Camp Noah Registration

Camp Noah is a 6 week summer day camp that consists of character development in a safe and fun family atmosphere. Daily activities include friendly competitions, crafts, Biblically-based character development lessons based on the life of Jesus, and healthy Breakfast & lunch. Camp Noah 2024 runs from June 17 - July 26, from 9:00 AM - 5:00 PM. For more info on camp please contact Our Director of operations Mr. Jarrad.

Fill out the application below to start the registration process for Camp Noah.

Registration For Camp Noah 2024 is CLOSED as of 4/15/24

Camper Information

* Indicates required field

Student Name *

First

Last

Birth Date *

Gender *

Parent/Guardian Name *

First

Last

Parent/Guardian Phone Number *

Parent/Guardian Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact #1 *

First

Last

Emergency Contact #1 Phone Number *

Emergency Contact #2 Name *

First

Last

Emergency Contact #2 Phone Number *

T-Shirt Size *

Drop Off/Pick Up Information *

Is allowed to walk home Is allowed to be picked up by parent/guardian or emergency contacts

Program Attendance
Camp Noah will begin at 9:00am each morning and ends at 5pm on Monday - Friday

Arrival Time *

Medical Information
Please fill out the section below as thoroughly as possible to help us best serve your child.

If your child has any allergies, enter them in the text box. If not, type N/A *

If your child were to come in contact with their allergen, how would you deal with the situation? If your child does not have any allergies, type N/A. *

What medications does your child take? If none, type none. *

What special needs (medical conditions, disabilities, learning issues) does your child have? If none, type N/A *

Other Information

Will Your Child Be Attending Summer School? *

Yes No

What Days/Times *

Grade in 2022-2023 Year *

Will your child miss any days of camp that you already know about? *

Additional Comments *

Permissions & Agreements

Prior to your child starting program, you will be asked to sign the following agreements.

I give my permission to the school district to release my child's records to Hartford City Mission.
I understand my child may be photographed or recorded on video to be used for memorabilia and program promotion. You have my permission to photograph and videotape my child or display samples of his/her work.
I understand that my child may need to be transported to various sites within the state of Connecticut for field trips and other programmatic events. Children will only be transported by licensed staff. I give Hartford City Mission staff and/or volunteers permission to transport my child for program activities and release the staff and/or volunteers from any liability.

By hitting the submit button below you are acknowledging agreement with the following statements:

I understand that placement in this program is not guaranteed and space is limited.
I understand that in order for a child to have an excused absence, I must inform the program by 8:30am.
I understand Hartford City Mission reserves the right to remove students based on conduct and/or attendance.
I understand that I am responsible for my child's transportation to and from program.
I understand that Hartford City Mission's programs use lessons that are Biblically based and my child will be exposed to and participate in Christ-centered activities.
I understand that my registration is not complete until all paperwork has been completed and submitted including a physical.

Submit

Fill out the application below to start the registration process for Camp Noah.

Registration For Camp Noah 2024 is CLOSED as of 4/15/24

Camper Information

Permissions & Agreements

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