Address *

Address 1

Address 2

City

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Zip/Postal Code

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Contact Person

First Name

Last Name

Phone *

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Starting Date *

Please enter the date you have confirmed with Camp Eagle for your retreat.

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Anticipated Arrival Time *

Please enter your anticipated arrival time at Camp Eagle. This will help the Camp Eagle Staff prepare for your arrival. If necessary, this time can be adjusted as late as two weeks before your group arrives at Camp Eagle.

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Ending Date *

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Anticipated Departure Time *

Please enter your anticipated departure time. This will help the Camp Eagle Staff prepare for your departure. If necessary, this time can be adjusted as late as two weeks before your group departs Camp Eagle.

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Lodging & Meals *

Lodging in Large Group Cabins (1st nights' lodging $75/per person)**

Additional Lodging (Each additional night of lodging & 3 meals/night @ $45 per night per person)**

Private Cabins (Queen bed, Futon, Kitchenette, Private Bathroom, & Linens provided @ $110 per night)

Tent Camping

Extra meals - Any extra meals needed for your group ($10 per person)

*Day Retreat Only (>15 participants = $15 per person, < 15 participants = $20 per person) (Deposit based on number of participants. The Camp Eagle Office will contact you with the deposit required after your agreement form has been submitted.)

Adventure Activities

Bomber Ball - An exhilarating dodgeball style game using modified paintball markers that shoot low impact foam balls. ($10 per person)

Climbing Wall - 40' Climbing wall facilitated by trained staff ($10 per person)

Hunting Grounds - Archery, Tomahawks, Sling Shots & BB Guns ($7 per person)

Laser Tag - 3 games of Laser Tag ($20 per person)

Paintball - Includes CO2, paintball marker, mask and 200 paintballs. Extra paint can be purchased as needed. ($20 per person)

Zip Line ($20 per person with Overnight Retreat)

Zip Line ($25 per person without Overnight Stay))

Additional Activities

Amazing Race - Team Building Activity with multiple staff-led challenges ($200)

Hay Rides - Hay wagon pulled by tractor ($50 per session)

Lake Eagle - Includes trained lifeguards, boats, fishing, beach, 100' suspension waterslide, blob & water trampoline ($200 per hour)

Luau - Enjoy a night at the lake with hotdogs, drinks, music, s’mores and night swimming. ($10 per person)

Team Building/Camp Eagle-Led Game - Let us facilitate your groups interactive team building sessions or lead them in a dynamic game that is sure to excite and challenges all of your participants ($10 per person)

Certificate of Insurance Needed! *

Outside groups using Camp Eagle, a ministry of Shenandoah Baptist Church, must obtain liability insurance in an amount satisfactory to Shenandoah Baptist Church, in its sole discretion, and Shenandoah Baptist Church must be named therein, as an additional insured. Please send with this agreement, a copy of your “Certificate of Insurance”.

I understand

Important Information *

This registration form will need to be accompanied by $325.00 deposit* (Day Retreats will vary) once approved. This is needed to guarantee the reservation of the dates you have requested and is considered a non-refundable deposit. Deposit will be applied to total cost. Balance will be invoiced and is due at the time of check-in. Any changes resulting in additional charges or refunds will be invoiced and due within 10 days of the invoice. We would love to exceed your expectations in every way. To prepare appropriately for your arrival, a retreat schedule must be received 10 days before the retreat start date. In addition to a schedule, any food concerns and the number of people with those concerns (allergies or sensitivities) must be communicated 10 days before your retreat start date. This will allow our staff to prepare for those needs. If the food concerns are not communicated within the 10 days before the retreat starts, Camp Eagle may not be able to accommodate their food concerns appropriately. As a representative of the Sponsoring Organization listed above, I agree with the terms listed and will make every effort to ensure our group will abide by all written and verbal rules of Camp Eagle. I have read the Camp Eagle/Shenandoah Baptist Church Statement of Faith and agree not to teach against or violate by practice the principles therein. The Sponsoring Organization promises and warrants it carries liability and medical payments insurance to cover the liability and medical payments exposures resulting from participation on Camp Eagle's property. The Sponsoring Group will have Shenandoah Baptist Church/Camp Eagle as “Additional Insured” on the group's policy and will provide a copy of a “Certificate of Insurance” to Camp Eagle showing Shenandoah Baptist Church as an “Additional Insured”. The Sponsoring Organization agrees to hold harmless, indemnify and defend Camp Eagle, Shenandoah Baptist Church, and all employees and agents of Shenandoah Baptist Church/Camp Eagle from any and all liability which may result from any person using Camp Eagle's property, facilities, and surrounding areas. The Sponsoring Organization agrees to pay for replacement or repair of any damaged equipment, property, and/or facilities due to neglect, misuse, and vandalism by persons of the Sponsoring Organization. Cost of replacement or repair is at the sole discretion of Shenandoah Baptist Church/Camp Eagle and its representatives. Either party may cancel this agreement unilaterally by written notice seven (7) days prior to the beginning date of the listed above activity or retreat.

