TWO SIDED
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WHAT TO BRING:
o BEDDING: PILLOW, SLEEPING BAG, ETC.
o TOILETRIES: SHAMPOO, SOAP, TOOTHBRUSH, DEODORANT & TOWEL
o CLOTHES: MODEST CLOTHES; CLOTHES THAT CAMPERS CAN GET DIRTY. ALL CAMPERS
AND STAFF MUST WEAR SHOES AT ALL TIMES.
o ADDITIONAL ITEMS: BIBLE, NOTEBOOK, PEN, CAMERA, SUNSCREEN, AND SPENDING
MONEY. CONCESSIONS AVALIABLE.
WHAT NOT TO BRING:
o NO OUTSIDE FOOD OR DRINK OTHER THAN WATER ALLOWED IN CABINS
o PERSONAL ELECTRONICS.
o SHAVING CREAM IS ONLY FOR SHAVING.
o TOBACCO PRODUCTS.
o WEAPONS
o NO ILLEGAL SUBSTANCES
o NO SKATEBOARDS
o A BAD ATTITUDE
GUIDELINES:
o WILLFUL DESTRUCTION OF CAMP OR PERSONAL PROPERTY WILL NOT BE TOLERATED.
o NO ONE IS ALLOWED TO LEAVE CAMP WITHOUT PERMISSION FROM THE CAMP
EXECUTIVE STAFF.
o CAMPERS WILL NOT BE ALLOWED TO LEAVE THE CAMP WITH ANYONE EXCEPT THE
PARENT OR LEGAL GUARDIAN WHOSE SIGNATURE APPEARS ON THE REGISTRATION
FORM.
o CAMPERS MUST REMAIN ON THE CAMP PROPERTY AT ALL TIMES UNLESS ON A
GROUP OUTING.
o NO PERSONAL ELECTRONICS USED AT CAMP.
o NO GUESTS ARE ALLOWED AT CAMP AT ANY TIME.
o CAMP IS NOT A PLACE FOR PUBLIC DISPLAY OF AFFECTION.
o ALL MEDICATION MUST BE CHECKED IN WITH THE CAMP NURSE IN THE ORIGINAL
BOTTLE.
o ALL CLOTHES MUST COVER SHOULDERS, BACKS, SIDES, AND STOMACH AT ALL TIMES.
NO TIGHT CLOTHING WILL BE ALLOWED. SHORTS MUST BE MODEST FINGERTIP
LENGTH.
o ALL CAMPERS AGREE THAT ANY MEDIA CAPTURED PHOTOS, VIDEOS, AUDIO IS THE
PROPERTY OF OKLAHOMA YOUTH MINISTRIES AND CAN BE USED FOR FUTURE
PROMOTION.
o ALL CAMPERS MUST COMPLY WITH THE DETAILED POLICIES AND PROCEDURES
POSTED ON THE CAMPGROUNDS.
For Your Information:
 Church Registration Form + non-refundable $40 Deposit Due ASAP.
 Individual Camper Form + remaining balance $119.00 due upon arrival at camp.
 Registration: Monday Noon-3pm
 Ages: 12-19
 Cost: $159.00
 Camp ends Friday 11AM
Camp Address:
Mailing Address: PO BOX 160
Sparks Assemblies of God Campgrounds:
Sparks, OK 74869
347489 E0990 Rd. Sparks, OK 74869
918-866-2407
TWO SIDED
Sparks Camp
INDIVIDUAL CAMPER REGISTRATION AND MEDICAL RELEASE
FORM - $159.00
Registration:
CAMP # _______________
Church City Attending With_________________
Full Name:
______________________________________________________
Church Name Attending With_________________________
Birth Date:
12-19 years of Age:
_______________
________
Male
Female
Address
City, State, Zip
______________________________________________________
___________________________________________________________
Social Security # (in case of emergency)
Parents Name:
______________________________________________________
___________________________________________________________
MAY THE CHILD/STUDENT LISTED ABOVE BE GIVEN OVER-THE-COUNTER, NON-PRESCRIPTION MEDICATIONS OR APPLICATIONS, NOT TO
EXCEED RECOMMENDED DOSAGE FOR STOMACH DISCOMFORT, BURNS, CUTS, INSECT BITES, RASH, SCRAPES, MINOR ACHES OR OTHER
MINOR AILMENTS? CIRCLE ONE:
YES
NO
List Exceptions: ________________________________________________________________________________________________________
TO BE FILLED OUT BY PARENT OR FAMILY DOCTOR
Date of last immunization: ______________________________________________________________________________________________
Operations or Serious Illness: ____________________________________________________________________________________________
Penicillin or Other Drug Reactions: ________________________________________________________________________________________
List all medications: Explain: ALL MEDICATION MUST BE IN THEIR ORIGINAL CONTAINERS AND CHECKED IN.
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
List special Dietary Routines: Explain: _____________________________________________________________________________________
Insurance Provider: ________________________________________ INSURANCE #: _______________________________________________
In case of emergency, I understand that every effort will be made to contact me. If not reached, I hereby give permission to the camp first
aid personnel selected by the camp leadership to hospitalize and/or secure proper treatment for the above camper along with the approval
of transporting my child to the nearest treatment facility if needed. I also agree with and support the enforcement of the Camp Policies and
Procedures. Camp insurance is secondary to a camper’s personal insurance. Rules for acceptance and participation in the program are the
same for everyone without regard to race, color, national origin, age, or handicap.
Parent or Guardian Signature
Daytime Phone
________________________________________________________________________
_____________________________________
Parent or Guardian Signature
Evening Phone
________________________________________________________________________
_____________________________________
PLEASE ATTACH A COPY OF INSURANCE CARD WITH THIS FORM.