Ignite 2026

List Camper’s Home Church

Eagle Church

Eagle Male Camper ($425.00)
Eagle Female Camper ($425.00)

Camper's Name

Camper's Address

Camper's Gender at Birth

Male
Female

Camper's Date of Birth

Age at the time of camp

Camper Grade for the 2025/2026 School Year

Have you been to any Ignite Camp before?

Camper's T-Shirt Size - Adult sizes only

Preferred Room Bunk Mates (Roommates cannot be guaranteed but our team will do our best to accommodate for preferences)

Does your Camper have roommate preferences?

Primary Parent/ Guardian - Full Name

Primary Parent/ Guardian - Date of Birth

Primary Parent/Guardian - Phone Number

Yes, it's okay to send me text messages including order confirmations, updates, event reminders, and event information. Message frequency varies. Message and data rates may apply. Reply HELP for help, STOP to cancel. View our terms of service & privacy policy.

Primary Parent/ Guardian - Email

Relationship to Camper

Secondary Parent/Guardian - Full Name

Secondary Parent/Guardian - Date of Birth

Secondary Parent/Guardian - Phone Number

Secondary Parent/Guardian - Email

Relationship to Camper

Additional Authorized Pickup

Please note that you will be required to show ID in order to pick up a camper early.

Check if you would like to add additional authorized pickups

Authorized Pickup #1 - Phone Number

Authorized Pickup #2 - Phone Number

Is there anything else we should know?

Primary Care Doctor - Full Name

Primary Care Doctor - Phone Number

Medical Insurance Company

Medical Insurance Policy Number

Policy Holder - Full Name

Are your Camper's Immunizations up to date?

Please list all Medications that will be brought to camp:

Do you give us permission to administer Tylenol, Benadryl or Ibuprofen to your Camper as needed?

Describe any food allergies the camper has

Describe any medical conditions the camper has (e.g., asthma, diabetes, seizures)?

Describe any past behavior/discipline issues or difficulties that we should know about (so we can best support them)

Describe any recent trauma your camper has experienced (E.g. the loss of a loved one, extreme ill health, emotional or physical crises, etc.) that we should know about (so we can best support them)

A signed waiver by event participant or parent/guardian will be required before you can download your QR code. A link to obtain waivers for all registrants will be shown on the confirmation page.

Parent/Guardian Authorization - Release of Liability

I know my child is registering for Ignite Camp. I agree to meet financial deadlines. I agree to allow photos & videos of my child to be used for ministry purposes.

[Required] Release of Liability
I, the parent or legal guardian of the above mentioned student, (Hereinafter referred to as “MINOR”) a minor, hereby acknowledge that the Minor is presently under my care and custody. I give permission for the Minor to go to and participate in activities with Eagle Church of Zionsville, IN, (hereinafter referred to as “CHURCH”), including those activities, which require transportation to other locations. (example: camp, small group, outings)

THE MINOR IS VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES, INCLUDING TRANSPORTATION TO AND FROM SUCH ACTIVITIES, WITH MY FULL KNOWLEDGE OF THE DANGERS INVOLVED AND HEREBY WE AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OF SUCH PARTICIPATION AND TRANSPORTATION.

In the event there an emergency arises, necessitating medical or surgical attention, I consent to and give my permission to the Church, its representatives, or trip leaders to make decisions to perform medical treatments and/or surgery upon the Minor which may, in their sole discretion, be necessary and proper under the circumstances.

I understand that I will be financially responsible for any part of the cost of any medical treatments and/or surgery which may be deemed necessary for the Minor to the extent not paid by insurance.

I, the undersigned parent and/or guardian of the Minor, do release, discharge, and agree to hold the Church and its representatives, or trip leaders harmless, from any and all claims, actions, damages, and/or liabilities arising out of any accident or sickness, or treatment thereof, incurred by the Minor during activities with the Church.

I understand by checking the box below it is my consent to the above release of liability.”

I, the undersigned, agree to the terms above.

Camp Illiana Refund Policy

To ensure fairness and accommodate the high demand for our camp sessions, Camp Illiana has implemented the following refund policy:

1. Cancellations More than 30 Days Before Session Start Date
- A $25 processing fee will be charged for cancellations made more than 30 days before the session start date.

2. Cancellations Within 30 Days of Session Start Date
- Cancellations within this period will result in a forfeiture of 50% of the camp fee.
- Alternatively, campers have the option to transfer their registration to another available session.

I have read and agree to the terms above.

Scholarship Code

Billing Information

Secure checkout PCI compliant

Name

Credit CardSecure Payment

Address

Phone Number

Safe & Secure Checkout PCI-compliant • 256-bit AES encryption