I agree

Medical Authorization *

In case of medical emergency, I hereby give my permission to have the staff member in charge hospitalize my child (or myself) and/or secure a licensed physician, surgeon, or anesthetist in providing the necessary care for my child (or myself) as named on this registration form. I certify my child or (myself) is in good physical health and is able to participate in the entire camping program, except for the activities listed as restricted. I further give permission to the camp staff to administer Tylenol or Benadryl, if needed. I understand and agree I will be responsible for any and all expenses associated with providing medical care for my child or myself.

I have read this agreement

Assumption of Risk Participation and Indemnity Agreement *

I am aware during certain events and activities on Camp Eagle property, there may be inherent risks associated with this as well as any other outdoor activity. These events include, but are not limited to, Zip Line, Swimming, Hiking, Challenge Courses, Team Building Exercises, games, paintball, The “Blob”, Hay Rides, archery, BB guns, tomahawk throwing, sling shots, Laser Tag, and all other camp related activities. Since safety is of utmost importance to the Camp Eagle Staff, I agree, once made aware of the rules, regulations, and standards as set forth by Camp Eagle instructors, I will abide by them or accept dismissal without benefit of refund for refusing to follow such rules. In consideration of and as part payment for the right to participate in these events and activities, I have and do hereby assume all risks and will hold Camp Eagle and its sponsoring organization, Shenandoah Baptist Church, (along with all employees or agents of Camp Eagle and Shenandoah Baptist Church), harmless from any and all liability, actions, causes of action, debts, claims and demands of every kind and nature whatsoever which I now have or which may arise from or in connection with my and/or my child’s participation in outdoor program activities arranged for me and/or others by Camp Eagle. The terms hereof shall serve as a RELEASE AND ASSUMPTION OF RISKS and INDEMNITY for my heirs, executors, and administrators and for all members of my family. If the participant is a minor, the undersigned parent or guardian gives permission for said minor to participate in events and activities sponsored by Camp Eagle and accept all risks as stated above. I hereby give permission for my child(ren) to be photographed or videotaped while participating in the events at Camp Eagle. I give Camp Eagle and their agents permission to use or distribute such photographs or video for any reasonable purpose including advertising or promotion. I understand this consent complies with Section 8.01-40 of the Code of Virginia or its equivalent. (Please call the Camp Office at 540-366-2433 with any questions). I have carefully read all the information from the Camp Eagle FAQs webpage (www.campeagleva.org/faq) and agree to cooperate and comply in all these areas. I understand violations in any of these areas may result in the dismissal from Camp Eagle.

I have read the agreement

Camp Eagle Retreat Guidelines *

Guidelines bring order, safety, and protection to our camp. Failure to follow these guidelines, written and verbal, could result in dismissal from the Camp Eagle campus. 1. Sexual immorality will not be tolerated. 2. The speed limit on camp property is 14 mph. 3. No males should be in the girls’ area and no females should be in the boys’ area. 4. Physical contact and public displays of affection by single men and women are discouraged. 5. Only one person per bed. 6. Do not go into facilities which are not in operation. For example, Joe Mama’s bathrooms should not be used unless Joe Mama’s is open for business. 7. Due to Camp Eagle's insurance policy only Camp Eagle's Staff members are permitted to use the kitchen facilities. 8. Food should not eaten in the sleeping facilities and all food should be stored properly. 9. The group leader is responsible to inform all members of their group of the guidelines of Camp Eagle. Leaders are responsible to provide adequate supervision for their group during periods when guest are not actively involved in programming led by the Camp Eagle Staff. 10. The use of cigarettes/tobacco products, alcohol, illegal drugs, fireworks and firearms or weapons are prohibited on the Camp Eagle campus. The entire campus is a smoke-free and tobacco free environment. 11. Offensive language or swearing is not permitted. 12. Children and teens must be supervised at all times by an adult (anyone 18-years-old or older is considered an adult) on Camp Eagle property and facilities including meal times. You are responsible for their behavior and safety of your group members. 13. Do not enter buildings you have not reserved. Only buildings and equipment you have reserved are available and accessible to you and your group. 14. No pets, no dogs and no animals are permitted on the Camp Eagle campus by rental groups participants. 15. Should you need first aid, there is an A.E.D in the Camp Eagle Country Gift Shop and a first aid kit. In a life-threatening emergency, please call 911. Please complete our online accident report found at www.campeagleva.org/accidentreport and call the Camp Director, if you need assistance. 16. Camp Eagle recommends performing comprehensive background checks for all leadership who will have the responsibility for or access to children and teens during your event. For a fee, through an outside service and with 10 days advance notice, Camp Eagle can perform a comprehensive background check for your leadership with their permission. Please contact the Camp Office at 540-366-2433 or email campinfo@sbcfamily.org for more details. 17. In order to provide adequate adult supervision, an adult should bunk in the cabins with persons under the age of 18.

I have read the guidelines

Name of Person Completing this Agreement *

First Name

Last Name

Please enter the date this form is being submitted. *

A Camp Eagle Staff member will be in contact with you concerning the availability of the dates you have requested and the details concerning your retreat. If you have not heard from a Camp Eagle Staff member within 10 days of your submission, please call 540-366-2433 to ensure we received your submission.

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