2023 CAMP EMMANUEL REGISTRATION FORM
(Must be to your Pastor by July 2, 2023 in order to attend Camp)
CAMPER:_________________________________SEX: M/F BIRTHDATE____/___/___GRADE IN FALL__
PARENT’S PHONE:(___)______________________________Been to Camp Emmanuel before? Y / N When?_________
__TEENS(Jr. & Sr. High) July 16-22 ___JUNIOR(ages 9-12) July 16-22 – BOTH CAMPS ARE THE SAME WEEK
Want to purchase Camp T-shirt ? ($10) yes/no Size: y-medium y-large small medium large xlarge xxlarge
NOTE; ALL Campers are to arrive Sunday afternoon between 4:00 and 5:00 pm.
ALL campers will leave at 10:30 a.m. SATURDAY morning.
CAMPER AGREEMENT: I have read and agree to abide by the standards, guidelines and rules of Camp Emmanuel while attending as a camper. I understand if I do not, I MAY BE SENT HOME immediately.
Email:______________________________ Camper Signature:______________________________________
PARENT/GUARDIAN AGREEMENT: I give my permission for my child to attend Camp Emmanuel. In case of emergency, I give consent for medical treatment prescribed by a licensed Medical Doctor. Furthermore, I agree to hold Camp Emmanuel "harmless," free of liability, in the event of an accident or Covid-19. I agree that if my child does not obey the standards, guidelines and rules and/or is uncooperative, I WILL COME TO TAKE HIM/HER HOME IMMEDIATELY. I have read the standards, guidelines and rules.
Email:______________________________ Parent/Guardian Signature:_______________________________
PARENT/GUARDIAN RELEASE OF LIABILITY AGREEMENT: I give my permission for my child to attend Camp Emmanuel. I agree to “Hold Harmless” Camp Emmanuel and Yellow Creek Lake Ministries, free of liability, in the event of any accident including archery, zip-line, hay-ride, sports activities and swimming or Covid-19.
Email:______________________________ Parent/Guardian Signature:_______________________________
PASTORAL ENDORSEMENT: I certify this camper is an active participant of our church or a guest of one. I certify this camper has faithfully attended church. I (or one of the staff) have heard this camper state the Roman's Road. I have discussed with this camper the standards, guidelines and rules of Camp Emmanuel and have been assured of his/her understanding of the expectations and his/her willingness to abide by them and to cooperate with the Camp leaders. If the camper does not and is dismissed, I will insure he/she is taken home immediately.
EACH OF THE ABOVE MUST BE SIGNED BEFORE THE CAMPER'S REGISTRATION WILL BE ACCEPTED.
-----------------------------------------GIVE TO THE PASTOR ON OR BEFORE JULY 2, 2023-------------------------------------------
CAMPER NAME: _____________________________________________________
CAMP EMMANUEL/YELLOW CREEK LAKE CAMPGROUND ZIP LINE/ARCHERY
ACKNOWLEDGEMENT AND ASSUMPTION OF RISKS AND RELEASE OF LIABILITY
I understand that participation in zipline/archery activities involve significant risks which include, but are not limited to, falling or slipping, impacting objects or being impacted by objects, equipment malfunction, equipment misuse by me, other participants or employees, natural, mechanical and environmental conditions and risks, any of which may independently, or in combination with the participant’s action, cause serious personal injury, death or property damage to the participant or others. I agree that I alone am responsible for my safety while participating in zipline/archery activities, and that Camp Emmanuel / Yellow Creek Lake Ministries, their employees, affiliates or any person or entity associated with them are not responsible for my safety. I AGREE FREELY AND VOLUNTARILY TO ASSUME ALL RISKS, including the risk of death, injury or damage to person or property associated with participation in zipline/archery activities. I agree to accept the conditions as they exist even though I may have chosen not to inspect the zipline/archery facilities as well as to accept and abide by the rules and regulations of the zipline/archery facility.
