Home › Castle Bluff: Crossing RegistrationCastle Bluff: Crossing Registration Castle Bluff 2017: High School Ready to register? Great! To complete this form, you'll need a credit or debit card, and a picture or scan of your insurance card (if you carry insurance). Student Name* First Last Address* Street Address City State ZIP Student PhoneStudent Email Grade*9th10th11th12thBirthdate* Gender*MaleFemaleSchool*Medical InformationRemember, if you have any illnesses such as asthma, please bring extra medication. Please enter any information about allergies, meds, etc., below:Parent Name First Last Parent PhoneParent Email Release & ConsentPlease note: You are NOT required to agree to the photography release for your child to attend camp. However, you MUST agree (which is the digital equivalent of your signature) to the Parental Consent in order for your child to be able to attend this camp. You will not be able to complete this registration unless you do.Photo/Video Release*I give permission to employees & representatives of Fellowship North and/or Castle Bluff to take photos/video of my child over the camp weekend. I authorize the use of such photos/video to publish in print and/or electronically. I agree that Fellowship North and/or Castle Bluff may use such photographs with or without my child's name and for any lawful purpose, such as publicity, illustration, advertising, and web content. AgreeDisagreeParental/Guardian Consent*I give permission for any medical attention necessary to be administered to my child in the event of an accident, injury, sickness, etc., until such time as I may be contacted. I also assume the responsibility for payment of any and all such treatment, and release Fellowship North and it’s sponsors/employees against any claim by the registrant. I understand that if my child fails to comply by camp rules or displays inappropriate conduct that I will be contacted and will be responsible for their early return from camp.AgreeDisagreeInsurance*Please indicate whether or not you carry insurance that covers your student.Yes, we carry insurance.No, we do not carry insuranceUpload your insurance card*Please scan or photograph both sides of your insurance card and upload the file(s) here. A simple way to do this is to take a picture with your phone. Drop files here or Accepted file types: jpg, gif, png, pdf. Castle Bluff Fall Camp Registration*Deposit Only ($50)Full Balance after Oct 16 - Regular ($105)Total $0.00 This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes. Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.