Black Hills Bible Camp

A Week of Heaven on Earth

Black Hills Bible Camp 2017

50 Years of Black Hills Bible Camp


Parents must register children under the age of 18.  Our new registration includes the health form, medication, insurance, and release all in one!  Be sure to complete a registration for every person attending camp.

Name of Camper *
Name of Camper
Gender *
Select the Grade level the Camper will be going into this Fall. (note: 0 for PreCampers, 14 for College Campers & 20 for Adult Campers)
Campers Phone# if applicable
Leave blank if registering as an adult.
Parent Contact Number *
Parent Contact Number
Alternative Contact Phone Number
List the name of someone we can notify in case of an emergency
Enter how the camper knows this contact
Emergency Contact Phone *
Emergency Contact Phone
Enter the church the camper attends
Please list any allergies the camper may have so that we can ensure a safe week for everyone.
Medications *
All medications brought to camp, both prescription and non-prescription, must be in the original containers and clearly labeled with campers name. All prescription medications will be dispensed according to physician's instructions.
Please list each medication, dosage, and the time it needs to be taken. (Breakfast, Lunch, Supper, Bedtime, Other)
Verifying Medication Instructions *
I, the undersigned, give permission for my child to be given over-the-counter medications (non-prescription).
If you checked "No", please explain.
Health Notice *
In the event that your child becomes ill, you will be notified. For his/her health, as well as for the health of the other campers and staff, and upon the advice of the Camp Nurse, the camp and parent together may decide it best for the parent to pick the child up early from camp. Camp administration holds the right to make the final decision.
Please list any recent surgery, injury, health or emotional condition that the camp staff should be aware of that might restrict your child from participation in camp activities. Please list the restricted activities, due to health reasons.
Please list: Family Insurance Company, Insurance Subscriber's Name, Insurance Claims Address, Policy #, ID #, and the Pre-Authorization Phone # if required.
Please list the name or names of campers that you would agree to share sleeping quarters with if necessary.
Photograph Release *
I hereby give my consent for BHBC to use any photograph and likeness to be used in its publications, including its website. I release them from any expectation of confidentiality for the minor child and myself and attest that I am the parent or legal guardian of the child listed above.
Behavior Agreement *
I (and the camper) have read and agree to follow, the Dress Code and Rules and Disciplinary Policies provided by BHBC and understand that if my child must be expelled from camp early, all camp fees will be retained by BHBC and no refunds will be granted. These policies of Black Hills Bible Camp are available at the link at the bottom of this page.
Emergency *
In case of an emergency, I hereby give permission for a representative of Black Hills Bible Camp to seek necessary medical attention from qualified personnel and secure proper treatment for my child.

To read BHBC CAMP Policies