Parent/Guardian/Contact Information
Please input Work phone number if applicable. If none, please input Cell number again.
Please input Work phone number if applicable. If none, please input Cell number again.
For multiple campers please put their name next to the medication, allergy, and activity restrictions that apply to them.
I affirm that I will obey all the rules of Oklahoma Wesleyan University and the Tri-State District of The Wesleyan Church. I will strive to be Christ-like in my actions and words and will show respect to the camp leaders, my roommates, other campers and Oklahoma Wesleyan University property. I understand that failure to follow these rules could result in my early dismissal from camp or punishment equal to my offense.
I give consent for my child to join the Tri-State District of The Wesleyan Church Youth Camp and I fully understand the rules that have been set forth for my child to follow. The health information give above is correct, so far as I know, and I give permission to the camp medical team to administer medical aid as required for illness or injury under a physician's orders (including transportation to and form the necessary facilities).
I, the undersigned, do hereby grant or deny permission to The Wesleyan Church to us the image of my child as marked by selection(s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images and/or videos take of myself or my child for us in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the local, district, and general Wesleyan Church websites and social media.
I recognize that certain hazards and dangers are inherent in the events and programs of the Tri-State District Youth Camp. I acknowledge that although Tri-State District Youth Camp has taken safety measures to minimize the risk of injury to participants, Tri-State District Youth Camp cannot guarantee that the participants, equipment, premises, and/or activities will be free from hazards, accidents, and/or injuries.
In consideration of Tri-State District Youth Camp accepting and permitting my child to participate in this trip, I agree that Tri-State District Youth Camp, a non‐profit corporation, its agents, officers, employees, trustees, and volunteers will not be liable for any injury, death, damage and/or loss to my child, and/or anyone claiming on my child’s behalf, and I further agree to hold harmless, indemnify and defend Tri-State District Youth Camp, its officers, agents, employees, trustees, and volunteers for and from any and all damage during the trip, whether such injury, illness, or damage occurs on or off the church premises.
I acknowledge the registration cost is $225.00 per person. In order to complete my registration, I will need to submit payment via online, check or by filling out a scholarship application and returning it by May 31st. *If you are a Leader you are not required to pay please select Scholarship under payment options*
If you are needing a scholarship for camp please click on this link provided where it will take you to a pdf for that you must either print or fill out online and return to Pastor JHuff by May 31st.
https://drive.google.com/file/d/18YvpEkwmgMiPRlJXjjRUYP4EL_8qkudw/view?usp=share_link