Church that your camper is attending camp with
Please Select
Acorn Baptist Church
Board Camp Baptist Church
Calvary Baptist Church
Cherry Hill Baptist Church
Concord Baptist Church
Dallas Ave. Baptist Church
DeQueen FBC
Grannis FBC
Gilham Baptist Church
Hatfield FBC
Hatton Baptist Church
Mena FBC
New Hope Baptist Church
Salem Baptist Church
Vandervoort FBC
Yocana Baptist Church
Other
CAMP COURAGEOUS
June 25-28, 2025
Camper's Name
First Name
Last Name
Gender
Please Select
Male
Female
Last Grade Completed
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
Shirt Size
Please Select
Y Small
Y Med
Y Large
A Small
A Med
A Large
XL
2XL
3XL
4XL
PARENT/GUARDIAN CONTACT INFORMATION
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name & Phone
Pick-up Authorization
Person(s) other than parent/guardian or emergency contact who have permission to pick up your child from camp.
MEDICAL & DIETARY INFORMATION
Medical Conditions
List medical conditions that we should be aware of (asthma, diabetes, etc.)
List any surgeries, illnesses, or injuries that are relevant to the current health of the camper
Prescription Medication(s)
List any prescription meds that will be administered to your child while attending camp.
Permission to administer (as needed):
Tylenol
Ibuprofen
Benadryl
Tums/Pepto-Bismol
Food Allergies and/or Dietary Restrictions
List any severe allergies or dietary restrictions.
POLICIES & PERMISSIONS
READ THE FOLLOWING STATEMENTS AND CLICK THE BOX TO ACKNOWLEDGE YOU ARE AWARE OF EACH POLICY.
MEDICATIONS All prescription medications must be in original pharmacy container with cam per's name and dosage instructions on it. Send only the doses needed while at camp. By federal law, we cannot mail any medications that are accidentally left. Place medications and completed Medication Form in a resealable bag and give to your church group leader prior to departure for camp. DO NOT PACK IN CAMPER'S BELONGINGS!
I understand
FOOD ALLERGIES/RESTRICTIONS If your child has essential dietary restrictions or will bring their own food items for meals, you must contact the camp coordinator @ (501) 472-8452 prior to camp so we can ensure proper precautions be taken, and we have appropriate menu options.
I understand
CONSENT TO TREAT I do consent that OBA Staff may secure medical attention for healthcare for my child when such attention or care is desirable or necessary. I do hereby release, wave, and discharge Ouachita Baptist Association and OBA Campground Staff of all liability whatsoever arising from any injury or illness my child sustains while attending or because of attending this camp.
Type your FULL NAME
Signature
PHOTO/VIDEO NOTICE Campers may be photographed or videotaped during normal camp activities and photos and/or videos may be used on social media platforms and in promotional materials.
I understand
LIABILITY Ouachita Baptist Association and OBA Campground are not responsible for lost, stolen or damaged property. Please do not bring valuables to camp. Found items left at camp will be gathered and taken to the OBA Office @ 1201 College Dr. in Mena where you can pick them up.
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BEHAVIOR All campers are expected to behave appropriately and follow the rules and regulations of the camps and campground. If a camper significantly disrupts the purpose of the camp or causes a safety issue they will not be allowed to remain at camp.
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