Triple S Registration

Enter Access Code
Provide the access code given to you by your church group leader to begin registration for summer camp at Triple S Christian Ranch.
Access Code*
Click "Next" to continue.
The code you entered is incorrect. Be sure you typed it correctly or contact your church group leader.

Parent/Guardian Information
Must be filled out by a parent or legal guardian of the camper(s).
Name*
First NameLast Name
Date of Birth*
MonthDayYear
E-mail*
Phone Number*
Area CodePhone Number
Address
Same as that of the delegateDifferent address
New Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Please read the below terms of consent:
I hereby authorize the staff of Triple "S" Christian Ranch to act for me according to their best judgment in case of any accident, serious illness, or in an emergency requiring medical attention. In any such emergency, I authorize Triple ‘S’ Christian Ranch to call upon the physician of their choice and to follow his instructions. I will not hold Triple ‘S’ Christian Ranch, or any members of its staff, liable for any injuries incurred by me or my child during their stay at Triple ‘S’ Christian Ranch. In case of emergency, the staff will notify me as soon as possible. I understand that Triple ‘S’ Christian Ranch has secondary insurance and that any medical cost incurred must be filed with my insurance first.
Parental Consent*
I acknowledge that I am the delagate's legal guardian and have read and agreed to the terms in the above statement.
Electronic Signature*

Medical/Insurance Information
Insurance Company/Group*
Policy Number*
Date of Last Tetanus Shot/Booster*
Give a date for each camper you are registering.
Allergies / Health Conditions of Camper(s)
If any of the campers have a know health condition/allergy, please describe them.
If any camper has a special dietary need, they will need to bring their own special food, if a supplement beyond the regular meals is needed or desired. By clicking next, you acknowledge that you are aware of this.

Payment Information
The cost for a week of summer camp at Triple S Christian Ranch is $125.00 per camper.
Your group leader will be notified of your registration and will contact you about your payment.
Should be Empty: