Online Registration for Summer Camps

Please complete the required information below.  If you do not enter any of the required fields, you must use the BACK button in your web browser to return to this page and fill in the additional information.  (Not using this feature will result in a deletion of all previously entered data.) If you need to print a registration form to mail in download Summer Registration form.

Please make note of the following registration policies:

  • REGISTRATIONS:  Subject to space availability and cannot be processed without accompanying credit card information authorizing payment of either the required minimum non-refundable deposit of $35 (per camper for each camp session) or payment in full.
  • CONFIRMATIONS:  Look for your confirmation notice via email within 14 days.  If you do not receive a confirmation 2 weeks after you have registered, please contact our office to verify we received your registration.
  • PAYMENTS:  Full payment must be received at least 14 days before the start of the camp session (including any extended care or transportation fees), or you may lose your spot.  No payments can be accepted at check-in.  If payment is not received, this will be considered a cancellation and the spot is opened up to those on our waiting list.  We usually have an extensive wait list for each camp session, and this allows us adequate time to contact those who wish to fill those relinquished spots.  Please call us if you know your balance will be unpaid within 14  days of the first day of camp so we can work with you to ensure your child has a camp experience. 
  • CHANGES/CANCELLATIONS: All changes and cancellations must be made in writing.   Send  notice via Email to register@campberachah.org  -  Fax to 253.833.7027  -  or by US MAIL to 19830 SE 328th PL Auburn, WA  98092.  Any approved refund amounts will be issued within 30 days of cancellation notice. 

Camper Information:
(* indicates required fields)  
secured site    
  Camper Last Name:*
First:* MI:
  Birthday (MM/DD/YY)* Campers are grouped by age
 Gender (male or female):*
 
  Grade Completed:*
    
  Church Attending:
 

Roommate or Buddy Request:

(Not available for Red Barn Horse Camps as campers are placed in groups by ability)

(Limit of one name.  Cannot be more than 2 years difference in age. Boys and girls are in separate groups.)
 
  Street Address:*
  City:*
 State:*
Zip code:*
 
   
       
  Parent1/Guardian Last Name:*
 First:*
  
  Home phone:*
Work phone:*
 
  Cell/Pager phone:
 
  Email: (required for confirmation)
  
  If you do not want to receive future email information of upcoming Camp Berachah events please initial here.  
  Parent2/Guardian Last Name:
 First:
  
  Home phone:
 Work phone:
 
  Cell/Pager phone:
  
  Email:
 
  Emergency Contact Name:*
  
  Emergency phone:*
  How did you hear about us?
       

Medical information and adult consent for minors:
  • All prescription and over-the-counter medications must be turned in at check-in upon arrival to camp. All prescription medications must be in the original pharmacy bottle, labeled with the patient name and physician's ordered dose on the bottle (e.g., pills in Ziploc baggies are not okay. Non-prescription/over-the-counter medication, including vitamins and herbal supplements, must also be in their original containers. Campers are allowed to carry one inhaler with them at camp, if medically necessary.
  • *Special Needs sessions are notated with an asterik. If you would like your camper with special needs to be considered for summer camps, please print off the prescreening application and send to Natalie Head, email nhead@campberachah.org Special Needs Coordinator at Camp Berachah. Click here for SN Application 

The following over-the-counter medications are dispensed during our summer camp sessions as needed: acetaminophen, ibuprofen, antihistamine, throat lozenges, anti-nausea, anti-diarrhea, antibiotic ointment, anti-itch cream, ipecac, aloe, eyewash, and sunscreen.

