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 Name
Last Name
Grade
Gender
Male
Female
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Information
Name
First Name
Last 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 Name
Last Name
Relationship
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Other
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.
Yes, I understand and give permission
No, I do not give permission, and I do not wish my teenager to attend
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LoneStar Youth Rally Registration
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