Western Plains District Camp Registration 2024

Western Plains District Camp Registration 2024

Fill out registration form completely; all fields must be completed. Registration is not complete until clicking the “SUBMIT” button at the bottom of the form. Registration confirmation will be sent to the camper’s e-mail address and the e-mail address provided for Parent/Guardian A (below).

IF REGISTERING ADULTS for Come Along with Me or Family Camp, submit a separate registration for the adults (i.e. if registering a family of 3 youth and 2 adults, submit one registration for the 3 children/youth, and one registration for the 2 adults).

If registering multiple youth campers, Parent/Guardian information must be the same for all youth that are being registered on one form.

Camper 1

This e-mail address will receive registration confirmation, as will the e-mail address for Parent/Guardian A (below).
If more than one, please separate with commas.

Parent/Guardian Information

Parent/Guardian A

Parent/Guardian B

Emergency Contact

If parent/guardians not available


If none, type “None”

Health Information

If so, please upload a copy of camper’s health insurance card (front & back). A picture is an acceptable format.

The camper’s own health insurance will provide primary coverage should the camper become sick or injured. The camp carries a small amount of insurance (secondary) for uninsured campers, and parents will be responsible for any costs that exceed the camp’s coverage.

Health Form Upload

Please upload a copy of the camper’s completed health form (found here). Because this online registration form is not encrypted, you may choose to mail the health form to your camp director.

If you choose not to upload this form here, it MUST be mailed to and received by directors at least 2 weeks in advance of the start of camp – per state childcare regulations.

Click or drag a file to this area to upload.

Authorization for Emergency Medical Care

By typing my initials below, I hereby give my permission to camp officials to call a doctor or emergency medical service, and for the doctor, hospital or medical service to provide emergency medical or surgical care for my child(ren) should an emergency arise. It is understood that camp officials will make a conscientious effort to locate the emergency contacts listed on the camp registration form before any action is undertaken. If it is not possible to locate emergency contacts listed, I/We accept the expense of emergency medical or surgical treatment (to the extent that it is not covered by my child’s health care insurance, or the limited camp-provided insurance).

Parental Authorizations

By typing my initials below, I understand that camp staff will provide sunscreen to campers, with a minimum SPF 30, if the camper does not bring their own sunscreen.

By typing my initials below, I give my permission for my child to make special trips and excursions under camp leadership.

By typing my initials below, I give permission for my child’s image to be used in future camp promotional materials.

By typing my initials below, I understand that campers and staff are expected to follow COVID 19 health guidelines. Guidelines for the 2024 camping season will be posted on the camp websites by 3/1/24.

By typing my name below, I understand that all campers are expected to participate in the camp program and take direction from the Camp Manager, Camp Director, and Counselors/Staff. Campers who are consistently unable to follow camp rules and take directions, could, at the discretion of the Camp Director or Camp Manager, be asked to leave. Parents, under these circumstances, would then be contacted to make arrangements to have their camper picked up before the scheduled end of camp.

Camper Agreement

For camper to read and agree to

I understand that this camp is about living in Christian Community. All leaders and campers are expected to:

    • Respect one another,
    • Respect the camp property, including the natural setting,
    • Use no profanity, tobacco products, alcohol, or illegal drugs,
    • Wear modest and appropriate clothing,
    • Participate and cooperate in activities, and
    • Behave in a way that is not disruptive to the program.

By typing their name below, the camper indicates thier willingness to abide by these guidelines.