Please list any exceptions to the over-the-counter drugs
listed above, allergies & reactions:*

Please list any allergies or dietary restrictions (and reactions):*
(Food prepared by Berachah staff may come into contact with nuts during preparation)

Current Medications:*

Current Medical Conditions i.e. ADHD/ADD, Autism (including Asperger Syndrome), blind/visually impaired, Deaf/Hard of hearing, Down Syndrome, and other physical limitations or developmental delays (must list ANY medical conditions and special needs) :

* Special needs campers must complete SN Application and be approved by Natalie Head before registering for their camp session. Email nhead@campberachah.org

 

Tetanus Booster up-to date?*

Immunizations up-to date?*
       

Parent/Guardian Release is required.  Please read the following statement: 

"My child has my permission to participate in all activities on or off the grounds.  In case of a medical emergency for my child, I hereby authorize Camp Berachah Staff to act in their best judgment to seek medical attention through appropriate means, including emergency room treatment as deemed appropriate by attending medical personnel.  I also accept responsibility for expenses incurred through such treatment." AND "I give permission for Camp Berachah to use any photo or video of my family in publications.  I release my right to any kind of remuneration for said photos."
If you agree please type your initials here:**

 
 

Select Your Session(s): (Camps with * are open to SN Campers upon approval-require SN addendum)

Day Camp Sessions:

 

Classic Day Mon-Fri 9 am to 4 pm - Thursdays include Parent Night at 5:40pm and optional camper sleepover!

New Day Camp Plus option ages 11-12 (campers spend extra night Friday and leave Saturday at 11 am) sessions D003, 5 & 8

Junior High Xtreme Camp - Daily Mon-Fri 8:30 am to 5 pm ages 12-14 Preschool Camp Tues-Thurs 10 am to 1 pm ages 3-4
(Multiple Selections allowed, hold CTRL while selecting)

Options: (only available for Classic Day Camp, not for Junior Extreme Camp): Horse riders must be 52" with boots on and must pre-order

LUNCH NOT INCLUDED UNLESS HOT LUNCH OPTION IS PRE-ORDERED before camp session

NO BUS TRANSPORT THUR AFTERNOON & FRIDAY MORNING DUE TO OVERNIGHT STAY
 

Overnight Camp Berachah Sessions:

  
(Multiple Selections allowed - hold CTRL while selecting)

Options:(HORSE RIDERS must be 52" with boots and MUST PRE-REGISTER on-line)


   

Buck Creek Camp Sessions:

  
(Multiple Selections allowed - hold CTRL while selecting)
 No horse rides, email or mail service available at Buck Creek
   

Overnight Horse Camp Sessions:

 
Mon 9am to Fri 4:30 pm - Fridays include "Game Day" from 1:00 to 3:00pm, family invited, bring your camera!
(Multiple Selections allowed - hold CTRL while selecting)

Overnight Horse Campers must be ages 8+ and 52" tall with boots on

Overnight Horse Camp Options:
   

Red Barn Horse Day Camp Sessions (drop off and pick up is now at Camp Berachah):

  
Mon-Fri 9 am to 4 pm - Fridays include "Game Day" from 1:30 to 3:30pm, family invited, bring your camera! 
(Multiple Selections allowed - hold CTRL while selecting)

Red Barn Campers must be ages 7+ and 52" tall with boots on

Bus Transportation & Extended care is available for Red Barn Camps

NO BUS TRANSPORT THUR AFTERNOON & FRIDAY MORNING DUE TO OVERNIGHT STAY
   

WIT (Wrangler In Training) Sessions:

  
To qualify as a WIT, you must demonstrate the ability to control the horse at a walk, trot and lope with a reasonable safe and balanced seat--as well as catch, groom and saddle with minimum supervision. Call Kathy at 253-939-0488 ext. 105 for a screening phone interview before registering. 

(Multiple Selections allowed - hold CTRL while selecting)

Must be pre-approved before registering

(email a paragraph about horse experience and your interest in Christian discipleship)
   

CIT (Counselor In Training) Sessions: preapproval

 Must be pre-approved before registering (complete application & interview process)
Hold CTRL while selecting multiple sessions
CIT Options:
   

Additional Registration Notes or Comments:

  
     

After submitting this registration information select the back button on your browser
to register any additional campers. Once all of your campers have been registered, you must make a payment of the required deposit for each camper to complete the process.

If you did not enter any of the required fields, you must come BACK and complete.
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