TTTC Junior Camp 2025 Application
May31 – June 3, 2025 CAMPER REGISTRATION
Email
*
example@example.com
Name
*
Camper's First Name
Camper's Last Name
Age
*
Date of birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
*
Please enter a valid phone number.
Emergency Phone
*
Please enter a valid phone number.
Sex
*
Male
Female
T-shirt Size (Adult)
S
M
L
XL
Other
Parent or Legal Guardian
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address of Parent or Guardian (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Check one event: When signing up for barrel racing we ask that you be able to walk, trot and lope circles both directions
*
Bull Riding
Bareback Bronc Riding
Barrel Racing
Team Roping
Breakaway Roping
Goat Tying
Trick Roping (No horse needed)
Horsemanship 1 or 2
Chute Dogging
Check one event: When signing up for barrel racing we ask that you be able to walk, trot and lope circles both directions
Back
Next
HEALTH RECORD AND RELEASE
Note to parents: Every precaution will be taken to ensure that your child’s stay with us is a fun and safe experience. Occasionally, people do get hurt. We require that you have INDIVIDUAL HEALTH INSURANCE to protect your child. In case of sickness or accident, please fill out the following health information completely and accurately for our camp records.
Doctor's Name
*
First Name
Last Name
Doctor's Phone
*
Please enter a valid phone number.
Name of Insurance company
*
Insurance's Phone
*
Please enter a valid phone number.
Group or policy number
*
Personal ID number
*
Date the camper last saw a physician
*
-
Month
-
Day
Year
Date
Reason
*
Date and physician seen for camper’s last physical examination
*
-
Month
-
Day
Year
Date
Date of last tetanus shot
*
-
Month
-
Day
Year
Date
Check any allergies or illnesses:
*
Hay Fever
Poison Ivy
Insect Sting
Penicillin
Asthma
Diabetes
Heart problems
None
Please give any information that will be helpful in providing routine or emergency care for the camper
PARENT / GUARDIAN CHECKLIST - (please initial each item)
I have had the Consent and Release of Liability form notarized
*
Upload Form Here
Browse Files
Drag and drop files here
Choose a file
If you have trouble uploading, please email to trailtothecross@gmail.com.
Cancel
of
I have enclosed a copy of my insurance card
*
Upload a copy of your insurance card here
Browse Files
Drag and drop files here
Choose a file
Cancel
of
I understand that my child is NOT to bring a cell phone or ANY ELECTRONIC DEVICE to camp. If he / she does, I know that the device will be kept by TrailTo The Cross, returned on the last day, and no liability for the device will be accepted by Trail To The Cross
Please mail to: Kim Hodges, 12672 Kimrey Drive, Plato, MO 65552 PH: 417-217-0499
Signature (please sign below)
Payment
*
prev
next
( X )
TTTC Junior Camp 2025 (Full payment)
Registration for the TTTC Junior Camp 2025 Summer Program
$
250.00
TTTC Junior Camp 2025 ($100 DEPOSIT ONLY)
Registration for the TTTC Junior Camp 2025 Summer Program - ($100 Deposit, remainder due before event)
$
100.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please enter your zipcode in the last entry box
Continue
Continue
Should be Empty: