Winter Kids Camp Online Registration

Which session do you wish to attend?
Camper Name
Mailing Address
City     State     Zip
E-Mail Address
D.O.B.(MMDDYY)   Grade     Sex
Home Phone  
Father's Name   
Father's Work Phone     cell  
Mother's Name   
Mother's Work Phone        cell  
Church You Attend
Roommate Preference  

Payment Information:

  • Deposit for individual camper is $20 (non-refundable)
  • Please make all checks payable to Sugar Pine Christian Camps .
  • If you wish to pay by credit card, please call Deb at 559 683-4938 X 101 and she will be happy to take your information.

NAME OF ADULTS AUTHORIZED TO PICK UP YOUR CHILD:

Sugar Pine Christian Camps will release your child only to adults listed below.

Emergency Information

If you child should require medical attention at camp for injuries or illness contracted prior to coming to camp,  the following information will be necessary to give your child proper medical service.
Do you have insurance?
Insurance Company
Policy Number
Name of Insured
Family Doctor

Health History

  Drug Alergies   Chronic Asthma     Handicaps
  Food Alergies   Hay Fever   Diabetes   Frequent Colds
  Other Alergies   Stomach Upset   Epilepsy   Insect Stings

If any of the above are checked, please provide details, including normal treatment.

Date of last Tetanus Shot  (MMYY)  

Name and Dosage of any medication that must be taken.
 Any activity restrictions?  
If yes, please explain
Please explain any special needs.

In order to complete registration please print out our medical release form by clicking the "Medical Release Form" below
fill out and sign the form and fax it to us at 559 683 4910

Sugar Pine Christian Camps reserves the right to include pictures, videos, or other likenesses of all guests for Sugar Pine promotional purposes.