Deeper Life Bible Camp
PO Box 27 Blackduck, MN 56630
Camper's Name *
Date of Birth *YYYY-MM-DD
Grade Entering the Fall *
Post High School
Week/Days Attending *
Must Select Week
Sr. II (11th & 12th Grades)
Sr. I (9th & 10th Grades)
Primary (1st & 2nd Grades)
Junior I (3rd & 4th Grades)
Junior II (5th & 6th Grades)
Jr. High (7th & 8th Grades)
SoulFuel (Post High School)Please remember this is based on the grade the student is entering in the fall.
Gender at Birth *
Parent's Email *
Home Phone *
Home Church & Denomination
Please Select Appropriate Price for Initial Payment Being Made *
$150 (Week Long Camps)
$75 (Deposit for Full Week)
$60 ( Primary Camp)
$90 Couple ( Per Couple)
OtherOther When Paypal comes up you can close it off, we will still have received the registration form with no payment.
Registration starts on Sunday at 4PM and ends on Saturday at 10AM
Registration starts on Sunday at 4pm and ends Tuesday with a Family Lunch.
Camper Details First time at DLBC Top Bunk Unacceptable Life Jacket Required for ALL Water Activities
I wish to bunk with:
*It is our policy to avoid as much as possible, a group of THREE or more from the same church or area in the same cabin.
Racial/Ethnic History *
American Indian/Alaskan Native
Native Hawaiian/Pacific Islander
If party other than parent is responsible for any portion of the registration fee please indicate it below. ALSO include if camper is a counselor or CIT this summer.
The camper’s health insurance is responsible for any illness while at camp. DLBC provides accident excess insurance. This means that any medical bill resulting from injury must first be sent to your insurance carrier. All prescriptions must be paid by camper.
Health Insurance Company *
Employee Group Number
Medial Info - Please mark all that apply, even if only occasionally. Asthma Heart Problems Epilepsy Headaches Bed Wetting Bowel Habits Allergies Other
Minnesota State Law requires ALL campers to be fully immunized.
Immunizations are up to date Yes
Last tetanus shotYYYY-MM-DD
Emergency Contact *
Emergency Contact Number *
All Medications Brought to Camp must be labeled and put into a ziplock bag with the camper’s came on it. There must also be written instructions for the camp nurse.
No medications will be given to your campers without written permission by parent/guardian. THIS INCLUDES OVER-THE-COUNTER MEDICATION. We are under the same laws and policies as the schools of Minnesota.
DLBC may give Tylenol or non-aspirin product as needed for headache/pain. Yes
Emergency Name *
Emergency Phone Number *
Emergency Phone Number
I, hereby, give my permission, by submitting this form, to DLBC to authorize medical treatment for my child. Parents will be notified first if possible.
1. DLBC is a Christian camp. Therefore, we ask all campers and staff to seek to HONOR CHRIST in conduct, speech, and all other ways. Please bear in mind that, as a BIBLE CAMP, our desire is to be pleasing to God.
2. All campers and staff must first check in at the registration desk for assignment of cabins.
3. RESPECT one another, camp buildings, and equipment. For maximum enjoyment, get to know the other campers and staff as quickly as possible.
4. Parent/guardian permission to leave the grounds for outside activities or appointments must be submitted in writing at the time of registration and are subject to the director’s approval. Any camper who leaves the grounds without permission from parents/guardian and the director is
subject to being sent home with no refund.
Report all illnesses and injuries to your cabin counselor immediately. The camp nurse will be in charge of all decisions made for treatment. NO MEDICATIONS are allowed in the cabins at any given time, with inhalers being the exception. Please check all medication in with the camp nurse upon registration. This is in accordance with Minnesota State Law.
6. All spending /offering money must be deposited in the camp bank. We are not responsible for lost or stolen money.
7. Learn the camp SCHEDULE quickly. Respond promptly to all bells and attend all camp activities.
8. Campers and staff are expected to dress appropriately for the various activities (meals, games, swimming, chapel, etc). Sometimes the things we wear and the way that we wear them can communicate things about us that we don’t intend and can also be a great distraction to others.
9. The following items cannot be used or brought to camp: IPODs, radios, radio/CD alarm clocks, video games, CD players, tape players, computers, pagers, cell phones, firecrackers, water balloons, squirt guns, paintball guns, and accessories, or knives or any other type of weapon. If they are brought to camp, your counselor shall turn them in to the director for safe keeping until you go home. DLBC is not responsible for damage to or loss of any items of great value you might bring to camp.
10. Campers and staff will not be permitted to have access to the telephone, except in case of emergency. In that case, the director will be responsible for the call. If in case of illness or injury, the camp nurse will be responsible to call home. Staff personal calls shall be calling card/collect calls only and made when free of other responsibilities.
11. Your assigned cabin is your home for the week. Do not enter another cabin without the counselor’s permission. In cases of emergency it is important to be with your cabin so that we can account for you.
Your camp director and staff have been chosen by the DLBC Board/Committees, and have agreed to represent Deeper Life Bible Camp, Inc. in ministering to campers. All campers and staff must respect and follow the directors leadership. This policy will be enforced through the last moment of your camping session.
The director shall have the responsibility of discipline:
1. 1st Offense Verbal Warning from Director
2. 2nd Offense Camper/staff will be sent home with NO refund/payment.
For the safety of all campers and staff, DLBC is patrolled by security staff and the Beltrami County Sheriff’s Department throughout the sleeping hours and as needed at other times.
I have read the above rules and policies, and with God’s help I plan to respect and abide by them.
By submitting this form I recognize these rules and policies.
Once you click on the SAVE it automatically submits the registration to Deeper Life Bible Camp even if you cancel out on the paypal page.
Please do not resubmit the registration form again.