Date(s) - Tuesday, April 7
9:30 am - 2:30 pm



Attendee 1

Emergency Contact Information

Medical Information

The Camper (Adult/Child) registering on this form is immunized against the following according to H.H.S. standards: Polio, Measles, Mumps, Rubella, Diphtheria, Tetanus, and Whooping Cough. (Please notify the camp if the camper has been exposed to any communicable disease during the two weeks prior to camp attendance.) If the Camper is not immunized, please download, complete, and submit the Immunization Waiver.

Print Immunization Waiver


I understand that my personal insurance will provide coverage for medical aid to me, my spouse, my child, and/or any dependents. I also understand that if me, my spouse, my child, and/or any dependents must be sent home because of disciplinary or other problems, there will be no refund and I will assume all additional costs incurred.

IN CASE OF MEDICAL EMERGENCY, I hereby give permission to the physician selected by the camp director or his agent to hospitalize, secure proper treatment for, and order injection, x-ray, anesthesia, or surgery for my child (or the minor) as named previously.

A typed name is equivalent to a written signature.

Participation, Release, Waiver, & Indemnity Agreement

What to bring to camp: bedding, towels, toiletries, weather-appropriate casual clothing, Bible, spending money for Snack Shop

What NOT to bring to camp: fireworks, weapons, knives, illegal drugs, tobacco products, vape items, alcoholic drinks, cell phones, tablets, clothing with worldly advertisements, vulgar or graphic expressions

Dress Guidelines: We ask that all clothing be modest and appropriate for the event. Dress clothes are not required during retreats.

While we make every effort to provide a safe and pleasant environment for every camper who attends Rapidan Baptist Camp, we do require that this participation agreement be read, filled out, signed and dated by all campers (and their parent/guardian if under the age of 18) who wish to participate in activities at Rapidan. By signing this form, you acknowledge that you have read the form in its entirety and agree that you, your spouse, and/or your child will abide by the following terms while at camp.

Although Rapidan Baptist Camp has taken reasonable steps to provide equipment and skilled employees so yourself, your spouse, or your child can participate in activities for which he/she may not be skilled in, we do remind you that these activities are not without risk. Certain risks cannot be eliminated due to our camp’s rural setting and without destroying the unique character of those activities. The same elements that contribute to the character of these activities can be cause of loss or damage to your property, accidental injury or illness or, in extreme cases, permanent trauma or death. We do not want to frighten you or reduce your enthusiasm for these activities, but we do think it is important for you to be informed and know in advance about inherent risks.

Waiver: I, on behalf of myself, my children, my assigns and my estate, agree to release and hold harmless Rapidan Baptist Camp, its officers, board, agents or employees, for any and all claims for injuries, causes of action, or liability related to my child’s participation in any activity occurring at Rapidan. This release does not apply to intentional and/or willful acts of misconduct by Rapidan Baptist Camp or any of its officers, board, agents or employees. I give permission for my child to participate in activities that occur at Rapidan. These activities may include, but are not limited to, swimming, canoeing, zipnline, rail ride, archery, riflery, paintball, and strenuous competition games.

Should Rapidan Baptist Camp, or anyone acting on their behalf, be required to incur attorneys’ fees and costs to enforce this agreement, I agree to indemnify and hold Rapidan Baptist Camp harmless for all such fees and cost.

For promotional or marketing purposes, Rapidan reserves the right to use any audio, video, and/or photography of guests or campers participating at Rapidan Baptist Camp facilities.

By signing this document, I acknowledge that if anyone is hurt or property damaged during my or my child’s participation in these activities, I and/or my child may be found by a court of law to have waived any right to maintain a lawsuit against Rapidan Baptist Camp on the basis of any claim which has been released herein. I have had sufficient opportunity to read this entire document. I have read and understood it, and agree to be bound to its terms.

A typed name is equivalent to a written signature.

Account Information

Completing the following fields will create an account for you with Rapidan Baptist Camp, allowing you to edit current registrations and submit future registrations faster.