I hereby agree for myself, my heirs and for anyone on my behalf, to the fullest extent allowed by law, to RELEASE, INDEMNIFY AND HOLD HARMLESS Camp Emmanuel / Yellow Creek Lake Ministries, their owners, directors, officers, employees, agents, volunteers, representative, affiliates, successors and assigns from any and all responsibility and legal liability for any property damage, personal injury, damage or death which may result directly or indirectly from participation in zipline/archery activities, whether such injury or damage was foreseeable, including any claim regarding design or maintenance of the premises, design or condition of any equipment utilized while engaged in zipline/archery activities, or any other cause or claim arising from participation in zipline/archery activities, including any claims of breach of contract or other legal theory, including NEGLIGENCE. I PROMISE TO NOT SUE, and to INDEMNIFY, HOLD HARMLESS AND DEFEND Camp Emmanuel / Yellow Creek Lake Ministries for any claim of injury, damage or death which may occur from my participating in zipline/archery activities. Should any claim or action be asserted in contravention to this agreement, I or my successor shall be liable for all expenses, INCLUDING LEGAL FEES incurred by Camp Emmanuel / Yellow Creek Lake Ministries and that if a claim or action is brought, it shall be submitted to the jurisdiction of the State or Federal Court in the State of Indiana, and no other jurisdiction, and shall be governed by the laws of the State of Indiana.
As a parent/guardian with legal responsibility for minor participant(s) participating in zipline/archery activities, on behalf of whom this agreement is entered, I verify that I have the authority to enter this agreement on behalf of the minor child(ren). I have read, understood and agree that the minor child(ren) or anyone on behalf of the minor child(ren), including me, is bound by the terms of this agreement. Furthermore, if a claim or action is brought in contravention of this agreement, including any claim alleging NEGLIGENCE, I agree to INDEMNIFY, HOLD HARMLESS AND DEFEND Camp Emmanuel / Yellow Creek Lake Ministries for any and all expenses incurred, INCLUDING LEGAL FEES, and any DAMAGES for which they may be adjudged legally liable to pay.
I have carefully read and understand this agreement is a COMPREHENSIVE RELEASE OF ALL LEGAL LIABILITY which is binding upon me, my heirs, agents and assign, that it is not intended to assert any claims or defenses that are prohibited by law, and that if any part of this agreement is held to be invalid or unenforceable, the remainder shall be given full force and effect.
SIGNATURE:_______________________________________ DATE: ____________________
PRINT NAME: ________________________________
CITY: _________________________ STATE: ___________ ZIP CODE: ______________
(Signature of Parent/Guardian if participant is under 18 years old.)
PLEASE COMPLETE FOR EACH CAMPER.
BRING with the camper to registration on Sunday.
Camp Emmanuel 2023
Camper’s name______________________________________________________date of birth___________
Allergies (please include meds, food and others)
Med, food and other
We ____________________________ (parents name) give permission to the nurse that they can give this camper medication as needed (please mark the meds you are ok for the nurse to give. We will provide these meds.)
________Tylenol or acetaminophen 325 mg or 650mg every 4 hours for pain or fever
________ Advil or Ibuprofen 200 mg every 4 hours for pain or fever
________ Benadryl or diphenhydramine 25 mg every 4 hours for allergies, runny nose, sneezing,hives, insect bites or itchy skin
Please fill out med list on back of sheet even if you have pills in a pill box. Thanks
Name of medication
1 or 2 tablets
"WHERE GOD IS WITH US"
---MAKING NEW FRIENDS
---WEIRD OLD JOKES
---FOOD AND MORE FOOD
---KIDS YOUR AGE
CAMP DATES FOR 2023
NOTICE: BOTH Camps are at the SAME time. We will function at TWO SEPARATE camps – different sleeping quarters, different classes, different activities times. Together ONLY for meals and perhaps swimming time.
SENIOR CAMP JULY 16-22
For those just completing grades 7 - 12.
(NOTE: MUST be 13 by July 22.)
JUNIOR CAMP JULY 16-22
For those who are ages 9 - 12 years old.
(NOTE: MUST be 9 by July 22)
ALL Campers are to arrive Sunday between 4:00 and 5:00 pm. ALL Campers will leave at 10:30 a.m. SATURDAY.
