Southern Wesleyan University

Central, SC

June 23-27, 2025

Before completing this registration, you will need the following information: Emergency Contact Information and Medical Insurance Information. You must also be over the age of 18 and/or be the Parent or Legal Guardian of a minor participant.

All registration fees are collected from your church or the organization you are coming to camp with. Your registration is only complete after you have registered with both Clarity Camp and your church.

If your church or group name is not listed, please first contact your Student Ministry Leader or email [email protected] to register.

Church Name

This registration is for a:

Participant Name

Home Address

Participant Date of Birth

Participant Phone Number

Grade just completed:

Grade entering in the fall:

Gender

T-Shirt Size (Adult Sizes)

Participant Medical Information

This participant has dietary restrictions or food-related allergies

This participant has non-food-related allergies

Medications Currently Taking:

Medical Conditions

Medical Insurance Carrier and Policy Information

Emergency Contact Information

Emergency Contact:

Relationship to Participant

Phone Number

Parent/Guardian and Emergency Contact Information

Parent/Guardian Name

Relationship to Participant

Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Secondary Emergency Contact (Other than already listed):

Relationship to Participant

Phone Number (other than already listed)

Code of Conduct

If this registration is for a participant under the age of 18, parents or legal guardians are responsible for sharing this information with participants. Agreeing to the terms below the Code of Conduct PDF states that you have discussed this information with the participant.

Code of Conduct

I, the undersigned, agree to the terms above.

Liability Waiver

Liability and Medical Release

I, the undersigned, agree to the terms above.

Waiver Acknowledgement*

I acknowledge that the required information on Page 1 and 2 of this waiver was completed correctly above on this registration form.

Name of Signee

Relationship to Participant

Release of Confidential Information

Information Release

I, the undersigned, agree to the terms above.

Name of Signee

Relationship to Participant

After completing this form, please check your spam or promotions folder to access your confirmation email.

Questions? Email [email protected]

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