Fusion Camp

Fusion Camp - Online Camper Registration

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip Code

Gender At Birth

Birthdate

Age

Email

Have you ever been to Fusion Camp before?

Yes

No

Parent/Guardian's First and Last Name

Cell Number

Home Phone Number

Emergency Contact

Relationship To Camper

Contact Number

Does the camper have any illnesses we need to be aware of?

Yes

No

If yes, please explain.

Does the camper take any medications regularly?

Yes

No

If yes, please list name of medications, time, and dosage.

Does the camper have any allergies? (i.e. plants, insect stings or bites, foods, medications, etc.)

Yes

No

If yes, please list.

Church presently attending, if any.

Church Address

City

State

Zip Code

Pastor's Name

Pastor's Contact Number

Tuition:
Tuition is $100 per camper. After submitting this form, please select the "CAMPER TUITION PAYMENT" button below for payment.

Camper Signature - To be read and signed by the camper: I agree to follow the rules and guidelines listed on the camp code. I also will obey the camp staff members while at camp and do my best to get along with other campers.

Parent/Guardian Signature - To be read and signed by the camper’s parent or guardian: I have discussed the camp code with my child, and they understand it. I give my permission to let my child attend camp. I give permission to the nurse/med tech at Fusion Camp to administer the medications listed above to my child. I give my permission for camp pictures or video of my child to be used in camp publications and promotional activities. In case of an emergency, I give my permission for my child to receive medical attention as necessary. I understand that in case of such an event, I will be contacted as soon as possible. I understand my child will be at camp with students and workers from other youth groups. I am aware of the existence of the risk on my child’s attendance to Fusion Camp and my child’s participation to the activities of Fusion Camp that may cause injury or illness such as, but not limited to Influenza, MRSA, or COVID-19. I waive and release Fusion Street Ministries and Camp Penuel from any and all claims, demands, injuries, cost, suits or causes of action, past, present, or future, arising out of or caused by myself or my child while participating in this camp, or should there be an injury traveling to or from camp. I verify the above information is correct.

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After submitting the camper registration form, please click here to submit payment for registration.

Camper Tuition Payment

Fusion Camp

Fusion Camp - Online Camper Registration

After submitting the camper registration form, please click here to submit payment for registration.

Fusion Camp is held at Camp Penuel, on Lake Killarney outside of Ironton MO.

Fusion Camp

The Reason School Let's Out For The Summer!

Contact Us

Do you have questions about Fusion Camp?
We'd love to hear from you. Fill out the form below to get started.

Service Times

Contact Info

Follow Us

Fusion Camp

Fusion Camp - Online Camper Registration

After submitting the camper registration form, please click here to submit payment for registration.

Fusion Camp is held at Camp Penuel, on Lake Killarney outside of Ironton MO.

Fusion Camp

The Reason School Let's Out For The Summer!

Contact Us

Do you have questions about Fusion Camp?We'd love to hear from you. Fill out the form below to get started.

Service Times

Contact Info

Follow Us

Do you have questions about Fusion Camp?
We'd love to hear from you. Fill out the form below to get started.