2024 SWOK Kids Camp Counselor/Camp Worker Application--Early Registration (by May 20) $50; Regular Registration (after May 20) $60
REGISTRATION FOR JUNE 17-20, 2024
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Email *
First Name *
Last Name *
Sex *
Street Address *
City *
Zip Code *
Cell Phone: *
Workplace: *
Work Phone: *
Emergency Contact Name/Relationship: *
Emergency Contact Number: *
Church Name *
Allergies (Food/Environmental) --If none, write N/A:
Drug Allergies--If none, write NKDA (No Known Drug Allergies) *
List churches (with pastor's name) that you have regularly attended for the past 5 years: *
List church work involving children or youth (Name of each church, type of volunteer work, and dates):   *
List any other non-church work involving children/youth (Name of organization, type of volunteer work, and dates): *
Name of church where you are a member: *
How many months/years you have attended: *
1.  Personal reference (not former employers or relatives) with name and phone number: *
2.  Personal reference (not former employers or relatives) with name and phone number: *
T-Shirt Size *

SWOK District Release Form

I do hereby release and will hold the SW Oklahoma District, Salyer Lake Campground, and any connected affiliate, harmless of any and all liability and claims resulting from any injury, loss, or accident that might occur while participating in the activities affiliated with the Kids’ Camp during the designated year.  This shall also constitute authority to the camp director or staff to give consent for any doctor, nurse and/or hospital to administer medical aid and treatment if an accident is sustained or emergency exists. This includes any X-ray examination, anesthetic, surgical or dental diagnosis or treatment, and hospital care.

By electronically typing my name, I acknowledge that this is the legal equivalent of my handwritten signature and I consent to be legally bound to this agreement.

Type your full legal name and date below:

*
I agree to submit a copy of my Driver's License or ID to my local Church AND to complete the online Ministry Safe Training (which will come to my email listed above if it has not already been completed through my local church) by May 20.
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A copy of your responses will be emailed to the address you provided.
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