Please provide the information below.  If the address is the same as above for your camper, there is no need to input that information again.  We MUST have an emergency phone number for the primary parent/guardian.

If your camper requires medical treatment while at camp, your family's or camper's health insurance information will be used at the hospital.  Please provide that information below.

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

• Any medications your camper will take during camp
• Over-the-counter medications allowed or not allowed for your camper
• Allergies, diet, nutrition, and vaccinations
• Social and emotional health
• General health questions and any restrictions

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 Rev. Michael Davison ([email protected]) or call: 918-899-8940. 

With your permission, the 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 the facilities that the Region rents to host our Summer Camp program (Canyon Camp, Camp Christian, Camp Tawakoni, or Be the Neighbor) 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. Additionally, the Oklahoma Disciples Foundation which provides grant funding for camps and Regional ministries has permission to photograph your child for the express purpose of promoting endowment funds which benefit the grant program through print media, digital media or Internet platforms.

Please select the appropriate permission from the dropdown menu.

The undersigned person represents that he/she is the custodial parent/legal guardian of the above identified participant. The camper has my/our permission to attend the camping program that I selected, which is sponsored by the Christian Church (Disciples of Christ) in Oklahoma between the dates of June 1, 2025, and August 5, 2025.

In case of a medical emergency, I/We understand that every effort will be made to contact a parent or guardian 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 order injection, anesthesia or surgery for my child/youth while attending camp. I/We further release the camp director(s), volunteer counselors, onsite staff, and the Christian Church (Disciples of Christ) in Oklahoma 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 to my/our child/youth.

I/We understand and accept that if my camper exhibits Covid-19 symptoms as described by the CDC, 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.

My camper 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 with Camp Directors and staff to provide care for the camper.

Our summer camp, retreat, education, and mission trip experiences depend on a commitment to live in an 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 the community, and as a community.  We require all participants to read and agree to our Community Covenant below.

The Region practices “Two Deep Leadership” to ensure the safety of all participants. I will not wander away from the camp, small group, cabin group, or the total group without permission from a counselor.

I will participate fully in all activities.

I will be respectful to all persons and the camp environment at all times.

I understand that the adults are present for my safety and questions about life and faith. They are responsible for upholding the Region’s policies and boundaries and those of the camp facilities.  I will respect and trust the adults.

I will respect the personal items of other participants (children, youth, and adults) and respect the personal space and another person’s physical autonomy.

I will only bring food to camp if authorized by the Associate Regional Minister due to my health requirements.

Accidents happen.  I understand that my family could be held financially responsible for any repairs needed to the property due to my actions.

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

I will not bring weaponry(knives, firearms, etc) to camp. 

I will not bring or consume illegal drugs, alcohol, or tobacco of any sort. 

I will not steal from anyone. 

I will not physically harm another camper or adult. 

I will not participate in sexual activity of any kind. 

If I behave consistently in a way that disrespects the adult, 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 a 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.  Youth bringing these items to camp are required to check-in the items on the open day of camp.  If I am found to have any of these items after the opening day of camp, I understand and accept that I may be sent home.

Parents: 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 child’s experience of an intentional Christian community and affects both my child and the camp community. We know that the demands outside this camp event may conflict with the commitment to spend a week apart in Christian camping, and I/We have chosen to have our child spend a week at camp uninterrupted.  Thus, I/We agree not to text or call my/our child/youth during the week of camp.

Camper:  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.