Camp Registration

If you are registering multiple campers, you must complete a separate registration for each camper.

Camp Ellie Mae fills up fast, and every spot is special. When you register, you’re committing to attend – so please keep your camp dates in mind as other opportunities arise.

Last-minute cancellations mean another camper misses out and also impacts the time, effort, and generous donations that make camp possible. We understand life happens, but we kindly ask that you make Camp Ellie Mae a priority once you’re registered.

Thank you for understanding – we can’t wait to welcome your camper this summer!

Please enable JavaScript in your browser to complete this form.

Camper Information

Camper's name
Camper's date of birth
Camper's home address
Optional
Optional
Is this your camper's first year at CEM?
Pool is 4 feet deep. Campers are supervised while the pool is open by at least 1 adult volunteer.

Parent/Guardian Information

Parent/guardian's name

Emergency & Medical Information

Additional Emergency Contact

We will ask about medications later; this question is specific to allergy information.
Later we will ask about administering over-the-counter medications, provided by CEM. This question is strictly addressing medications sent with your camper.
If not applicable, please write NA

Over-the-counter medication authorizations

Here you will indicate which over-the-counter (OTC) medications CEM is authorized to administer to your camper on an as-needed basis, and according to accurate dosing instructions. If you choose "Other," please explain in the field provided below the list of medications.

If there is a specific OTC medication that is not listed, and you do not wish us to administer, please indicate in the field below the list.

NSAIDs (ibuprofen, Advil, Motrin, Aleve/naproxen)
Acetaminophen (Tylenol)
Antacids (chewable or liquid)
Bendryl pills (for allergy/itching)
Topical hydrocortisone creams
Benadryl/Calamine lotion
Neosporin & topical burn creams
Benzocaine, topical
Betadine/antiseptic/hydrogen peroxide
Eye wash/artificial tears
Ocufen eye drops (for chlorine irritation)
Swimmer's Ear drops
Midol

Additional Permissions

Photos
I authorize my camper's photos to be taken. Photos will be taken with discernment, careful scrutiny, and respect.
Social media/website
I authorize my camper's photos to appear on the Camp Ellie Mae website and social media accounts. All photos will be very carefully chosen, scrutinized, and deemed appropriate by the leaders of Camp Ellie Mae prior to posting.
Pool
I authorize my camper to use the pool and pool area during Camp Ellie Mae. I understand and assume responsibility for the risk of injury involved in this activity. If indicated above, I understand the use of a life-saving swim device is required to swim.
Trampoline
I authorize my camper to use the trampoline in adherence to the rules of Camp Ellie Mae. The trampoline will be used by several campers at a time, in adherence to the trampoline manufacturer's manual. I understand and assume responsibility for the risk of injury involved in this activity.
Zipline
I authorize my camper to use the zipline during Camp Ellie Mae. I understand and assume responsibility for the risk of injury involved in this activity.
Archery
I authorize my camper to participate in supervised archery during Camp Ellie Mae. I understand and assume responsibility for the risk of injury involved in this activity.
Tree climbing
I authorize my camper to participate in supervised tree climbing during Camp Ellie Mae. I understand and assume responsibility for the risk of injury involved in this activity.

Click "Next" to continue to Policies, Legal Statements, & Signature