Camp Damascus: July 13-18, 2025

Parent First & Last Name REQUIRED Please fill out this field. Please enter valid data.

Parent Email REQUIRED Please fill out this field. Please enter an email address.

Parent Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Child First Name REQUIRED Please fill out this field. Please enter valid data.

Child Last Name REQUIRED Please fill out this field. Please enter valid data.

Child's CURRENT Grade REQUIRED 5th Grade 6th Grade 7th Grade 8th Grade Please fill out this field.

School Attending REQUIRED Please fill out this field. Please enter valid data.

T-shirt Size REQUIRED Please fill out this field.

Street Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Medical Insurance Info (please include provider, policy/member #, group #, insurance phone #, and name of primary insured.)

Are immunizations up to date? REQUIRED Yes No Please fill out this field.

Is participant diabetic? REQUIRED Yes No Please fill out this field.

Does participant have asthma? REQUIRED Yes No Please fill out this field.

I give permission for my child to be given Tylenol (Acetaminophen), Advil/Motrin (Ibuprofen), Benadryl, or Pepto-Bismol/Tums and should my child request such and should the nurse deem appropriate REQUIRED Yes No Please fill out this field.

Please list any known allergies (medicine, food, etc.) Please enter valid data.

Do any of the above allergies cause an anaphylactic reaction? REQUIRED Yes No No Allergies Please fill out this field.

Select all dietary needs REQUIRED Gluten free Celiac Dairy free Vegetarian Nut free None Please fill out this field.

Please note that if you have further dietary needs, we can provide you with our menu with ingredient information and the available alternatives onsite. You and/or your child can then determine which foods are safe to have; for those that are not, we will ask that you prepare and send the needed food items with your child to camp. We are happy to store fully cooked and labeled items in our fridge, freezer and pantry and heat them/ serve them as needed throughout your/your child's stay at Damascus/CYSC.

To acquire more information about the menu and/or ask any questions, you can reach our Food Services team at [email protected]

Does your camper have any special needs (physical, mental, learning)? If yes, please list needs. REQUIRED Please fill out this field. Please enter valid data.

If you have a 5-11 passenger vehicle, would you consider driving us to camp for a discount on your child's registration? REQUIRED Yes Maybe No Would like more info Please fill out this field.

Permission, Indemnification and Release, and Medical Power of Attorney
I, the undersigned individual, or the lawful parent or guardian of this individual, hereby personally assume all risks in connection with my own or my child(ren)'s participation in this visit/event. 2. I am cognizant of the inherent dangers associated with participation in activities which may include but are not limited to: boating, swimming, archery tag, rock wall climbing, mountain biking, hiking, canoeing, ropes course, grounds initiatives, paintball, field games, zip lines, campfires, and tool use. Additionally, I acknowledge that certain activities may be subcontracted to vendors located off property that will require transportation. 3. I release and indemnify Damascus/Catholic Youth Summer Camp, Inc. from any and all liability, claims, judgments, costs and expenses, including attorneys' fees, arising out of any injury or illness the participant may incur while participating in or traveling to or from this activity and further agree not to bring or prosecute or allow to be brought or prosecuted (including but not limited to prosecution through subrogation) in my name, or on my behalf or that of the individual participant, any claims, lawsuits or actions against them. 4. I understand that participation is purely voluntary and is a privilege and not a right, and choose participation in spite of the risks. 5. I commit to cooperate withD amascus leadership. 6. I appoint leadership of Damascus as my attorney in fact to act for me in my name and my behalf, in any way that I would act if I were personally present, with respect to the following matters if any injury, illness or medical emergency occurs during the event or related travel: (i) To administer medications as indicated on the completed Information Form, if applicable. (ii) To give any and all consents and authorizations to any physicians, dentist, hospital or other persons or institutions pertaining to any emergency medications, treatments, diagnostic or surgical procedures or any other emergency actions as our attorney shall deem necessary or appropriate for my/the participant's best interest. (iii) I understand that the leadership of this event will make a reasonable attempt to contact my family as soon as possible in the event of a medical emergency. 7. This power of attorney shall lapse automatically upon completion of the visit/event and related travel. 8. This acknowledgement and release is intended to be as broad and inclusive as permitted by the law of the State of Ohio, and if any portion hereof is declared invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This acknowledgement and release shall be construed in accordance with the laws of the State of Ohio, notwithstanding choice of law provisions. 9. I am of lawful age and legally competent to sign this Permission, Indemnification and Release, and Medical Power of Attorney that shall be effective and binding upon me, and my own personal representative or estate, assigns, heirs, and next of kin; that I understand the terms herein are contractual and not a mere recital; and that I have signed this document of my own free act and volition. I have fully informed myself of the contents of this document by reading it before having signed it.

