The ODC Teen Camper Registration 2026

The ODC Teen Camper Registration 2026

The ODC Teen Camper Registration 2026
Applications must be posted by June 5th.
Camper First Name
Last Name
Date of Birth

MonthDayYear
Date
1/12

The ODC Teen Camper Registration 2026
Sex
Grade in Fall 2026
Home Street Address
City
State
Zip
2/12

The ODC Teen Camper Registration 2026
Parent or Guardian's Name
Relationship to Camper
Home Phone
Format: (000) 000-0000.
Cell Phone (Provide to receive camp confirmation and updates)
Format: (000) 000-0000.
Email Address
example@example.com
Church Home
3/12

1/29/26, 5:12 PM
The ODC Teen Camper Registration 2026
Is your church a member of the P. A. of W.?
Pastor's Name
Youth Pastor or Youth Leader's Name
In Case of Emergency, Contact
Relationship to Camper (Emergency Contact)
Phone Number (Emergency Contact)
Format: (000) 000-0000.
4/12

Secondary Number (Emergency Contact)
T-shirt Size
Does your camper have any physical disabilities that would prevent them from participating in camp recreational activities?
If yes, please list physical disabilities

Does your camper have any memory or learning disabilities their counselor should be aware of?
If yes, please list memory or learning disabilities
Part II: Water Baptism - If your child should so choose (and has not been), do we have your permission to baptize him/her in the Name of Jesus Christ according to Acts 2:38?
Parental Signature (Type name If water baptism is permitted)

The ODC Teen Camper Registration 2026
Camp Consent Agreement
I acknowledge and agree that the Ohio District Council and the Hallowed Hills Campground owners/directors shall not be held liable for any injuries, accidents, medical bills, or damages arising from the above-named camper while in attendance at Teen Camp. I understand in the event of illness or injury, every attempt will be made to contact me prior to seeking medical attention. However, if I am unable to be reached, I grant the Camp Director or designated staff to seek medical attention from a qualified Physician. I acknowledge my camper has not been diagnosed with any mental or emotional illnesses that prevent them from functioning independently of one-on-one supervision. I understand that the Camp cannot guarantee the staffing necessary to create a safe environment for children with special needs. I agree my Camper will abide by camp rules and regulations governing Teen Camp. Furthermore, I also understand that serious discipline problems, including leaving the Campgrounds, assault of staff or fellow campers, possession and/or use of illegal drugs, cigarettes, weapons, alcoholic beverages, and/or profane language, may result in an immediate dismissal from Camp. Should dismissal from Camp occur, I acknowledge that my camper must be picked up from Camp within 24 hours, at my own expense. By signing below, I hereby grant Teen Camp permission to print, photograph, and record my child for use in audio, video, film, or any other electronic, digital, and printed media. I also understand that Teen Camp believes in the Word of God as recorded in Acts 2:38 and therefore baptizes accordingly. By typing my name below, I consent and give my permission to the camp consent agreement, and I affirm that the answers on the application are true. *** Campers ages 18 and up do not require parental consent***
Parent or Guardian Consent

First NameLast Name
Family Physician Name & Phone #
Your answer
7/12

The ODC Teen Camper Registration 2026
Indicate any medical conditions your camper has (Select all that apply):
Please list any other medical conditions not listed above.

The ODC Teen Camper Registration 2026
Does your camper have any allergic reactions to the following (Select all that apply):
Please list any food allergies (make special note if anaphylactic) :
Has your camper been hospitalized in the last twelve (12) months?
If yes to hospitalization, please list for what purpose.
9/12

The ODC Teen Camper Registration 2026
Is your camper allergic to any medications?
If yes to medication allergies, please list:
Will your camper be bringing any prescription or over the counter medications to camp?
Medication 1: Name, Dosage, and Times per day (If applicable...Note: ALL prescription drugs are REQUIRED to be in the original containers labeled by a Pharmacy.))
Medication 2: Name, Dosage, and Times per day (If applicable...Note: ALL prescription drugs are REQUIRED to be in the original containers labeled by a Pharmacy.))

1/29/26, 5:12 PM
The ODC Teen Camper Registration 2026
Medication 3: Name, Dosage, and Times per day (If applicable...Note: ALL prescription drugs are REQUIRED to be in the original containers labeled by a Pharmacy.))
Please include any additional medications and/or instructions. (Note: ALL prescription drugs are REQUIRED to be in the original containers labeled by a Pharmacy.)
11/12
The ODC Teen Camper Registration 2026
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