Conference Registration Form with Payment

NAB Conference Youth Camp Registration

Please complete a form for each student attending.
Camper's Full Name*

First NameLast Name
Camper's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*

MaleFemale
Date of Birth

MonthDayYear
Date
Camp Registration*

Junior Camp (completing 3rd grade through 6th grade)Senior Camp (completing 7th grade through 12th grade)
T-shirt Size*

Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeAdult XX-LargeAdult XXX-Large
My child will be attending with the following NAB Church-*

Bethel Baptist - Cherokee, OKImmanuel Baptist - Loyal, OKEbenezer Baptist - Shattuck, OKZion Baptist - Okeene, OK
Parent or Legal Guardian Completing Registration *

First NameLast Name
Parent or Legal Guardian Phone Number*

Area CodePhone Number
Parent or Legal Guardian Email Address*
Camper's Primary Care Doctor and Contact Information *
Camper's Primary Health Care Insurance Provider *
Please upload a current copy of camper's primary health insurance card. *

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List any known allergies.*
List all medications, dosage, time usually taken and any additional comments that would pertain to administering the medication for camper.*
I understand all medication must be brought in the original prescription bottle or manufactured labeled bottle that has not expired. No medication will be accepted in any other form.*

I agree
Brief summary of campers medical history*
Hospital Emergency Department Preference (if circumstance allows) *
As the parent or legal guardian of the above camper, I do hereby authorize The Oklahoma Fellowship Camp Dean consent to: any Xray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care to be rendered to the above named minor under general or special supervision upon the advice of a physician, surgeon or dentist licensed under the laws of the State of Oklahoma. In giving this consent I recognize and understand that in situations where the above named minor requires immediate medical or hospital care it may not be possible to contact me, and that in such situations I will not be able to knowledgeably evaluate and choose among the risks attendant upon each, and the risks attendant to forgoing all treatment. I am aware that the practice of medicine and surgery is not an exact science and acknowledge that no guarantees or warranties are made concerning the results of any such procedures. In such situations where I am unavailable, I authorize a physician, surgeon, or dentist to exercise their professional judgment and assess the risks incident to and choose the necessary treatment from any available alternatives and to render such care and perform such treatment as their professional judgment determines to be necessary for the health or safety of the above named minor. I also agree that the Oklahoma Fellowship Youth Camp and all workers hereby fully, generally, and completely in all things do give release of and from all claims, demands, damages, actions or causes of action whatsoever for, or because of any matter or things done, omitted or suffered to be done by a camper, while attending Oklahoma Fellowship Youth Camp.*

I agree to the medical waiver
(1) ELIGIBILITY: Junior Camp is for those who recently completed 3rd grade – 6th grade. Senior Camp is for those who recently completed 7th grade - 12th grade. (2). Campers will attend all scheduled activities unless previous arrangements have been made with the Camp Dean. (3) Campers will keep the grounds, cabins, showers and toilet areas clean and sanitary. (4) Destruction of camp property, whether deliberate or through carelessness, will be compensated for by the camper(s) responsible. (5) The possession or use of smokeless or smoking tobacco, drugs (other than those prescribed by a physician), alcohol, pornography, firearms, knives, fireworks, or water guns is prohibited. (6) Cell phones are allowed at camp. However, there will be certain times of the day that cell phone usage is prohibited. This schedule will be discusssed with campers during the Day 1 Rules Meeting. Campers not abiding by the cell phone policy will have their cell phones confiscated for a period of time determined by a sponsor or the Camp Dean. (7) Clothing that reflects the spirit of Christ and His teachings will be worn at camp. a. Please bring shirts with shoulder straps 3 fingers wide that cover all undergarments. Shirts should cover entire torso. b. Shorts must be of modest length and must cover undergarments. c. All garments must be appropriate for a church camp setting -- no advertising of beer, sexual content, inappropriate language, etc. d. One-piece, modest bathing suits are required. No French cut or deep front cut suits. If a two piece is worn, a t-shirt must be worn over the suit. (8) Use of profane and abusive language is prohibited. (9) No bullying of any kind will be tolerated. (10) Walking around the campground barefoot is prohibited. (11)Head inspections of all campers MUST be done before arriving at camp. (12) Once on campus, no camper will drive any vehicle without the Camp Dean's permission or until camp has officially ended. (13) ALL visitors will report immediately to the Camp Dean upon arrival and state their reason for being on campus and length of stay. Visitors are subject to the rules, regulations and policies that have been established by the Camp Board and will be expected to participate in the activities that are planned. (14) Other rules and regulations will be shared with campers during the Day 1 Rules Meeting and must be followed.*

I agree to all rules and regulations
Campers in violation of camp policies are subject to the following disciplinary procedure:(1) A camper found in violation of any policy will be confronted by his/her counselor. If necessary, he/she will be presented to/disciplined by the Camp Dean. (2) If the above does not result in immediate correction of the matter, the camper will be dismissed from camp with full disclosure to his/her pastor and parents/guardians. If necessary, a parent/guardian will be asked to pick up the camper at the campground and remove him from campus.*

I agree to the discipline policy
Campers will be required to use the transportation provided by each church. No camper will be allowed to choose an alternative method of travel unless written consent, signed by the parent or legal guardian, is provided to the Camp Director or Camp Dean.*

I agree to the transportation policy
The Oklahoma NAB Confrence only accepts registrations completed by a minor child's parent or legal guardian. By submitting this form I hereby acknowledge I am in fact the minor child's parent or legal guardian. Violation of the policy will cause this registration to be suspended until further notice.
Parent or Legal guardian*

I agree to the parent or legal guardian policy
Signature

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Payment information

Please make checks payable to OK Fellowship Youth Camp. This payment can be mailed to Patricia Vilhauer at 3128 E 690 Road, Loyal, OK 73756. Payment information will be included in the confirmation email sent upon registering your child.
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NAB Conference Youth Camp Registration

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