The primary purpose of Camp Emmanuel is: a) to strengthen the campers in their faith in the Lord Jesus Christ; b) to increase their knowledge of His word, the Bible; c) to encourage them to live faithfully for Jesus Christ -- by the leaders, counselors and other campers.
Camp Emmanuel is a ministry of faith supported by those who believe in its purpose. Because of donations, campers attend AT NO FINANCIAL CHARGE! Each evening a free-will offering is accepted from the campers. Donations are also cheerfully and thankfully accepted from interested parents, friends and churches.
Camp Emmanuel accepts campers from the Participating Churches. These Participating Churches are listed below. The Pastor of the church must certify the camper is actively involved in their church or is coming as a guest.
The campers MUST meet the following requirements: 1) have attended church at least 6 of the 8 Sundays preceding camp; 2) know and recite the Roman's Road – topic title, verse “address,” and the words of the verse; 3) complete and deliver the registration form to the Pastor on or before July 1.
ALL monies brought to Camp Emmanuel MUST BE placed in the camp bank. This is to safeguarding the camper's monies. The bank opens daily at store times and before the evening service. HOW MUCH? $5 to $20 for treats. $10 for a Camp Emmanuel t-shirt. $20 - $30 is plenty! Plus any money they want to give as an offering. The remaining balance is refunded before the camper returns home.
THE ROMAN'S ROAD
You need to memorize the Starters, the references AND the entire verse as printed below. (Other versions OK)
1. ALL HAVE SINNED
Romans 3:10 As it is written: There is none righteous, no, not one.
Romans 3:23 For all have sinned and fall short of the glory of God.
2. SIN BRINGS DEATH
Romans 6:23a For the wages of sin is death.
3. GOD GIVES LIFE
Romans 6:23b The gift of God is eternal life in Christ Jesus our Lord.
Romans 5:8 But God demonstrates His own love toward us, in that while we were still sinners, Christ died for us.
4. CONFESS & BELIEVE IN THE LORD
Romans 10:9 If you confess with your mouth the Lord Jesus and believe in your heart that God has raised Him from the dead, you will be saved.
5. CALL ON THE LORD
Romans 10:13 For whoever calls on the name of the LORD shall be saved.
ALL CAMPERS ARE EXPECTED TO:
---conform to Christian standards of conduct
---cooperate with the Camp leaders
---be modest in dress/appearance
---be respectful to others
---be on-time for & participate in ALL activities
---remain on camp grounds at all times
---not leave services without permission
---remain in cabin after curfew
---not be in or near cabin of opposite sex
---stay in lighted areas of camp ground
NO IMMODEST CLOTHING--TOO SHORT, TOO TIGHT!!
Daytime: jeans, slacks, finger tip-length shorts (NO SHORT SHORTS), t-shirts or collared shirts (shirts MUST be worn at all times) – NO bare midriffs.
Evening: Neat, slacks, jeans
Lake: MODEST swim trunks. (NO BIKINIS)
Daytime: jeans, slacks, finger tip-length shorts (NO SHORT SHORTS), culottes, skirt and blouse, dress (NO MINI SKIRTS) – NO bare midriffs.
Evening: Neat, slacks, jeans, skirt, dress
Lake: MODEST one-piece swimsuit. (NO BIKINIS)
There will be swimming in the lake. A certified life-guard will be on duty during all swimming.
The store is open each afternoon and evening for the camper to purchase candy, gum, pop and other like items.
WHAT TO BRING
---Water bottle with name on it
---Bibles, notebooks, pens, pencils, sharpie, etc.
---Musical instrument, camera, sunglasses
---Sleeping bag, pillow, blankets, sheets, etc.
---Towels, washcloths, soap, toiletries, etc.
---Robe and swimwear (Modest one-piece)
---Athletic (tennis) shoes
---Wading or water shoes/''flip-flops'
---Spending money (up to $25)
---NO Short Shorts, "Bike" shorts, or cut-off tops
---NO Rock, Booze, or Tobacco t-shirts
---NO CELL PHONES (possession of a cell phone after registration is grounds for being sent home.)