Release of Information
All individuals participating in this Damascus event, grant Damascus, and its assignees, the right to photograph them, record their voice, and to use their likeness, actions and voice in recordings. Whether these recordings be audio or video in nature, Damascus maintains the right to their distribution and use in advertising in all current and future media, which may also include the name, city, parish, or other personal information of the individual(s) recorded. Individuals will not receive any payment for such use and waive any right to bring any action in law or equity against Damascus, its successors, assignees or licensees, for such use.

I, the participant or parent/legal guardian of the participant named below, consent to this release of personally identifiable information.

Code of Behavior
• Participants may not leave an event prior to conclusion unless Damascus has been given explicit permission from the parent/guardian or the participant is being accompanied by an adult leader or parent/guardian.
• The possession or use of alcohol, tobacco, drugs, or weapons of any kind is not permitted.
• Participants must heed directions of counselors, staff, volunteers, or other appointed leadership.
• Unless otherwise specified, no activity elements are to be used when not in session.
• Participants must respect the rights and property of others. Damage to or defacing of property will be the financial responsibility of the participants involved and the participant's parents/legal guardians.
• Participants must uphold the dignity of others. Inappropriate jokes or language, dress, public display of intimate affection or attraction, and possession or use of pornographic materials or media is prohibited. Refer also to policy 200.82 on bullying.
• Participants will not act in any way, or promote, through language, dress, or materials, any message that contradicts the moral teachings of the Catholic Magisterium.

I HAVE CAREFULLY READ THESE AGREEMENTS AND FULLY UNDERSTAND THEIR CONTENTS. I AM AWARE THAT THEY CONTAIN A RELEASE OF LIABILITY, A RELEASE OF IDENTIFIABLE INFORMATION, AND AN AGREEMENT TO ABIDE BY ALL CYSC/DAMASCUS POLICIES INCLUDING THE CODE OF CONDUCT AND HARASSMENT POLICY. I AM AWARE THAT THIS IS A CONTRACT BETWEEN MYSELF AND THE ABOVE NAMED PARTIES AND SIGN IT OF MY OWN FREE WILL.

Prayer Permission
With specific training and the utmost pastoral sensitivity, the missionary staff of Damascus are committed to partnering with program participants to open their hearts to powerful moments of encounter in a way that fosters authenticity and personal autonomy. We offer these opportunities intentionally in our programming throughout the week, working to create spiritually safe environments not influenced by hype or exaggeration, and employ extensive pastoral training in an attempt to eliminate the potential for scandal or confusion. We believe that the goal of every sign is to point to relationship with Jesus, and every experience of prayer at Damascus is positioned with this in mind.

In preserving an environment of freedom in worship and prayer, safe and appropriate direction is considered so that 'everything should be done in a fitting and orderly way' (1 Corinthians 14:40). Damascus has the opportunity to host individuals and groups from many diverse locations and faith environments and we work to be sure that we provide a welcoming and engaging environment for all through safe and age appropriate moments of prayer.

Missionary formation stresses the importance of awareness of situation and context, seeking permission before offering prayer or physical touch, observation of safe environment standards, age appropriate language and style, respecting authority of parents, medical providers, and group leaders, and giving all glory to God.

Completion Acknowledgement REQUIRED I have read and agree to all of the information listed above Please fill out this field.

Camp Deposit100.0

Transaction Fee1.5