LoneStar Youth Rally

LoneStar youth Rally

October 31, 2026
Registration Form

You will need to fill out one form per teen you are registering.
Attendee's Full Name

First NameLast Name
Are you a youth leader/youth pastor coming with a group?
Church Name and City
Grade
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Format: (000) 000-0000.
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Does the attendee have any allergies, chronic illness, or medical conditions? If yes, please describe.
If you are attending with a church, please list the name of the church (include the city and state) in the box below.
I give permission for the participant named above to attend and participate in the Lonestar Fest Youth Rally at Camp Liberty. I understand that this is a Christian youth event that may include preaching, worship services, group games, recreational activities, meals, and other organized activities. I understand that participation in youth rally activities involves ordinary risks, including slips, falls, collisions, illness, allergic reactions, weather exposure, transportation incidents, and injuries associated with recreational or athletic activities. I understand that Camp Liberty and its staff will take reasonable precautions but cannot eliminate every risk. I have disclosed any medical condition, allergy, medication, dietary restriction, disability, or other concern that may affect the participant’s safe involvement. I authorize Camp Liberty staff to limit or discontinue the participant’s involvement in any activity when they believe it is necessary for the participant’s safety or the safety of others. If I cannot be reached during an emergency, I authorize Camp Liberty, its designated staff, adult leaders, and medical personnel to obtain and consent to reasonable emergency medical care for the participant, including first aid, evaluation, treatment, medication, transportation by ambulance, and hospital care. I understand that I am responsible for medical expenses not covered by insurance. I understand that participants are expected to follow Camp Liberty rules, respect staff and other attendees, remain with their assigned group, and avoid conduct that could endanger themselves or others. Camp Liberty may contact a parent, guardian, or church leader and require a participant to leave the event for serious or repeated misconduct. I have read and understand this form. I certify that the information provided is accurate and that I am authorized to give this consent. I voluntarily allow the participant to attend and participate in the Lonestar Fest Youth Rally.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature

My Products

LoneStar Youth Rally Registration

$20.00

LoneStar Youth Rally Registration (pay on arrival)

You will pay nothing now, but there will be $20 due upon your arrival. Please pay through your group leader.

Free

Youth Leader Registration

Nothing due - thanks for bringing your group!

Free

Total

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

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LoneStar youth Rally

Registration Form

My Products