OZARK HOLINESS YOUTH CAMP
REGISTRATION FORM 2026
NOTICE: If you have registered online, you do not need to complete a paper form.
Registration type (Please circle):
Registration Type
Camper
Counselor
Worker
RV(Registration for RV space)
Family (Registration for Family with small children NOT staying in an RV)
Pastor/Minister
Name:
Phone Number
Address:
City:
State:
Zip:
Date of Birth (Campers):
-
Month
-
Day
Year
Date
Age (Campers):
Select: Male / Female
Male
Female
Church Name:
Pastor:
Counselor Name (if applicable):
Are you covered by medical insurance?
Yes
No
Please list any medical information below, including prescriptions, allergies, etc.
Name of Insurance and Policy/Group ID:
Emergency Contact #1:
Please type name, relationship, and phone number
Emergency Contact #2:
Please type name, relationship, and phone number
Emergency Medical Authorization: Please Initial:
YES
NO
I hereby authorize the Directors and/or Board Members of the Ozark Holiness Youth
Camp to obtain medical treatment if deemed necessary for the above named registered
persons to which I am responsible for during camp on July 13-17, 2026.
Liability Release Statement: Please sign below:
I hereby agree to hold Ozark Holiness Youth Camp and its officers, agents, employees,
and volunteers harmless from any and all liability, actions, causes of actions, claims,
expenses, and damages on account of injury to the the above named registered
persons to which I am responsible for, even injury resulting in death, or damages to
personal property, for which persons may be liable in connection with the activity or
participation in any other associated activities.
Authorized Signature of Legal registered person, parent, or guardian:
Today's Date:
-
Month
-
Day
Year
Date
Registration Fee is $25 per person (everyone staying or participating). Please pay using the QR code below or use the following link: https://square.link/u/MD8oS0zJ
PLEASE NOTE:
If you are paying on behalf of a group, you may make one payment for all registrants. However, please make sure everyone attending has completed an application.
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If NOT a Camper, please complete the next section:
Worker name or head of household:
What is your position at camp:
(ie. counselor, concession worker, kitchen, custodial, night guard, pastor/minister, etc.)
Please Note: Volunteer workers must be 18+ years of age; Counselors must be 21+ years of age. All persons 18+ years of age are subject to a Pastor's Evaluation; counselors and any person age 18+ staying in the dorm are required to have a Pastor's Evaluation.
Are you bringing a RV?
Yes
No
Do you request to stay in a family unit at camp (Worker dorm, family dorm, other)
Yes
No
Other:
How many are staying with you?
Please list names below:
Have you ever been convicted of a criminal offense (excluding traffic violations), currently pending criminal actions, or currently under probation or parole?
Have you ever been involved in an incident of impropriety with a child (abuse, etc.)?
A Pastoral Evaluation is required for all counselors. Please access this form from our website: www.ozarkholinessfellowship.org.
Authorized Signature of Legal registered person, parent, or guardian:
Date:
Please make as many copies of paper forms as necessary
Mail all forms to: OHYC, PO Box 527, Brandsville, MO 65688-0527
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