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Camper Information




Emergency Contact


Camper Medical Information

This section helps our volunteer staff and medical personnel know about your camper's medical needs including:

  • Allergies, diet, nutrition, and vaccinations
  • General health questions and any restrictions
  • Social & Emotional Health

Brief Medical History

Help our volunteers understand your camper's medical history so they can better care for your camper.





What have we forgotten to ask?  If your explanation about your camper's health exceeded the space above, please provide additional information about the camper that you think is important or that may affect the camper’s ability to fully participate in the camp program by emailing the Camp and Conference Coordinator, Kylie Graham at (913-669-4782) or email ([email protected]).


Consent and Release

Permission to Photograph


With your permission, the Greater KC Region's Ministerial staff and our volunteer camp staff (counselors and directors) will photograph or video tape your child for the express purpose of promoting the Region's Summer Camp (outdoor ministry), Children's Ministry, and Youth Ministry programs through print media, digital media, or Internet platforms.  Further, the staff of Tall Oaks Conference Center (the facilities the Greater KC Region rents to host our Summer Camp program)  has permission to photograph or video tape your child for the express purpose of promoting their facilities and ministry of hospitality through print media, digital media, or Internet platforms.  Below you can choose to NOT give your permission.

In Case of Emergency

The undersigned person represents that they are the above identified participant. 

In case of medical emergency, I/We understand that every effort will be made to contact the emergency contact of the camper. In the event I/We cannot be reached, I/We hereby grant permission to the camp staff to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for the camper while attending camp. I/We further release the camp director(s), volunteer counselors, onsite staff, and the Christian Church (Disciples of Christ) in Greater KC from responsibility and liability for any accidents or illnesses occurring during camp. I/We also authorize the camp director or medical supervisor to dispense non-prescription drugs (i.e. Tylenol; ibuprofen) if the situation warrants. I/We understand that the camping experience grows in intensity as the week progresses. I/We recognize that missing any part of the week compromises my experience of intentional Christian community and affects both my individual child and the camp community as a whole. I/We know that the demands outside this camp event may be in conflict with the commitment to spend a week apart in Christian camping, and I/We have chosen to have my child spend a week at camp uninterrupted. 

I/We understand and accept that if my camper exhibits Covid-19 symptoms as described by the CDC, that my camper will be sent home from camp.  I/We will follow the process outlined in the Region's Covid-19 Summer Camp procedure and obtain a Covid-19 PCR test and report the findings.

The participant has no physical or mental disabilities that would impair their participation except as noted above. I/We understand that the information provided on this form will be kept confidential and shared only as necessary to provide care of the participant.

Checking this box represents your digital signature and authorization. You cannot register for camp without accepting the "Consent and Release" information.

Community Covenant

Our summer camp, retreat, education and mission trip experiences depend on a commitment to living in intentional Christian community by the participants and the adult volunteers. To do so, we agree to a covenant that helps manage our relationships with one another, our behavior within community, and as a community. We require all participants to read and agree to our Community Covenant below.

Summer camp, retreat, mission trip, or education trips are an opportunity to come to know God while living in intentional Christian community. To ensure every person’s worth as a child of God and each person’s safety, all participants (youth, children, and adults) follow this Community Covenant.

  • I will participate fully in all activities.
  • I will be respectful to all persons and the camp environment at all times.
  • I will respect the personal items of other participants (children, youth, and adults) and respect the personal space and other person's physical autonomy.
  • Accidents happen. I understand that I could be held financially responsible for any repairs needed to property as a result of my actions.

I understand and accept that if I am found with, or participate in any of the following, that I could be sent home from summer camp, from a retreat, education trip, or mission trip experience at my families expense. I also understand that being sent home may limit or disqualify my participation in summer camp, retreats, education or mission trips in the future.

  • I will not bring weaponry of any sort (knives, firearms, etc.) to camp.
  • I will not bring or consume illegal drugs, alcohol, or tobacco of any sort (or bring/consume prescription drugs that are not prescribed to me).
  • I will not steal anything from anyone.
  • I will not physically harm another camper or adult.
  • If I behave consistently in a way that disrespects the adults, other campers, or the facility that does not reflect the grace and love that is expected of persons who claim Christian faith. 

Summer Camp is ideally Cell Phone Free Zone for campers. Cell phones, Internet hotspots, electronic entertainment devices, game devices, or devices capable of connecting to cell towers often detract from the camp experience. 

I look forward to spending time in community with those who share my interest in exploring Christian faith and the practice of Christianity as we play, pray, study, worship, and serve one another following the example of Jesus.

You cannot register for camp, retreat, study trip, or mission trip experiences without agreeing to uphold the Community Covenant.

Cancellation Fee

Please be advised that cancellations made up to 30 days before a scheduled camp will be processed without a penalty. You will receive a full refund.

Cancellations made 15- 30 days before a scheduled camp will result in a 50% refund.

If you choose to cancel 14 days (Two Weeks) prior to a scheduled camp you will not receive a refund.

You cannot register for camp, retreat, study trip, or mission trip experience without agreeing to the cancellation policy.


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Why protect your registration purchase? Purchase Protection covers:

Severe Illness and InjurySevere Illness and Injury
COVID-19COVID-19
HospitalizationHospitalization
Death in FamilyDeath in Family
Transportation FailureTransportation Failure
Crime and Home EmergencyCrime and Home Emergency
Employment ObligationsEmployment Obligations
Acts of NatureActs of Nature
Legal ObligationsLegal Obligations

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* Terms, conditions and exclusions apply. Not available for or applicable to events, attendees, or travel outside of the USA. Purchase Protection is a service offered by Purchase Protection LLC. Purchase Protection is not an insurance policy. It is a service that will refund you 100% of your event fees, taxes and dues should you be prevented by unforeseen circumstances from attending the event. Purchase Protection does not apply to, and will not reimburse, merchandise purchases and charitable donations. Purchase Protection fees will be charged as a separate transaction. Any changes made to your purchase will not change the amount covered in this agreement.

Read Full Terms and Conditions

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