-18

June 11-14, high school teams