SWOK Youth Camp 2024 Student Registration

Please fill out this form and click submit.

Early Bird Registration Ends on April 14th: $225
Regular Registration Ends on April 28th: $245
Late Registration Ends on May 5th: $265

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Sex Assigned at Birth

*

Please select one option.

Male Female

Grade Completed

*

Please select one option.

7th 8th 9th 10th 11th 12th

Address

*

Emergency Contact #1 Name

*

Emergency Contact #1 Relationship to Student

*

Emergency Contact #1 Phone Number

*

Emergency Contact #2 Name

*

Emergency Contact #2 Relationship to Student

*

Emergency Contact #2 Phone Number

*

Church You Attend

*

Food Allergies

*

Medical Conditions (asthma, seizures, etc.) or Environmental Allergies (seasonal allergies, i.e)

*

Drug Allergies--If none write NKDA (No Known Drug Allergies)

*

Over-the-Counter Medications that my child may take as needed (Check all that apply)

*

Please select all that apply.

Tylenol Ibuprofen Benadryl Imodium Claritin Zyrtec

Shirt Size

*

Please select one option.

S M L XL 2XL 3XL

I give permission for my student's picture to be used in documents, publications, and events for the campground, the church, and the SWOK District

*

Please select one option.

Yes No

I give my child permission to swim:

*

Please select one option.

Yes No

I WILL Print & Bring with Me to Camp the SWOK Medical Form & Camp Permission Forms that are attached

*

Please select one option.

YES

Description

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