2009 Sooner Camp Registration

Contact Information
First Name*
Last Name*
Address 1*
City*
State*
Zip Code*
Home Phone Number*
Work Phone
Camper's E-Mail Address*
Parent's Email Address*

General Information
I will be attending**

Sex**

 
Birth Date* (Format: mm/dd/yyyy)
 
Age*
 
Grade ( at Camp Time)*
Home Church / Congregation*
This year will be my _____ year at SYC.*
T-Shirt Size*

Medical Information
As the parent or guardian of the applicant:

I understand that my child is subject to being sent home at my expense for any conduct deemed inappropriate by the Camp Director and hereby agree to abide by his decision. I hereby give my approval and consent to this application, and in consideration thereof, hereby relieve Sooner Youth Camp and its Board and Staff  for any and all liability for sickness, accidents, or injuries of any nature or cause whatsoever while attending, coming to, or leaving the camp.

I further give authorization for  the Camp Director, nurse, counselors, water activity directors, or other appropriate camp personnel to administer such acts of first aid as seem necessary to save the life or health of the camper. I give my permission for the camp nurse to administer minor first aid treatment and to give such medications as she sees necessary for conditions occurring prior to or during camp.  Authorization is also given for appropriate staff members to transport the camper to a doctor's office or emergency room of a hospital to secure services of a licensed physician.

I understand that each camper is insured by Sooner Youth Camp for medical charges that are in excess of the amount that is payable by any individual or family medical insurance that I have.

In the event my child must have medical treatment, I will file a claim on my own coverage first. I understand attempts will be made to reach me by telephone in the event of serious illness or injury to my child.
I Agree*
Drug Allergies ( If none, enter None )*
 
Chronic Illness or Pertinent Health History ( If none, please enter None )*
 
Medicines Taken EVERY DAY ( Please include dosage, frequency, and reason for taking medicine. If none Please enter NONE )*
Name of Medicines taken AS NEEDED ( Please include dosage, frequency, and reason for taking medicine. If none please enter NONE )*
Insurance Information: Include Insurance Company Name, Phone #, Group #, ID #, and SS# if needed. If Not sure please provide all.*
Camper's Physician's Name*
Camper's Physician"s Phone Number*
 

Please note camper's name and week attending on the subject line of your check!