Kamp Koinonia 2026

Brighter and Brighter - Proverbs 4:18

July 12th-July 18th 2026

Registration is at 2:00 PM on July 12th.

Camper pickup is no later than 10:00 am on July 18th.

Cost is $275

How many campers are you registering?

Sponsor Code

Some congregations pay for all of their campers at once. Reach out to Julie before submitting if your campers are already paid for.

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Parent/Guardian Information

Parent/Guardian Name

First

Last

Parent/Guardian Email

Parent/Guardian Phone

Parent/Guardian Address

Address Line 1

Address Line 2

City

State

Zip Code

Congregation You Attend

Emergency Contact Information

Father's Name

Cell Phone

Father's Employer

Work Phone

Mother's Name

Cell Phone

Mother's Employer

Work Phone

Additional Emergency Contacts

Contact #1 Name

Contact #1 Phone

Contact #1 Relationship

Contact #2 Name

Contact #2 Phone

Contact #2 Relationship

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Camper 1

Camper 1 Name

First

Last

Camper 1 Gender

Camper 1 Age

Dietary Limitations/Allergies

It is our desire to provide whatever we are reasonably able to for a camper who has any dietary needs or limitations. We are open to providing a gluten-free diet based on two understandings. We are not responsible for a camper eating what is placed before them or choosing to eat someone else’s food if shared without our knowledge. Our staff will do everything possible to keep your child healthy with the understanding they must be old enough to take on this responsibility for themselves.

Does Camper 1 have any special dietary needs or limitations?

Yes
No

List any medications for Camper 1

Other Medical Information for Camper 1

If there is anything that Kamp Koinonia staff needs to know, write it here.

Medical Release

In case of emergency, I understand that every effort will be made to contact me. In the event I cannot be reached, I hereby give permission to the physician selected by the Camp Director to hospitalize and secure proper treatment for my child. I understand that campground insurance is secondary to my personal insurance.

Medical Release Parent/Guardian Signature

Clear Signature

Trip Release

I give permission for my child to go on scheduled trips as a part of the program at Kamp Koinonia.

Trip Release Parent/Guardian Signature

Clear Signature

KAMP KOINONIA AGREEMENT

Campers must be 9 years old by September 1, 2026 unless a special request has been made and then approved by the staff administrator. We all want camp to be a positive growing experience for each camper. Rules for acceptance and participation are the same for everyone without regard to race, color, national origin, age, sex, or handicap. This is an equal opportunity program.

To maintain a wholesome Christian camp experience, it is essential that the following dress code be strictly adhered to throughout your stay at camp – including the days you arrive and leave. Parents, please help us with this by making certain you and your children abide by the dress code.

No shorts, of any length, no halter-tops, tube tops, short shirts, sleeveless shirts, yoga pants, leggings, holes in jeans or any kind of immodest clothing will be allowed.

If you decide to dress-up (which is not necessary) for dinner on Friday evening, dresses should reach the knee, not be low cut, and not sleeveless. If you have any doubts about the modesty of your dress, please
do not bring it. Campers will be asked to change if their clothes do not follow the dress code.

No smoking, drugs, alcohol, or bad language. Note: There will be no second chances - campers will be sent home. If illegal items are involved, the police will be called. No pets, guns, knives, hatchets, or any type of weapon will be permitted. Bullies will be sent home immediately.

Canteen is on our schedule three times each full day of camp. Several options are available: pop, candy, healthier drinks (i.e. Vitamin Water, Gatorade, etc.) and bottled water. Fruit is available at each meal. We do encourage campers to either bring a bottle for water to refill or purchase one and re-use it. Each
canteen time is limited to one candy and one drink. Water can always be purchased, but drinking water is available in the cafeteria throughout the day.

We ask that all money be handed in at registration. This money will be recorded as credit on the canteen card – whatever they have not spent will be given back at the end of the camp week.

The directors reserve the right to send any person home for improper attitude or action or lack of cooperation, in which case, NO refund of money will be made. All visitors must receive director approval before they will be allowed to stay overnight. All visitors will abide by all the rules. Visitors do not need to turn in money.

I have read and agree to abide by all camp rules and follow the direction of the staff.

Camper Signature

Clear Signature

I understand the rules and terms of payment. This registration has my approval. While Kamp Koinonia is expected to take every reasonable precaution, it is agreed that Kamp Koinonia assumes no responsibility for campers' personal property and is released from liability in connection with medical administrations.
All necessary forms must be signed. No child can be allowed to register without these signatures.

Parent/Guardian Signature

Clear Signature

Your electronic signature shows that you have read, understood, and accepted the terms and conditions stated above.

Camper Signature

Clear Signature

Parent/Guardian Signature

Clear Signature

T-Shirt Order

All shirts are adult sizes. Choose between long or short sleeve.

Camper 1's T-Shirt Order

How would you like to pay for Camper 1?

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Camper 2