Clone of 2025 Midsouth Camp Registration

2026 Midsouth Camp Registration

Midsouth Covenant Camp has been a significant faith-building experience for hundreds of campers since 1989. We are looking forward to another exciting week on July 26 to August 1, 2026!

Registration for campers entering 2nd - 12th grades is on a first-come, first-served basis. A waiting list will be maintained for registrations received after cabins are full.

The Counselors In Leadership Training (CILT) program during camp provides an excellent opportunity for high school students (entering 10th -12th grade) who are interesting in acquiring additional skills as leaders and counselors. CILTs need to fill out a CILT application with 2 references and be approved before completing this form.
Camper's Information
Camper Legal Name*

First NameLast Name
Preferred first name (nickname)*
Gender*

MaleFemale
Address*
City*
State*
Zip*
Birth date*

MonthDayYear
Date
Grade entering in the fall*
Camper's Email
Optional: confirmation & info emails can also be sent to camper
Cabin Mate request?
Friend must be same gender and age, not all requests are guaranteed

Parent or Legal Guardian Information
Parent/Guardian Name*

First NameLast Name
Relationship*
i.e. parent, grandparent, etc.
Cell Phone*

Area CodePhone Number
Work or Home Phone*

Area CodePhone Number
Parent/Guardian Email (confirmation will be sent by email)*
example@example.com
Other Parent/Guardian Name #2

First NameLast Name
Relationship #2
i.e. parent, grandparent, etc.
Cell Phone #2

Area CodePhone Number
Work or Home Phone #2

Area CodePhone Number
Other Parent/Guardian Email #2 (confirmation and information will be sent by email)

Emergency Contact Info

In the event of an emergency, camp staff will contact parents/guardians first. If camp staff is unable to reach a parent/guardian, we will call an emergency contact.
Emergency Contact Name #1*

First NameLast Name
Relationship #1*
i.e. grandparent, friend, etc.
Emergency phone number #1*

Area CodePhone Number
Emergency Contact Name #2*

First NameLast Name
Emergency Contact Name #2*

First NameLast Name
Relationship #2*
i.e. grandparent, friend, etc.
Emergency phone number #2*

Area CodePhone Number

Transportation Release

Please specify who will take your camper home. If plans for picking up your child change, please fill out a revised transportation release form by July 26, 2026.
My camper has permission to leave camp with:*
My camper does NOT have permission to leave camp with:

Health Information

A health worker is on site in case of emergency and to oversee medications. Please provide details about your camper's health. Separate forms need to be completed for special dietary requests or medication brought to camp.
Are immunizations required for school up to date? If you have an exemption, then select other.*

YesNoOther
Date of last tetanus shot*

MonthDayYear
Date
List any allergies and/or dietary restrictions. If special food is needed at camp, please fill out the special dietary request form.
Describe any emotional, social, mental, or sensory conditions that require special attention? We would like to know how to help your camper thrive at camp! Our staff welcomes tips!
Describe any activities the camper should be exempted from for health reasons?
Describe any recent health treatments or surgeries the camper has received.
Primary healthcare provider name?*
Primary healthcare provider phone number*

Area CodePhone Number

Camp Payment Information

$75 non-refundable (but transferable) deposit is required to reserve a camper's place at camp. All registration fees must be paid in full by camp check-in. Partial payments may be made as long as the balance is paid in full by July 26. Cancellation notice must be received by July 20, 2026 for full refund (minus deposit and any credit card processing fees). Should a camper withdraw during the camp session, no refund will be made unless a licensed physician has ordered the withdrawal because of a physical illness or accident.
Type of camper registration?*

REGULAR registration: due by June 15, $525 total cost ($75 deposit plus $450 balance), total due by July 26LATE registration: after June 15, $625 total cost ($75 deposit plus $550 balance), total due by July 26CILT registration: $475 cost, due July 26, no deposit required, must submit CILT application for approval
What method of payment do you plan to use? A link to the online payment system will be given after submitting this form.

