Buffalo Ranch

Buffalo Camp (Camper) Registration

Get ready for the most intentional, action packed, and funnest camp that you have ever been to! To register your camper please complete all sections below. Please note that the total cost of camp is $200 per camper. A deposit of $50 per camper will be due April 22nd, with the full payment being due May 27th. Kids Camp dates are June 25th - 28th. Teen Camp dates are June 29th - July 2nd.
Select Camp
Camper's Full Name

First NameLast Name
Camper T-shirt Size
Grade Completed ('25-'26 year)
Date of Birth

MonthDayYear
Date
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Emergency Contact Name

First NameLast Name
Alternate Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does your Camper have any food allergies? (If yes, list allergies)
Is your camper aware of their food allergies? (If no, please list specifications)
Does your Camper have any PRESCRIPTION Medication?
If yes, Please List PRESCRIPTION Medication and directions for use.

Wilderness Church

2026 Medical & Surgical Waiver (Minor Under 18)
I, Parent / Guardian* the parent and/or guardian of Camper* , a minor, hereby acknowledge that said minor is presently under my care, custody, and control. I hereby give the said minor my express permission to travel or participate in church- sponsored events and functions of Wilderness Church from January 1, 2026, through midnight December 31, 2026. In the event that arises an emergency necessitating emergency medical or surgical attention, I hereby consent and give permission to Wilderness Church, or its representatives, and any attending physician to make such decisions and to perform such medical or surgical treatment upon said minor, which in their sole discretion, may be reasonable and necessary under the circumstances.

I, the undersigned parent and/or guardian of said minor, do release, acquit, discharge, and covenant to hold harmless the said Wilderness Church or its representatives from any and all actions, damages, and/or liabilities arising out of the treatment of any sickness or accident incurred by said minor. It is the intention of this release that Wilderness Church and its representatives incur no liability whatsoever while attending to the reasonable and necessary treatments, surgery, and other medical needs that may in their sole discretion be needed by said minor.
Parent / Guardian Name:

First NameLast Name
Parent / Guardian Signature:
Parent / Guardian Contact:
Please enter a valid phone number.Format: (000) 000-0000.
Date:

MonthDayYear
Date
Person to Contact in an Emergency if Parent / Guardian in unavailable:
Name:

First NameLast Name
Contact
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Camper:

Thank you!

Please remember that a deposit of $50 per camper is due April 22nd, and the full payment of camp ($200) is due May 27th.
Should be Empty:

Buffalo Camp (Camper) Registration

Wilderness Church

Person to Contact in an Emergency if Parent / Guardian in unavailable:

Thank you!