Individual Camp Registration

Rise Youth ($550.00)
This registration is for 1 student (of Rise Youth Sacramento or a someone attending with a Rise Youth Sacramento student) to attend camp (transportation included) and receive a camp t-shirt. If you wish to register more than 1 student, please "add registrant" at the end of the form.
Visiting Youth Student ($485.00)
This registration is for 1 student to attend camp (transportation NOT included) and receive a camp t-shirt. If you wish to register more than 1 student, please "add registrant" at the end of the form.

Donate to a student in need

SEND A KID TO CAMP

Do you have a specific student you would like to donate too?

Register your student

Student Name

Student Gender

Male
Female

Student Grade (2025-2026 school year)

Student School

Roommate Preference - Please give us the names of one or two friends you want to bunk with!

Yay! You get a free T-Shirt. Tell us your size.

Parental Consent Form

Parents and legal guardians of minor children are asked to complete this form and return it to Jesus Culture Sacramento, hereinafter collectively referred to as JCS. The information requested is designed to assist JCS in providing for the safety of minors during JCS sponsored activities

Parent / Guardian Name #1

Parent / Guardian Name #2

Parent / Guardian Email

Parent / Guardian Phone Number #1

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Parent / Guardian Phone Number #2

Child's Address

Health Insurance Company Covering Child

Policy Number

Family Doctor

Doctor's Phone Number

Child's Date of Birth

List any activities you DO NOT AUTHORIZE your child to participate in:

CONSENT AND CERTIFICATION:

I / we, being the parent or legal guardian of the child named above (the "child"), do hereby consent to theparticipation of our child in the activities of Rise Youth Camp , 7/11 - 7/15. The Summit CA- 12338 JourneyRoad, Whitmore, California 96096

ON CAMPUS ACTIVITIES including, but not limited to: Activities including, but not limited to, Ultimate Frisbee,Basketball, Volley Ball, Dodge Ball, Tug-of-war, Football, Swimming, Hiking, Climbing, canoeing, paddle boating, kayaking, and inner- tubing in which participants may be subject to bites from insects, ticks, mosquitoes, spiders, and / or snakes. OFF CAMPUS ACTIVITES: traveling from Jesus Culture Sacramento toThe Summit.

I / we hereby represent that child is in good health and in proper physical condition to participate in the above activities. Further, I / we certify that my child is physically able and adequately trained to participate in such events, including swimming. I / we understand and acknowledge the physical rigors associated with the activities and understand that participation involves risks and dangers which include, without limitation, the potential for serious bodily injury, permanent disability, paralysis and death; inaccessibility of medical care; dangers arising from adverse weather conditions; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of JCS; and other undefined harm or damage which may not be readily foreseeable, and other presently unknown risks and dangers ("Risks"). I / we understand that theseRisks may be caused in whole or in part by child’s own actions or inactions, the actions or inactions of others participating in the activity, and I / we hereby expressly authorize our child to participate in the above activities.

I have read and agree to the terms above.

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