Registration Fees for 2025 Midlands Region Church of God Youth Camp

Early Bird Registration (Through May 1, 2025) - $200.00

Regular Rate Registration (May 2- June 29, 2025) - $250.00

Early Bird registration includes a free camp t-shirt.  At a regular rate, t-shirts can be purchased separately for $10.  Walk-on rates: there is no guarantee that a t-shirt will be available. 

Have your credit card available, as you must submit for payment to finalize registration.

Youth Camp Dates: June 30th through July 4th, 2025

Midlands Region Youth Camp is at Jericho Hills Camp And Retreat Center

900 Jericho Rd Lucas, Iowa 50151

Note:  We do not accept printed applications for youth camp.

A $25.00, non-refundable, non-transferable pre-registration fee must accompany this completed application for you to be officially pre-registered.  The $25.00 deposit will be deducted from the total cost, and the remaining balance must be paid before or on the day of camp.

A $20.00 discount will be for any additional children in a single household.  Please submit all household applications together.  This applies to early bird and regular rate registration.

A $20.00 discount will be applied for any child that attends both weeks of camp (12-13 year olds)

Check must be recieved in state office with in seven days of registaration, or registraition will be voided. 

I hereby give permission for my child to participate in any and all aspects of the Midlands Region Church of God Youth Camp, including physical, spiritual, and social activities. I understand that this is a Midlands Region Church of God camp and doctrines and practices of the Church of God, Cleveland, TN will be taught and practiced (Declaration of Faith 42nd A. 1948, pp. 31,32).

I understand that spiritual ordinances may be administered including communion and baptism. I waive all claims of injury or loss of property arising out of the activities against the leaders of this camp, participants, and the Church of God Executive Offices of the Midlands Region and/or International.

I understand that the Camp Insurance Policy provides secondary coverage, and I provide primary coverage for my child. I understand that eyeglasses and/or contacts are not covered if damaged or lost. All claims must be filed within a year of the accident. I give permission and am financially responsible for my child's medical treatment as determined by the camp staff. Further, I understand that the camp schedule may call for transportation to social activities on or off campus. I give my child permission to ride in a vehicle operated by a licensed adult volunteer or CDL-licensed agent. I give permission for my child to be photographed or recorded to promote future activities. I am financially responsible for my child’s destruction of camp property, furnishings, or others’ belongings. I understand that if my child breaks the camp rules or is disobedient to camp leaders, I am responsible for immediately retrieving my child from the property.

By entering onto any property owned or rented on behalf of the Midlands Region Church of God or participating in any Midlands Region Church of God programs or events, I (on behalf of myself and my family members) acknowledge and agree with the following:

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and is reported to be highly contagious. The state of medical knowledge is, of course, ever-evolving. Still, the virus is believed to spread from person-to-person contact and/or by contact with contaminated surfaces and objects, even in the air. People reportedly can be infected and show no symptoms, spreading the disease. The exact methods of spread and contraction are unknown, and there is no known cure for COVID-19. Evidence has shown that COVID-19 can cause serious and potentially life-threatening illnesses and even death.

The Church of God cannot prevent my family members or me from becoming exposed to, contracting, or spreading COVID-19 while on any property of the Midlands Region Church of God or when participating in Midlands Region Church of God programs or events. Therefore, by entering a Midlands Region Church of God facility or participating in one of its programs, I acknowledge that I may expose myself and my family members to and/or increase my/our risk of contracting or spreading COVID-19. I expressly assume that risk, on behalf of myself and my family. I (on behalf of myself and my family members) forever release and waive my right to bring suit against Midlands Region Church of God or any of its affiliates, officers, directors, employees, or other representatives related to any of the foregoing. 

In Consideration of the services of Midlands Region Youth Camp & Midlands Region Church of God Regional Office, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “MRCOG”) I hereby agree to release, indemnify and discharge MRCOG, on behalf of my spouse, my children, my parents, my heirs, assigns, personal representative, and estate as follows:

1. I acknowledge that outdoor adventure based activities such as ropes or challenge course activities, missions project, inflatable slides, cow-tongue soccer, or all other physical activities entail known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.

The risks include, among other things: This program is based on the “challenge by choice” principle. At any time you and/or your group are free to withdraw from participation in challenge course activities, missions project, inflatable slides, cow-tongue soccer, or any other physical activities and its potential for: slips and falls and falling; rope burns; accidental drowning, pinches, scrapes, twists and jolts that could result in scratches, bruising, sprains, lacerations, fractures, concussions, or stings, allergies, and associated diseases.

Furthermore, MRCOG employees and volunteers have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction.

2. I expressly agree to assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate fully aware of the risks.

3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless MRCOG from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of MRCOG’s equipment or facilities, including any such claims which allege negligent acts or omissions of MRCOG.

4. Should MRCOG or any one acting on their behalf, be required to incur legal fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

5. I certify that I have insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I assume the risk of any medical or physical conditions I may have.

6. In the event that I or my representative files a lawsuit against MRCOG, I agree to do so solely in the state of Iowa, and I further agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect.

By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against MRCOG on the basis of any claim from which I have released from herein.

By submitting an application to the camp, each camper agrees:

1. He/she will abide by all rules and operations of the camp.
2. The camp is a private church-operated camp and is not a public accommodation.
3. He/she will abide by all the teachings/tenets/practices of the Church of God.
4. Any violation of rules/regulations may result in the dismissal of the camper from the camp, at the camper's expense, including transportation home.
5. His/her belongings, suitcases, backpacks, and all possessions, may be searched at any time by the camp administration.
6. Camp administration reserves the right to dismiss any camper for any reason, all in the sole discretion of the camp administration.

I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

I hereby give my child permission to attend and participate in Midlands Region Church of God Youth Camp. I hereby waive, release, and discharge any and all claims, demands, and causes of action against Camp Officials, the Church of God in Iowa and Nebraska, and the International Offices of the Church of God, their agents, employees, and participants arising from any damages, property loss, or injury my child sustains at Midlands Region Church of God Youth Camp.

I further consent to allow Camp Officials to seek and obtain emergency medical or surgical treatment for my child should my child need medical treatment.

I further grant permission for my child to appear in Camp Videos and any promotional videos or photography.

I fully understand that my family’s insurance is the primary carrier for all accidents incurred at camp and the camp’s insurance is the secondary carrier.