2023 Camper Registration Form

2023 Camper Registration

Hope of the Ozarks (Formerly Camp David of the Ozarks) is an Angel Tree camp for children with one or both parents in prison. Do not register your child if they do not have a parent in prison, unless they are an alumni camper who has had a parent in prison in the past. Many parts of our program are uniquely designed to help children dealing with parental incarceration.
**MUST FILL OUT SEPARATE REGISTRATION FORMS FOR EACH CHILD.
Camper's Full Name*

First NameLast Name
Nickname
Birth Date*

MonthDayYear
Age at time of Camp*
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Name of Parent/ legal guardian*

First NameLast Name

Phone Numbers:*

	Phone number inlcuding area code	This is a:	Check if can receive texts
Primary
Secondary
Work

E-mail
First Time Camper*

YesNo
Years at Camp
Emergency Contact: Relative*
Phone Number*

Area CodePhone Number
Emergency Contact: Close Friend
Phone Number

Area CodePhone Number
Number in Household
Annual Household Income
Check the camp your child would like to attend:
Note: Select only one week per child. Junior Camps- If the week you selected is already filled up, we will contact you to offer an alternative. These camps are filled by a first come, first served basis.
Teen Camp (Youth ages 13-16)

Teen Boy's Camp - June 12-16Teen Girl's Camp - June 19-23
Junior Camp (Youth ages 8-12)

Junior Boy's Camp 1- June 26-30Junior Girl's Camp 1 - July 10-14Junior Boy's Camp 2- July 17-21Junior Girl's Camp 2 - July 24-28
Health Record
Camper's Doctor's Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Health Insurance or Medicaid Number
Are Immunizations up to date?*

YesNo
Date of last Tetanus*

MonthDayYear
Recent Operations?*
Does the camper have any allergic reactions to food, drugs, poison ivy, or insect stings? If so, please describe.
Special Considerations

SleepwalkBed WettingFaintingEpilepsyDiabetesHay FeverAsthmaADD/ADHDODDOther
Explain any of the above if applicable:
List any childhood diseases:
I give permission for my child to receive:

TylenolIbuprofenAllergy MedicationAntacidAnti-itch creamOtherMelatonin 5mg
We have allowed 6 blocks for medications. If your child doesn't have any medications, just leave them blank. If your child has more, please contact the office. Medications must be in their original packaging for us to administer them at camp.

	Medication	Dosage	Directions
1
2
3
4
5
6

Medical Permission & Release
"I accept the risks involved in camp activities and do hereby release Hope of the Ozarks, and all staff and volunteers, from any and all claims for bodily and personal injuries or death sustained by my child, whether such injury occurs on or off the camp property. I give permission for Hope of the Ozarks to secure emergency medical and surgical treatment, and routine, non-surgical medical care for my child while at camp. I understand that should my child become ill I may need to make arrangements to pick them up."
Parent/Guardian Signature:*
Relationship to Child:*
Date signed:*

MonthDayYear
Inmate Verification

Angel Tree requires this inmate information to verify qualifications for camp scholarships. Hope of the Ozarks will not use this information for any other reason.
Inmate Name*

First NameLast Name
Inmate Booking Number *
Relationship to Camper*
Prison*
City*
State*
If parent/step-parent was released from prison - Date or year of release:
Child knows parent is incarcerated:

YesNo
Scholarship Requested

Full scholarships are available, but if you are financially able to pay for all or part of the fee, we request you do so.
Scholarship Request:

I am paying the full cost of the camp (I will pay $200)Partial Scholarship of $50 (I will pay $150)Partial Scholarship of $100 (I will pay $100)Partial Scholarship of $150 (I will pay $50)I am requesting a full scholarship of $200
MAKE ONLINE PAYMENT
Transportation

If necessary, Hope of the Ozarks can provide transportation for your child from pick-up points in several cities.
Note: Camp starts at 11:30am on Monday and ends at 1:00pm on Friday. You will receive a letter confirming your transportation plan one week prior to your child's week of camp!
Your Transportation Plan:*

I will provide transportation for my child to and from campMy child(ren) will need to ride the van from my nearest pick-up spot
Select the city pick-up spot that is nearest to you:

St. ClairSt. LouisJefferson CityRollaSt. Robert
Parental Permission & Release

This must be signed in order to register your child!
"I understand that while attending Hope of the Ozarks my child may be involved in various activities including, and not limited to swimming, horse rides, obstacle course, and other traditional camp activities.

I understand the mission for Hope of the Ozarks is to provide a Christian Camp where one can experience love, find hope, and grow in a relationship with Jesus Christ. I do hereby grant permission for my child to attend camp and participate fully in all camp activities.

Pursuant to Missouri Section 210.211.3 RSMo, Hope of the Ozarks must disclose they are not a licensed childcare facility. I am aware of this fact.

I have instructed my son/daughter to obey the rules of Hope of the Ozarks. I understand that should my child become very disruptive I will need to make arrangements to pick them up.

I also give permission to Hope of the Ozarks to use camp pictures of my child in promotional and sponsorship material."
Parent/Guardian Signature:*
Relationship to Child:*
Date Signed:*

MonthDayYear
Enter the message as it's shown*
*For registration questions: Call: 573-364-2786 or email: info@hopeoftheozarks.org
Should be Empty:

2023 Camper Registration

Health Record

Medical Permission & Release

Inmate Verification

Scholarship Requested

Transportation

Parental Permission & Release