Home - Pine Acres Youth Camp

LEARN ABOUT CAMP

Are you interested in learning about PAYC?

ABOUT CAMP

2023 CAMP INFO

REGISTRATION

Sign up now for PAYC 2023 on July 24th thru 29th
at Cascade Lake 4-H Camp in Donnelly, ID!

Camper Information

Camper Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Gender *

Male
Female

School Grade Entering Fall 2023 *

Birthdate *//

Home Church

Medical Information

Health Insurance Carrier *

Subscriber Name *

Policy/Identification Number *

Special Medical Conditions / Medications Needed / Allergies

Emergency Contact Information

Contact Name *

First

Last

Relation to Camper *

Phone *

Pine Acres Youth Camp & Cascade Lake 4-H Camp Liability Release

I hereby approve this registration form, expressively waiving any and all claims against the sponsors of the camp, and Cascade Lake 4-H Camp, Inc., because of injury and/or damages that may be incurred to the applicant while at camp.

I also signify that I have read the camp information and guidelines. I understand the requirements for attending this camp and have reviewed them with my camper.

CLICK HERE to view the full Waiver of Liability & Indemnity Agreement

Acknowledgement of Liability Release *

By checking this box and signing below, I acknowledge that I have read and understand all of the terms of this Agreement and that I am voluntarily giving up substantial legal rights, including the right to sue Cascade Lake 4-H Camp, Inc.

Guardian Name *

First

Last

Guardian Signature *

Payment

Single Camper Registration Fee *

Price: $ 150.00

Would you like to make a donation to camp?

Enter Donation Amount

Total

$ 0.00

Credit Card *

Card

Name on Card

*If you have financial hardships, please email info@pineacresyouthcamp.com with your contact information to discuss payment options. You do not need to continue with the registration process. Thank you!

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LEARN ABOUT CAMP

Are you interested in learning about PAYC?

REGISTRATION

Sign up now for PAYC 2023 on July 24th thru 29that Cascade Lake 4-H Camp in Donnelly, ID!

Camper Information

Medical Information

Emergency Contact Information

Pine Acres Youth Camp & Cascade Lake 4-H Camp Liability Release

Payment

COUNTDOWN TO CAMP

days

hours

minutes

seconds

Sign up now for PAYC 2023 on July 24th thru 29th
at Cascade Lake 4-H Camp in Donnelly, ID!