Gallery
June 29th-July 4th
Registration Opens Sat April 19
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2025 Dates:
June 29th — July 4th
Registration Opens Saturday April 19 at 10am
Please enable JavaScript in your browser to complete this form.
First Name
*
Last Name
*
Preferred Name
*Nickname you prefer to go by: this will be the name used on all camp lists.
Gender
*
Male
Female
Birthdate
*
MM
1
2
3
4
5
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9
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12
DD
1
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25
26
27
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31
YYYY
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
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1938
1937
1936
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1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Age (during camp week)
*
Ages are 12-15. 1st year campers must have turned 12 on or before the last day of camp, which is 7/4/24.
Address
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Parents or Guardian
*
Mother's Number
Home Phone/Work Phone/Cell Phone
Father's Number
Home Phone/Work Phone/Cell Phone
Camper's Personal Cell Phone Number
If you would like to include it for your counselor(s) to have a way to reach you outside of camp.
Email
*
This MUST be a PARENT’S or GUARDIAN’S email address, not the camper’s email address. Communication to parents/guardians will be sent via email.
Church Name and address
*
If not attending a church at this time, no problem! Just type that in.
Pastor's Name
If you don’t have a pastor, you can share the information of a person close to you that you consider a Godly mentor in your life!
Pastor's Phone Number
Date of last tetanus shot
Family Doctor
*
Name and Telephone Number
If needed, which medications do you approve?
Tylenol
Ibuprofen
Tums
Pepto-bismol
Check each one that is allowed.
Any allergies?
*
Yes
No
What is the allergy and reaction to it?
*
Any medical conditions?
*
Yes
No
Please describe any medical conditions we should be aware of below.
Please List any medical issues the camper has currently or has had within the last year
Any Medications?
*
Yes
No
Check yes if there are prescriptions or over the counter medication your child will be needing at camp during the week.
List names, dosage, and times to administer medication.
*
I do hereby give my consent for any necessary medical treatment to be rendered to the above named minor while they are at Youth Fellowship Camp located Prairie Camp (63526 CR 9 Goshen IN 46526). Medical treatment that may include emergency examination, aesthetic, medical diagnosis, minor surgery or treatment, and/or care. This will be rendered under the general or special supervision and on the advice of any physician licensed to practice medicine. I understand this is to be used only if I cannot be reached. I understand this is to allow emergency treatment to be initiated without delay and the staff will continue efforts to contact me. Secondary medical insurance is covered in the cost of registration. I further recognize that certain hazards and dangers are a possibility at camp events. I understand also, that although the camp has taken precautions to provide proper supervision, and instruction for each activity, it is impossible for the camp to guarantee absolute safety. Further, I waive any claim that may arise against Youth Fellowship Camp, Griner Church, Prairie Camp. The Missionary Church, North Central District, Inc. and/or employees or volunteers, as a result of participation in the program, except for those that are a direct result of gross negligence of the camp or its employees and/or volunteers. I also give permission as a parent or guardian for my child to be photographed or videotaped for promotional purposes of Youth Fellowship Camp. I am also aware of the Youth Fellowship Camp guidelines and am willing to follow the standard of the dress code.
Parent Signature
*
First
Last
Type Parent/ Guardian name here to show you have read and agree with the above statement.
Camper Signature
*
First
Last
Type Camper Name here to show you have read and agree with the above statement.
T-Shirt
*
(select a size)
YM
YL
YXL
Small
Medium
Large
X-Large
XX-Large
Everyone will get a tee shirt. It is included in the registration fee!
Has the applicant been to YFC before?
*
Yes
No
If this is your 1st year, how did you hear about Youth Fellowship Camp?
Activity Choices
Select your first 4 choices for your activity classes. We try our best to put you into your two first choices, but some classes can fill up quickly, so it’s helpful to know what else you would enjoy.
1st Choice
*
(select one)
Archery & Axe Throwing (14 & 15 year olds)
Basketball (boys only)
Candle-making
Crafts
Disc Golf
Drama
Finger Pottery
PVC Pipe Marshmallow Gun
Ultimate Frisbee
Simple Art and Coloring
Softball
Table Games
Volleyball
Woodworking
Yard Games
Select your first choice for activity period.
2nd Choice
*
(select one)
Archery & Axe Throwing (14 & 15 year olds)
Basketball (boys only)
Candle-making
Crafts
Disc Golf
Drama
Finger Pottery
PVC Pipe Marshmallow Gun
Ultimate Frisbee
Simple Art and Coloring
Softball
Table Games
Volleyball
Woodworking
Yard Games
Select your second choice for activity periods.
3rd Choice
*
(select one)
Archery & Axe Throwing (14 & 15 year olds)
Basketball (boys only)
Candle-making
Crafts
Disc Golf
Drama
Finger Pottery
PVC Pipe Marshmallow Gun
Ultimate Frisbee
Simple Art and Coloring
Softball
Table Games
Volleyball
Woodworking
Yard Games
Select a third choice in case one of your first 2 choices is full.
4th Choice
*
(select one)
Archery & Axe Throwing (14 & 15 year olds)
Basketball (boys only)
Candle-making
Crafts
Disc Golf
Drama
Finger Pottery
PVC Pipe Marshmallow Gun
Ultimate Frisbee
Simple Art and Coloring
Softball
Table Games
Volleyball
Woodworking
Yard Games
Also select a fourth choice in case both of your first two options aren’t available.
Additional Questions or Comments
Snack Shop Update
Money for snack shop is separate from the registration fee. You can pick the amount you would like to add to your camper’s account for the week. Snack shop is typically open 2 times each day. Any money that is leftover from their account at the end of the week will not be refunded. We try to keep our snack shop prices at cost or just a bit above per snack, candy, or drink. $20 is a pretty common amount.
Snack Shop
No Snacks – $0.00
Tier 1 Snack Option – $15.00
Tier 2 Snack Option – $20.00
Tier 3 Snack Option – $25.00
Tier 4 Snack Option – $30.00
Registration Fee plus 1.5% processing fee
Registration Fee – $100.00
I would like to apply for financial assistance – $0.00
If you need financial assistance with the registration fee please select that option form the dropdown above. We had to take down the online payment option temporarily, but once we receive your information, we will send you an address where you may send a check for payment.
Submit