Pay deposit online, then bring balance to camp check-in on July 26Pay balance onlineSend check to Midsouth office (Please note: camper's place is not reserved until deposit is received)Church scholarship (Please note: camper's place is not reserved until the church notifies camp about scholarship amount. Each family needs to contact their church and arrange payment. )Other

Frontier Camp Release (minor)
Frontier Camp, Inc. requires a parent or guardian of all minor guests or campers to sign this form before the minor participates in any GENERAL CAMP ACTIVITIES or PROGRAMS, HORSE/EQUINE ACTIVITIES, WAKEBOARD/CABLE PARK ACTIVITIES, BOATING/AQUATIC ACTIVITIES, LAKE AND POOL SWIMMING ACTIVITIES, SKATEPARK ACTIVITIES, or ROPES COURSE/CHALLENGE ACTIVITIES.

The undersigned acknowledges that, while minors attend Frontier Camp and participate in the camp’s activities and programs, certain risks and dangers may occur, including those related to contracting or spreading coronavirus or other virus or disease. The undersigned further recognizes that these risks may include physical, emotional or psychological damage or injury, not excluding fatality, due to accidents or disease that may occur or result from any general camp activities or programs, horse/equine activities, wakeboard/cable park activities, boating/aquatic activities, lake and pool swimming activities, skatepark activities, and ropes course/challenge activities. (The undersigned acknowledges that Frontier Camp, Inc. may take photographs or video of the minor named below to be used in promotional materials.) The undersigned parent/guardian and minor understand and assume all risk of participating in the above activities, and agree to abide by all policies and procedures of Frontier Camp, Inc., in order to maintain the utmost level of safety.

With respect to horse/equine activities, House Bill 280 took effect on September 1, 1995, and contains the following warning: Warning UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE & REMEDIES CODE) A FARM ANIMAL PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN FARM ANIMAL ACTIVITIES RESULTING FROM THE INHERENT RISKS OF FARM ANIMAL ACTIVITIES.

In consideration of the above, the undersigned, for himself or herself and on behalf of the below-named minor in any capacity, WAIVES LIABILITY and RELEASES the directors, officers, employees, and agents of Frontier Camp, Inc. in their individual capacities from any claim or judgment based on negligence or other ground of liability, or based on contracting or spreading coronavirus or other virus or disease, whether for bodily injury, property damage or loss, or otherwise.

In further consideration of the above, the undersigned, for himself or herself and on behalf of the below-named minor in any capacity, COVENANTS NOT TO EXECUTE on any asset of Frontier Camp, Inc. or of its directors, officers, employees, or agents for any judgment or claim for negligence or otherwise, or based on contracting or spreading coronavirus or other virus or disease. Instead, the undersigned agrees to limit the satisfaction of any such judgment to the available proceeds of any applicable insurance policy of and covering Frontier Camp, Inc.

The undersigned also gives permission to the staff of Frontier Camp, Inc. to administer or obtain any MEDICAL attention or treatment of the minor named below for any illness (including coronavirus, or other virus or disease), accident or injury occurring or identified during the minor’s stay at Frontier Camp. The undersigned fully understands this form, and has the capacity to sign on behalf of the minor named below.
E-signature*
Type your name here

Midsouth Camp Release
Midsouth Covenant Camp has limited accident and sickness insurance coverage on each camper. Expenses over and above this coverage must be paid by the primary insurance covering the camper or the responsible party. You have read and understand the limited medical insurance coverage. You understand that every effort will be made to contact the parent/guardian should a medical need arise. You give permission to the staff of Midsouth Covenant Camp and/or Frontier Camp to seek the needed medical treatment, hospitalization and/or surgery for your child should an illness or accidents occur while at camp.

Permission is granted to the Midsouth Covenant Camp Ministry to use your child’s photograph or likeness in Midsouth Covenant Camp publications including advertising.

You understand that the above named camper will only be released to the person listed on the transportation release, and an update may be made at camp check-in.

You certify that your child has your permission to attend camp and participate in all activites. By typing your name and clicking submit, you agree that you are the parent or legal guardian of the above named camper and are over the age of 18.
E-signature*
Type your name here
Be certain your email address is correct so you can receive email confirmation.
Should be Empty:

Camper's Information

Parent or Legal Guardian Information

Other Information

Emergency Contact Info

Transportation Release

Health Information

Camp Payment Information

Frontier Camp Release (minor)