Teen Camp REGISTRATION Warning: Your browser does not support JavaScript or JavaScript is disabled. This site requires JavaScript to function properly. Please enable JavaScript to continue. Here are the instructions how to enable JavaScript in your web browser. Teen Camp is June 23-26 at Higher Grounds Retreat and Conference Center in West Harrison, IN. It is $225 per person. It is for students who have completed 6th grade- completed 12th grade. Step 1 of 4 25% Name First Last Registration Type Middle School High School Adult Gender Male Female Date of BirthMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Shirt SizeSmallMediumLargeX LargeXX LargeXXX LargeHome ChurchBasketball ChurchBelpreChesterChillicothe FirstCoal GroveColumbus - 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I also consent to the administration of such anesthetics as necessary.YesNo Statement of ReleaseI hereby waive any and all claims against the same, or any of its Boards or Representatives, because of injuries or other damages incurred to myself and said camper's property in connection with the South Central Ohio Nazarene Youth International Teen Camp at Higher Ground Campground. Agree Student Participation AcknowledgmentWe will not allow boys to go in girls' rooms and we will not allow girls to go in boys' rooms. There must be an adult leader (21 years or older) from each church. The adult leader/student ratio must be at least one adult leader for every 5 students. Students must keep adult leaders informed of their locations and activities at all times. Students are to always stay in groups of four or more. Prior to the retreat, pastors must inform the directors of any potential problem situations that might involve their students. Pastors will need to prepare all students for retreat by explaining the priority of the event is their spiritual growth and that our events are open to Christians and non-Christians alike. All students should be discreet at all times in their display of affection in public or in private. Our appearance should reflect modest dressing habits and appropriateness for all events. Reasons for immediate dismissal are as follows: Breaking any "special rules" as listed in the "Church of the Nazarene Manual" paragraphs 33 and 34. Use of any substance that defiles the body After hour curfew violation of event schedule South Central Ohio NYI Camping Policy The South Central Ohio NYI Council has set the following guidelines for refunds on all events that require a fee for participation. Unless further action is taken by the South Central Ohio NYI Council on any given event, the policy shall be that the fees paid for a NYI sponsored event are non-refundable and non-transferable with the following exceptions: Since any event that requires overnight stays dictates separate sleeping arrangements of male and female students, transfer of registration fees between students of the same sex will be permissible. Transfer of fees between students of the opposite sex are not permissible. A transfer of registration fees between persons of the same sex does not eliminate a person from the obligation to pay a late fee. The transfer must be made before the date that the late registration fee goes into effect. Non-attendance post registration (where the student may decide to not attend an event, however last minute) will be subject to 50% of cost of the event. This includes if a student has only paid the deposit for the event, and they will have to pay the reminder of the 50% for the event. I have read and understand the camping and refund policies.Student SignatureParent Acknowledgement for Student ParticipationI acknowledge and have read the South Central Ohio NYI Policies concerning Refunds and Camping as the parent of my child which describes what is expected of them while they are participating in this District NYI event. I also understand the "Reasons for Immediate Dismissal" as the consequence to me if they choose to do any action(s) as described in the "Reasons for Immediate Dismissal" section. I also understand that it will be my responsibility and expense to pick up my child from this event upon their dismissal. I agree.Parent SignatureThis field is hidden when viewing the formRegistration Date Registration Fee Price: Payment Method Credit/Debit Card Check Mail all checks to: Newark Church of the Nazarene Christina McCully 200 S. Williams Street Newark, OH 43055 Make all checks payable to: "South Central Ohio NYI" or "SCO NYI"Processing Fees Price: $0.00 Total Credit Card Δ