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McKenna Ranch - Little Wranglers Kids' Camp - Registration 2021
McKenna Ranch Camp is a Christian centered youth camp, owned and operated by Kathy McKenna Mueller, that is filled with outdoor adventure! We explore, discover, and challenge every youth to pursue a deeper relationship with Jesus Christ. Our counselors, volunteers, and staff are passionate about the outdoor experience, where God reveals His invisible attributes, eternal power, and divine nature. (Romans 1:20)

Youth registration can be completed by your submission of this form. Parents will need to fill out a registration form for each family. Once the submission has been accepted, a PayPal link will be emailed to the parental contact listed below. If you would like to pay via check or cash, please specify in the appropriate field below and an invoice will be sent to you.

This camp is specifically designed for children ages 2-7, but siblings of all ages are welcome. The total cost of the camp is $150 for the first child. Each additional sibling (excluding those under 2 years old) are $10 each. Parents are FREE.
Parent Names *
Family Mailing Address *
Mailing Address, City, State, Zip Code
Parental Contact - EMAIL ADDRESS *
Parental Contact - PHONE NUMBER *
Alternate Emergency Contact - NAME *
Alternate Emergency Contact - PHONE NUMBER *
Child(ren) - Name, Age, Gender, & Birth Date *
How many people will you be bringing to Little Wrangler's Camp?
T-Shirt Size *
This year, t-shirts will be issued to campers and CITs at no additional cost.
Would you like to stay in a cabin, camping tent, or will you be bringing an RV? *
Would you like to purchase a camp photo album? ($28.00 each) *
Food Allergies / Intolerance / Restrictions *
Please list any food allergies or dietary restrictions for parents or children. Please include the name of the child or adult who has each allergy or intolerance.
General Allergies - Please indicate the allergy and severity *
(Common allergens in this area are ragweed, cedar, pine, hay, bee, wasp, and mosquito.)
Allergy Medication Consent *
Do you give your consent for our health officer to administer allergy medications such as Zyrtec, Claritin, or Benadryl in the event of an unexpected allergic reaction?
Medical / Medication Allergies *
Insurance Coverage *
Please provide the company, name of the person who is primarily insured, the policy number, and the group number
Medical History *
Are there any medical conditions of which we need to be made aware? Please explain.
Youth Medications (Please list the medications that will be need to be administered at camp.) *
NOTE: The taking of prescription medication is the responsibility of the individual taking the medication and/or that individual’s parent or guardian.
Youth Clothing Agreement *
Due to the nature of activities during summer camp sessions, each participant will be required to bring shoes and clothing that is appropriate for hiking in rocky terrain. As a reminder, McKenna Ranch is a Christian organization; campers, parents, volunteers, and staff members are asked to dress modestly at all times.
McKenna Ranch Safety Statement *
The activities at McKenna Ranch Camp are challenging and require a variety of different skills and physical endurance. These activities are taught by mature, experienced instructors and safety is stressed with utmost importance. Activities may include: hiking, mountain climbing, overnight camping, swimming, dart board, sling shot, horseshoes, whittling, leather crafts, camp crafts, Indian lore, equine, and natural sciences. Although many of these activities are inherently dangerous, every effort will be made to ensure the safety of everyone.
McKenna Ranch Camp - Behavior Policy *
The McKenna Ranch Camp is a Christian youth camp, privately owned and operated, on the McKenna Ranch, in Del Rio, TX. We hold our campers, counselors, volunteers, and staff to a high moral standard. Behavior that is destructive, manipulative, violent, reckless, or in any way inappropriate will NOT be tolerated. If safety and/or behavior standards are not followed by a particular camper, counselor, or staff member, then he/she will not be allowed to participate and will be removed from camp. McKenna Ranch Camp reserves the right to dismiss any camper for misconduct or disobedience to camp rules. In the case of a youth dismissal, the parent or guardian would be required to pick up the youth immediately.
Photo Release *
I hereby assign and grant to the McKenna Ranch the right and permission to use and publish the photographs/film/videotapes/electronic representations and/or sound recordings made of me or my child at all camp activities, and I hereby release the McKenna Ranch and the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication. I hereby authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the McKenna Ranch, and I specifically waive any right to any compensation I may have for any of the foregoing.
Health Record Release *
Due to the regulations set forth by the Texas State Department of Health and Human Services, McKenna Ranch must keep a copy of health records for each camper. Please be aware that CAMPERS will not be allowed to attend camp unless they provide a copy of these records. Upon arrival, these records must be presented to the Health Officer. (These should be COPIES instead of original records, as these records will not be returned. Adults attendees are exempt from this regulation.)
Payment Information *
For those paying via CHECK- An emailed statement from McKenna Ranch (camptheranch@gmail.com) will be sent to you upon submission of this form. Payment MUST be received within 7-10 days. For those paying via PAYPAL - An emailed money request will be sent to you. You do not need to have a PayPal account in order to complete payment. Payment must be received within 5-7 days.
Informed Consent and Release Agreement *
In case of an emergency involving me or my child, I understand that every effort will be made to contact the individual listed as the emergency contact person. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical providers are authorized to disclose protected health information to the adult in charge, camp medical staff, camp management, and/or any physician or health care provider involved in providing medical care to the participant. Protected Health Information/Confidential Health Information PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities. I have carefully considered the risk involved and give consent for myself and/or my child to participate in camp activities. I approve the sharing of the information on this form with McKenna Ranch volunteers and professionals who need to know of medical situations that might require special consideration for the safe conducting of all activities at McKenna Ranch.I release the McKenna Ranch, its owner Kathryn McKenna Mueller, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.
WAIVER/RELEASE FOR COMMUNICABLE DISEASES (INCLUDING COVID-19) ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT *
In consideration of being allowed to participate on behalf of McKenna Ranch Summer Camp program and related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. Participation includes possible exposure to and illness from infectious diseases including but not limited to influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my and/or my child's participation in McKenna Ranch Summer Camp; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation in McKenna Ranch Camp and the protection measures against infectious diseases. If, however, I or my child develops any unusual or significant health hazard during his or her presence or participation in McKenna Ranch Camp, a McKenna Ranch Camp staff member will notify me (in the case of minors), and I will remove myself and/or my child from participation and bring such item to the attention of the nearest official immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS McKenna Ranch Camp, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, volunteers, advertisers, and if applicable, owners and lessors of premises used to conduct the event WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION). This is to certify that I, as parent/guardian, with legal responsibility for my child, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
Required
Digital Signature - PARENT / GUARDIAN *
"By typing my name in the space below, I acknowledge that the information provided in this form is true and correct to the best of my knowledge. I have read, accepted, and understand the McKenna Ranch Camp's safety, behavior, and health policies. I understand that by submitting this form, I am registering myself and my child for McKenna Ranch Camp during June 2021, and I am responsible for all fees and responsibilities associated with this enrollment."
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