Camp Maccabee Registration Test Page | Diocese of Jefferson City

TEST Camp Maccabee Registration 2025

Please note, page 3 of this online form require a parent/guardian e-signature. If needed, you can choose to "Save and Continue" this form later to complete any section. "*" indicates a required field.

"*" indicates required fields

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Comments

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Parent/Guardian Information

Primary Contact: Parent/Guardian Name*

First Last

Primary Contact: Cell Phone*

Primary Contact: Home Phone

Primary Contact: Email*

Primary Contact: Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Emergency Contact: Name*

Another Parent, Grandparent, Guardian, Relative, etc. Please do NOT enter the same contact information as the primary contact. We would like for the emergency contact to be a different individual.

First Last

Emergency Contact: Cell Phone*

Please do NOT enter the same contact information as the primary contact. We would like for the emergency contact to be a different individual.

Emergency Contact: Home Phone

Please do NOT enter the same contact information as the primary contact. We would like for the emergency contact to be a different individual.

Select your parish from our Diocesan List:*

Please select 'Other' if you are coming to us from outside the Diocese.

If you selected 'Other' please indicate your Diocese and Parish below.*

Are you interested in being a parent chaperone?*

We are offering a discount for chaperoning, more information will be sent to those interested.

Yes

Maybe

Camper Information

Name*

First Last

Gender*

Male

Female

Camp Maccabee is an adventure camp for young men. For our young women's adventure camp, please see the Camp Siena page on our website.

Camper Cell Phone*

Camper Email Address*

Birthdate*

MM slash DD slash YYYY

Grade in 2025-2026*

Please enter the grade that your camper will be in for Fall 2025.

Ethnicity*

If you selected 'Other' please indicate below.*

What languages do you speak?*

Check all that apply.

English

Spanish

Other

If you selected 'Other' please indicate below.*

What is your preferred language?*

If you selected 'Other' please indicate below.*

Select your camper's t-shirt size:*

Has your camper previously been to one of our camps?*

Yes

Which camps have they attended? Check all that apply.*

Camp Lolek

Camp Maccabee

Tell us a few hobbies, personal interests, or fun facts about your camper to help us get to know them before coming to camp!*

To help us prepare for camp, please check all that apply involving allergies, health concerns, behavioral concerns, etc.*

For each checkbox we ask that you explain in the corresponding lines that will pop up below.

Not applicable

Food Allergies

Behavioral Concerns

Environmental Allergies that could effect camp experience

Other Health Concerns that could impact camp

Food Allergies*

Please type here any food allergies and the severity of the allergy

Behavioral Concerns*

Pleases type here any Behavioral Concerns.

Environmental Allergies that could effect camp experience*

Please type here any Environmental Allergies that could effect camp experience.

Other Health Concerns that could impact camp*

Please type here any other Health Concerns that could impact camp

Which session are you attending?*

Week 1: July 13-18 (Camdenton)

Week 2: July 20-25 (Shelbina)

Medical Information Form

A medical form will need to be turned in on the day of arrival along with current medications. More information will be sent later.

Parent Agreement

Read the statements below, checking the box to verify you understand them, and enter your initials in the text area to complete the camper behavior agreement.

I would like to view the parent/guardian forms in*

English

Spanish

Liability Release*

I have read the below statement and understand it.

Liability Release

I as parent or guardian of my child, do hereby agree to allow my child to participate in the event/activity.

Event: Camp Maccabee

Dates: July 13-18, 2025 OR July 20-25, 2025

Location: July 13-18- McGrath Farm 344 Holly Oaks Lane, Camdenton, MO 65020
July 20-25 Camp Tolton 3834 Shelby 322, Shelbina, MO 63468

Method of Transportation: Parent drop off and pick up (to and from camp)

I acknowledge that I am responsible for transporting my child to and from camp

My child must comply with the Diocesan rules and procedures. In consideration of the Diocese allowing my child to participate in the event/activity, I also waive any claims against, and RELEASE AND HOLD HARMLESS AND INDEMNIFY, the Diocese of Jefferson City, the Parish, and any of its and/or their religious, employees, volunteers, agents and representatives from any liability, claims, demands and causes of action and claims arising out of or relating to any loss, damage or injury sustained in connection with or arising out of my child’s participation in the event/activity, including transporting my child to and from the event/activity.

