Far West Mission Center                                      Youth Camp Event Registration Form                        

If your child is planning to attend one of our Youth Camps 2024 at Camp Farwesta, please use this form to register. 

Payments can be sent to FWMC office 5130 Faraon St. Joseph, MO 64506 or made the day of the camp. 

If you plan to use Camper Scholarships (camperships), please reach out to your congregational leadership.   We look forward to this summers camping season!!

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Email *
Which camp will this camper attend? *
Required
Registrant's Name *
Registrant's Address, City, State, Zip Code *
Registrant's Phone Number-if available
Registrant's Date of Birth *
MM
/
DD
/
YYYY
Age & Grade Completed *
Congregation *
Registrant's Shirt Size (if camp shirts are available) *
Required
Payment Options *
Required
Special Needs or Requests
Parent/Legal Guardian Name  *
Parent/Legal Guardian Phone Number *
Parent/Legal Guardian Email Address *
Parent/Legal Guardian Name
Parent/Legal Guardian Email Address
Parent/Legal Guardian Phone Number
Emergency Contact *
Emergence Contact Phone Number *
Emergency Contact Email Address *
Other Persons Authorized by Parent/Guardian to transport Registrant home upon conclusion of Event
Registrant Medical History

Are you allergic to any foods, latex, medication etc? *
Are you presently under a physician's care for any acute/chronic medical conditions? *
Are you currently taking any medications? *
Please list all mental health and/or physical conditions, if any
Have you recently been exposed to a contagious disease or illness?  *
If yes, please describe
Do you have any special dietary needs? *
If so, please describe
Family Physician & Phone Number *
Final Steps-NOT DONE YET!!!!

**Next 3 sections are our required Waivers.

 Read, sign and submit for each camper.    

 Payments can be sent to or dropped off at the Mission Center office at 5130 Faraon St. St. Joseph, Mo 64506.    Office hours M- Thurs 9-3

 Payments of check or cash can be made day of camp or you can mail in payment to our Mission Center office at 5130 Faraon St, St. Joseph, Mo 64506.  Please note who the payment is for. 

 Thank you! 

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