Camp Credo Child Registration Camp Credo is July 31 – August 2, 2022. Sign up below. "*" indicates required fields CHILD'S INFORMATIONChild's Name* First Last Gender* Male Female Date of Birth* MM slash DD slash YYYY Grade*Please enter the grade your child will be entering in the Fall of 2022. 2 3 4 5 First CampLet us know if this is the first camp your child has gone to. Yes No TransportationWe will have a Charter Bus for the trip to camp. Please let us know if your child is planning to ride the bus or if you will provide your own transportation to and from the camp. Ride the Bus Provide Own Transportation Campus You AttendPlease let us know what Campus or church you attend. St. Luke's Downtown Campus St. Luke's Edmond Campus Other T-Shirt Size Youth Small Youth Medium Youth Large Youth XL Adult Small Adult Medium Adult Large Adult XL Adult XXL Adult 3XL MEDICAL INFORMATIONHealth InsurancePlease provide health insurance for your child. Please include the name of the company as well as any policy and/or group numbers. MedicalPlease list any and all medications, dosage, and time taken. AllergiesPlease list all medical, food and other allergies for your child. If none, please write "NONE." HealthPlease let us know of any health concerns your child has. CommentsIs there anything we should know about your child to make sure they have the best camp experience possible?GUARDIAN INFORMATIONMedia Consent*I consent to the use of my child's image or voice in photographs, audio and/or video recordings taken during the course of the event for the purpose of promoting and marketing. Yes No Medical Consent*I authorize an adult, in whose care the minor has been entrusted, to consent to any x-ray examination, anesthetic, medical, surgical, or dental diagnosis or treatment and hospital care, to be rendered to the minor under general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to the authorization. Yes No Parent's Name* First Last Cell Phone*Parent's Name (2) First Last Cell Phone (2)Parent Contact Email* Emergency Contact*Please share someone other than the parent's information. First Last RelationshipWhat is the relationship to the child. Emergency Contact Cell Phone*BILLING AND PAYMENTCamp Registration*Please select the payment option that works for your family. If you are in need of Scholarship Options, please select Need Scholarship Help and Taylor Easttom will be in contact you to discuss scholarship options available. $250 - Registration by June 30, 2023 $150 - Youth Helper Need Scholarship Help Total Billing Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Credit Card Cardholder Name Card Details Once you hit submit you will be redirected to the Oakridge Camp page to sign the waiver for the hosting facility. Δ