---NO Electronic devices of any kind – including IPODS, MP3 players, IPads, Computers OR ANYTHING similar
A Registered Nurse is on duty. ALL medications MUST be turned over to the Camp Nurse.
Please mark items for identification. Camp Emmanuel is not responsible for items lost by the camper.
To fully benefit from the Camp Emmanuel experience, it is expected the Camper will be in attendance for the entire week. If leaving the Camp is unavoidable, the parent or guardian must make the request to the Camp Dean.
The accompanying registration form MUST BE completed and signed by the camper AND the parent/guardian AND
the Pastor of a Participating Church (listed below) by July 2. A ‘hold harmless” agreement must also be signed for each camper. A camper without this completed pre-registration form WILL NOT be permitted to stay at Camp Emmanuel.
The standards, guidelines and rules of Camp Emmanuel are based on spiritual principles, convictions and experiences of the Camp leaders in order that ALL THE CAMPERS may have the best possible Christian Camp experience.
ALL counselors and teachers will have “passed” an official Background Check. Two reasons: a. safety of our campers; b. insurance regulations.
SPECIAL DIETARY NEEDS
If you have special needs, please BRING your own foods for the week. A refrigerator and microwave are available.
CONSEQUENCES OF NOT COOPERATING
If a camper (1) refuses to cooperate with the Camp leadership OR (2) displays an unacceptable attitude OR (3) breaks the rules OR (4) disregards the standards and guidelines of Camp Emmanuel, then without further warning nor "chances" the camper MAY BE SENT HOME. Camp Emmanuel MUST operate for the benefit of ALL campers and CANNOT allow one uncooperative camper to spoil camp for the rest. He/she WILL BE sent home.
LOCATION OF CAMP EMMANUEL
Camp Emmanuel is held at YELLOW CREEK LAKE CAMP, 6750 W 900 S, Claypool 46510
NOTE: You may send mail to the above address.
CAMP PHONE: Call one of these cell phones
Pastor Rod 574-835-11537
Pastor Joe 765-251-0045
Pastor Luke 765-480-5655
Pastor Nord 574-297-4482
Pastor Ed 765-480-5546
Pastor Steve 574-952-6522
Pastor Brian 574-242-1836
Pastor Thomas 219-240-4570
Camp Office 574-491-3075
In general: Yellow Creek Lake Camp sits in the country between Akron, Mentone, Silver Lake.
It is bounded by SR 25 on the north, SR 14 on the south, SR 15 on the east and SR 19 on the west.
1. On SR 19 between Akron & Mentone, turn EAST on 900 S. Go 4.25 miles. Enter Camp on left as meet 675 W turning South.
2. On SR 14 between Akron & Silver Lake, turn NORTH on 675 W. Go 2 miles. Enter Camp on right as meet 900 S turning West.
3. On SR 25 between Mentone & Warsaw, turn SOUTH on 700 W. Go 5 miles. Turn EAST on 900 S. Go 0.25 miles. Enter Camp on left as meet 675 W turning South.
Your Registration Form MUST BE SIGNED by the Pastor of one of the following churches. IF you are NOT a member of one of the following churches you should contact the closest one to see if you would be able to come as their guest. You MUST be a member or guest of one of the following churches.
FaithWay – Plainwell, MI
Pastor Tony Dear 269.397.2190;
First Community -- Matthews
Pastor Thomas Stone
C: 765.998.6045; Cell: 219-240-4570
Highland Park -- Kokomo
Pastor Luke Vasicek
Lockport Church -- Burnettsville
Pastor Nord Zootman
Riverview Community -- Tippecanoe
Pastor Steve Wilhelm 574-952-6522
Pastor Rod Ruberg 574.223.4193
Solid Rock Bible -- Rochester
Pastor Todd Rhymer 574-224-7654
Tippecanoe Community -- Tippecanoe
Pastor George Shoemaker
Whippoorwill Community -- Rochester
Pastor Brian Sewell 574.223.3905
Rossville Bible Fellowship – Rossville
Pastor Chris Albin
Church: (765) 379-2309