woohoo! it's camp time!

please submit a new form for each student/individual attending our summer camp.
students 7th-12th grades only. all volunteers will be sent a must complete a background check.

camp date: july 21st-24th        cost: $75 per student





Emergency Contact information

alternate emergency contact information


Complete contact information IF presently under a doctor's care.

authorization

I have read and understand the camp rules. I agree that my child (or I) will abide by them while at Cross Brand/Wilderness Camp. If my child (or I) does not abide by these rules, I understand that he/she/I could be sent home at any expense at the discretion of the camp administration. I also consent and give permission for the use of photographs/videos of my child (or myself) taken while at camp to be used in the promotion of summer camps.
Parent/Guardian: By clicking 'Submit,' I hereby give my consent for the above-named amper to take part in the activities including arena clinics, ropes challenge course, archery adn other activities occuring within the camp program. If in the event of an emergency I cannot be reached, I hereby give my consent for camp administration or church leadership to sign for emergency medical care should it be necessary. I understand that every effort will be made to provide the safest environment possible at camp, but that accidents can and do occur. I agree not to hold liable Cross Brand Cowboy Church, Wilderness Church, the camp staff, or the facility in the case of an unforeseen event.

For the safety of each camper, all medication (prescription and non-prescription drugs) will be held by and administered by camp-approved, certified medical personnel who are on duty. If you need to send medication to camp, please place it in a zip-lock bag with your child's name written on it. Please DO NOT send any medication that is not absolutely necessary.




For the safety of each camper, all medication (prescription and non-prescription drugs) will be held by and administered by camp-approved, certified medical personnel who are on duty. If you need to send medication to camp, please place it in a zip-lock bag with your child's name written on it. Please DO NOT send any medication that is not absolutely necessary.
EACH MEDICATION MUST BE IN ITS ORIGINAL CONTAINER FROM THE PHARMACY. NO BLANK PILL BOTTLES OR DAILY MEDICATION BOXES ARE ALLOWED.
I understand that Cross Brand/Wilderness Camp, in which I plan to participate OR allow a minor in my care to participate, involves certain risks and that regardless of the precautions taken by Cross Brand Cowboy Church and Wilderness Church, the camp facility and volunteers helping with camp, some bodily injuries may occur. Specific risks/hazards involved in camp include but are not limited to the following: (1) auto accidents while traveling to and from camp activities or traveling on the camp premises; (2) dehydration; (3) physical injury sustained while participating in camp activities, mayn of which include livestock; and (4) medical problems such as illness, allergies, etc.
(1) In consideration for receiving permission to participate in Cross Brand/Wilderness Camp, I hereby release, waive, discharge, and covenant not to sue, and agree to hold harmless for any and all purposes, Cross Brand Cowboy Church, Wilderness Church, the facility, and all associated officers, servants, agents, volunteers, or employees (herein regerred to as RELEASEES) from ANY AND ALL LIABILITIES, CLAIMS, DEMANDS, OR INJURY, INCLUDING DEATH, that may be sustained by me while participating in such activity, or while on the premises that is owned, leased, or controlled by RELEASEES, including travel to and from camp activities, and even injuries sustained as a result of negligence of RELEASEES. I understand this release does not apply to injuries caused by intentional or grossly negligent conduct on the part of the RELEASEES. I understand that Cross Brand Cowboy Church and Wilderness Church are separate legal entities. (2) I am fully aware that there are inherent risks involved with summer camp and I choose to voluntarily participate in said activity with full knowledge that said activity may be hazardous to me and my property. I acknowledge there may be physically strenous activities, many of which may include livestock. I know of no medical reason why I should not participate. I voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including death, which may be sustained by me as a result of participating in said activity including injuries sustained as a result of negligence of RELEASEES. I further agree to indemnify and hold harmless the RELEASEES for any loss, liabilty, damage or costs, including court costs and attorney's fees, which may occur as a result of my participation in said activity including injuries sustained as a result of the negligence of RELEASEES. I understand this agreement to indemnify and hold harmless does not apply to injuries causes by intentional or grossly negligent conduct. (3) All Parties to this agreement are Christians and believe that the Bible commands us to make every effort to live at peace and to resolve disputes with each other in private or within the Christian church (see Matthew 18:15-17 and 1 Corinthians 6:1-8). Therefore, the parties agree that any claim or dispute arising from or related to this Agreement shall be settled by Biblically based mediation, and if necessary, legally binding arbitration. The Mediator and/or Arbitrator shall be compensated based on the amount of time spent on the case at his regularly hourly rates plus reimburseable out of pocket expenses. The Parties agree to share the cost of mediation or arbitration equally. Judgment upon an arbitration award decision may be entered in any court otherwise having jurisdiction. I understand that these methods shall be the sole remedy for any controversy or claim arising out of this Agreement and expressly waive my right to file a lawsuit in any civil court against RELEASEES for such disputes, except to enforce an arbitration decision. (4) I understand that RELEASEES may not maintain any insurance policy covering any circumstance arising from my participation in this activity or any event related to that participation. As such, I am aware that I should review my personal insurance coverage. (5) It is my express intent that this Release shall bind the members of my family and spouse if I am alive, and my heirs, assigns, and personal representatives if I am deceased, and shall be governed by the laws of Texas. (6) I understand RELEASEES cannot be expected to control all of the risks articulated in this form, but RELEASEES may need to respond to accidents and potential emergency situations. Therefore, I hereby give my consent for any medical treatment that may be required during my participation with the understanding that the cost of any such treatment will be solely my responsibility. I agree to indemnify and hold harmless RELEASEES for any costs incurred to treat me, even if a RELEASEE has signed hospital documentation promising to pay for the treatment due to my inability to sign the documentation. (7) In signing this Release, I acknowledge and represent that I have read it, understand it, and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing agreement that has been reduced to writing have been made. I execute this Release for full, adequate, and complete consideration fully intending to be bound by the same, now and in the future. I represent that I am eighteen (18) years of age or older and am otherwise competent to execute this agreement.
Electronic Signature Consent: By typing my name above and clicking 'Submit,' I am recognizing this as an official signature. I verify that I have read and understand every provision of this agreement.