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.
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 recognize that certain hazards and dangers are inherent in the events and programs of Good News Community Church. I acknowledge that although Good News Community Church has taken safety measures to minimize the risk of injury to participants, Good News Community Church cannot guarantee that the participants, equipment, premises, and/or activities will be free from hazards, accidents, and/or injuries.
In consideration of Good News Community Church accepting and permitting my child to participate in this trip, I agree that Good News Community Church, 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 Good News Community Church, 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 (parent/guardian), of (camper), hereby authorize Good News Community Church the authority to seek, obtain, consent and administer medical attention to/for (camper) as deemed necessary by myself (parent/guardian) or any licensed medical or healthcare professional. This includes, but is not limited to, the administering of over-the-counter medications, cleaning and caring for minor scratches/burns, and administering prescribed medication given by parent/guardian in original container with instructions on dosage and taking. I take responsibility for any and all charges that occur during administering of medical attention. This includes, but is not limited to copays. Also, in the event of serious illness or injury of my child, I authorize Good News Community Church to contact the ambulance district for transport to the hospital for emergency treatment at my expense.
I certify that photographs, videotape pictures, and/or livestreaming video of my child participating in Good News Community Church programs may be reproduced and utilized in promotional materials for the Church such as social media pages and websites.
I acknowledge the registration cost is $225.00 per person and nonrefundable. In order to complete my registration, I will need to submit payment via online 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*