GRAND OAKS Youth Camp 2025

MISSOURI VALLEY BAPTIST ASSOCIATION
GRAND OAKS Youth Camp
JUNE 2-6 (MON-FRI)
CHECK-IN MON 10-11 AM

ENDS FRI 10 AM

FOR STUDENTS WHO'VE COMPLETED 7TH-12TH GRADE
REGISTRATION OPEN APRIL 27 -MAY 18
COST $175
For more information call Youth Camp Director, Marita Avilez: 660-815-3257
Sponsoring Church
Camper Name

First NameLast Name
Male/Female
School Grade Completed
Birth Date

MonthDayYear
Date
Home Address
City, State and Zip Code
Name of Parent/Guardian
Address
City, State and Zip Code
Cell Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
OtherPhone
Format: (000) 000-0000.
Roommate Preference (Not Guaranteed)
SMLXLXXLXXXL
Campers will pay fees to your local church in cash or by check made out to your church Your church will, in turn, write one check for the entire amount due.

Consent: By signing below, I give consent for the above named camper to swim, take field trips, and participate in any program activities, under proper adult supervision.
Signature of ParentGuardian

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MISSOURI VALLEY BAPTIST ASSOCIATION

CAMP MEDICAL FORM
Emergency Contact other than parent guardian who can be contacted in case of emergency:
Relation
Phone
Format: (000) 000-0000.
Family Physician
Physician Phone
Format: (000) 000-0000.
Allergies: Medical, Environmental, and Food:
Dietary Restrictions
AsthmaSeizuresDiabetesHigh Blood PressureHyperactivityADHD
No Upper bunkNo SwimmingOther
Date of Last Tetanus Shot

MonthDayYear
Date

Youth Camp Medications Form
Will camper be bringing Medication to camp?
MEDICATIONS WILL BE CHECKED IN TO THE CAMP NURSE UPON ARRIVAL AT GRAND OAKS. THIS INCLUDES ANY OVER THE COUNTER MEDICATIONS SUCH AS TYLENOL.
Please list all medications, dosages, and when they are to take them.
Acetaminophen (Tylenol) 500 mgIbuprofen 200 mgDiphenhydramine (Benadryl) 25 mgLoratadine 10 mgMiralaxCalcium Carbonate (Tums)Please don't give any medication to my child while at camp.
This information will be accessible to the Camp Directors and Camp Nurse. This form will be kept on file in the MVBA office.
MEDICAL RELEASE: I (we) have provided complete and accurae inforation about his camper/staff member and understand that, in the event medical treatment is required, every effort will be made to contact me (us) or the person named above. However, if I (we) cannot be reached, I (we) give permission to the staff or sponsor to secure the medical services deemed necessary to provide for this camper's/staff member's wellbing. I (we) also understand that the insurance provided by Grand Oaks Baptist Association, Inc. is a limited supplmental policy covering only injury or accidents during the event at Grand Oaks. Even then it will be used only to supplment the family insurance.
Signature

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CAMP RULES
I have gone over the Item list, clothing rules, and other notes on this page with my child and they will be held accountable to follow these rules at camp. Any disobedience can result in the child being sent home.

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I have gone over the Item list, clothing rules, and other notes on this page with my child and they will be held accountable to follow these rules at camp. Any disobedience can result in the child being sent home.

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GRAND OAKS Youth Camp