Verify by typing your initials here:*

Video/Photography Consent*

I have read the release

Video/Photography Consent

I understand and consent that photographs/video recordings/audio recordings of my child may be taken, produced and may be used in publications, websites or other materials produced from time to time by the Office of Youth and Young Adult Ministry, the Diocese of Jefferson City and parishes of the Diocese of Jefferson City (collectively “Diocese”). I also understand that my child will not be identified, without specific written consent. In consideration of the Parish allowing my child to participate in the event/activity, I grant to the Diocese the right to publish, reproduce and display photographic images/video recordings/audio recordings of my child for use in all media, electronic or otherwise, in connection with publications, web pages and/or social media of the Diocese. I hereby authorize the reproduction, sale, lease, copyright, exhibition, broadcast and/or any distribution of said photographs/video recordings/audio recordings without limitation for any purpose whatsoever; and I further waive all rights to any compensation for my child's appearance or participation in the photographs/video recordings/audio recordings. I hereby expressly assign to the Diocese, all the rights, title and interest in, and to all photographs/video recordings/audio recordings made by such in which my child appears and/or his/her voice is used in and in connection with the video recording of this event. I understand and acknowledge that the Diocese has no control over the use of photographs/video recordings/audio recordings taken by media that may be covering the event in which my child participates.

Do you consent to the statement above?*

Yes

Verify by typing your initials here:*

CONSENTIMIENTO & EXENCIÓN DE RESPONSABILIDAD*

He leído y entendido lo declarado

Yo, como padre o tutor legal de mi hijo, acepto permitir que mi hijo/hija participe en el evento/actividad:
Event: Camp Maccabee
Dates: July 13-18, 2025 OR July 20-25
Location: July 13-18- McGrath Farm 344 Holly Oaks Lane, Camdenton, MO 65020
July 20-25 Camp Tolton 3834 Shelby 322, Shelbina, MO 63468

Method of Transportation: Parent pick up and drop off (to and from camp), Bus or Vans (During Camp)

Yo reconozco que la Diócesis de Jefferson City está proporcionando transporte hacia y desde el evento/actividad y estoy de acuerdo con esto. Reconozco y acepto el riesgo de este transporte para mi hijo/hija.

Mi hijo/hija tiene que cumplir con las reglas y los procedimientos de la Parroquia. En consideración a que la Parroquia permita que mi hijo/hija participe en el evento/actividad, también RENUNCIO A CUALQUIER RECLAMO CONTRA, LIBERO Y MANTENGO INDEMNE a la Diócesis de Jefferson City, la Parroquia y cualquiera de sus religiosos, empleados, voluntarios, agentes y representantes de cualquier responsabilidad, reclamo, demanda y causa de acciones y reclamos que surjan o se relacionen con cualquier pérdida, daño o lesión sufrida en relación con o que surja de la participación de mi hijo/hija en el evento/actividad, incluido el transporte hacia y desde el evento/actividad.

Firma de padre/tutor legal:*

CONSENTIMIENTO DE VIDEO/FOTOGRAFIA*

He leído y entendido lo declarado

Entiendo y doy mi consentimiento para que se tomen fotografías/videograbaciones/grabaciones de audio de mi hijo/hija, se produzcan y se utilicen en publicaciones, sitios web u otros materiales producidos ocasionalmente por la Oficina del Ministerio con Adolescentes y Jóvenes Adultos de la Diócesis de Jefferson City y parroquias de la Diócesis de Jefferson City (colectivamente “la Diócesis”). También entiendo que mi hijo/hija no será identificado sin un consentimiento específico por escrito. En consideración a que la Parroquia permita que mi hijo/hija participe en el evento/actividad, otorgo a la Diócesis el derecho de publicar, reproducir y exhibir imágenes fotográficas/grabaciones de video/grabaciones de audio de mi hijo/hija para su uso en todos los medios, electrónicos o de otro tipo, en relación con publicaciones, páginas web y/o redes sociales de la Diócesis. Por la presente autorizo la reproducción, venta, arrendamiento, derechos de autor, exhibición, transmisión y/o cualquier distribución de dichas fotos/videos/grabaciones sin limitación para cualquier propósito; y además renuncio a todos los derechos de cualquier compensación por la aparición o participación de mi hijo/hija en las fotos/videos/grabaciones. Por la presente asigno expresamente a la Diócesis, todos los derechos, títulos, intereses sobre todas las fotografías/grabaciones de video/grabaciones de audio hechas por tal en las que aparece mi hijo/hija y/o su voz se usa en y en relación con la grabación de video de este evento. Entiendo y reconozco que la Diócesis no tiene control sobre el uso de fotografías/grabaciones de video/grabaciones de audio tomadas por los medios de comunicación que puedan estar cubriendo el evento en el que participe mi hijo/hija.

Consiente a lo declarado?*

Yes

Firma de padre/tutor legal:*

Camper Agreement

Read the statements below, checking the box to verify you understand them, and enter your initials in the text area to complete the camper agreement.

Youth Policy Agreement*

I have read the statement below.

Youth Participant

In signing the line below, I agree to abide by any/all policies established for this camp. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the camp and being sent home at my parent/guardian’s expense.

Verify by typing your initials here:*

Cell Phone and Digital Devices*

I have read and understand the device policy.

Cell Phone and Digital Devices

Camp Maccabee is a time to unplug from normal life. We ask that you do not bring tablets, I-pads, Ipods, MP3 players of any sort, smart phones, cell phones, laptop computers, hand held video games, and such. You will have limited access to wi-fi anyway and many places we will go do
not have adequate cell coverage. We intend to keep too busy to have time to play with these devices. All cell phones brought will be handed in and securely held by the Camp Director.

Verify by typing your initials here:*

Open Attitude and Respectful Behavior*

I have read and understand the attitude and behavior notice.

Open Attitude and Respectful Behavior

Camp Maccabee works when those who come are willing to be engaged in what is happening. We ask that you bring your best attitude. That attitude is to be shown in all aspects of the camp: activities, prayer, and fellowship. We expect you to respect the property of your fellow campers
and staff; the property of the various locations to which we will be going. Bullying, as it runs contrary to our Catholic faith, will not be tolerated. Prepare yourself for a positive experience by coming with a positive attitude.

Verify by typing your initials here:*

Roman Catholic Values*

I have read and understand the values statement.

Roman Catholic Values

Camp Maccabee is a Roman Catholic Camp. Hence, the moral code is Roman Catholic. We wish to instill the virtues of leadership, courage, and strength in each participant. We expect you to be honest, patient, and willing to engage even when you wonder if you can. The staff is here to help you be the best version of yourself you can be.

Verify by typing your initials here:*

No Weapons, Drugs, Alcohol, or other Illegal Items*

I have read and understand the no tolerance drug policy.

No Weapons, Drugs, Alcohol, or other Illegal Items

Camp Maccabee is about providing a safe Catholic environment. The following items are contraband: all firearms, tobacco products, alcohol, and narcotics. Any camper found with these items will be immediately sent home or, if appropriate, handed over to local law enforcement. There is zero tolerance for use of these.

Verify by typing your initials here:*

Camper Signature*

By typing your full name you are verifying that you have personally read and agreed to this camp registration. Your full name will serve as your e-signature.

Parent/Guardian Signature*

By typing your full name you are verifying that you have personally read and agreed to this camp registration. Your full name will serve as your e-signature.

TEST Camp Maccabee Registration 2025

Parent/Guardian Information

Camper Information

Camp Maccabee is an adventure camp for young men. For our young women's adventure camp, please see the Camp Siena page on our website.

Medical Information Form

Parent Agreement

Liability Release

Video/Photography Consent

Camper Agreement

Youth Participant

Cell Phone and Digital Devices

Open Attitude and Respectful Behavior

Roman Catholic Values

No Weapons, Drugs, Alcohol, or other Illegal Items

DIOCESAN OFFICES and PROGRAMS