Texoma Youth Camp 2026 Registration
Camp is June 21-26, 2026. Cost is $225 per camper.


Please fill out ONE FORM PER CAMPER in its entirety.
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Email *
PARENT INFORMATION
Parent Name *
Parent Phone Number *
Parent Address *
CAMPER INFORMATION
Camper Name *
Camper Address *
Gender *
Date of Birth *
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DD
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YYYY
Age *
Grade ('26-'27 school year) *
T-Shirt Size *
Church you attend *
CAMPER MEDICAL INFORMATION
Date of last tetanus shot *
Do you have asthma? *
Can you swim? *
Do you take any medication? *
If you do take medication describe what it is, what it is for, and the instructions for the medication (example: Allegra for allergies, taken as needed) *
Describe any and all allergies (foods, stings, medications, etc.) *
Describe all known physical activity restrictions *
Describe any mental health diagnosis, disorders, or concerns *
Describe any other pertinent information we should know *
Emergency Contact Name *
Emergency Contact Number *
Health insurance company and policy number *
DISCLAIMERS AND RELEASE OF LIABILITY
ELETRONIC SIGNATURE CONSENT

By selecting the “I agree” button, I am signing this document electronically. I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document. By selecting “I agree” using any device, means, or action, I consent to the legally binding terms and conditions of this document. I further agree that my signature on this document is as valid as if I signed the document in writing. I am also confirming that I am authorized to enter into this agreement. If I am signing this document on behalf of a minor, I represent and warrant that I am the minor’s parent or legal guardian.
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TEXOMA YOUTH CAMP AGREEMENT

In consideration of the privilege to visit and use Texoma Youth Camp, I hereby expressly release, waive, hold harmless and indemnify Texoma Youth Camp {"camp") and its directors, officers, employees, volunteers, other camp users, and representatives and their families, heirs and assigns from any and all accidents or mishaps of any nature which result in personal injury, death, pain or damage to any persons or damage to any property arising from, or in any manner related to, directly or indirectly, my or my minor child(ren)'s recreational, social, or other activities in any form (specifically fishing, camping, boating, athletics, swimming, etc.) at or in any way related to Texoma Youth Camp. Other examples include, but are not limited to, poisonous snakes, wild animals, ticks, chiggers, spiders, stickers, poison ivy, poison oak, animal dens or burrows, mud holes or other conditions that may present a hazard to campers and recreational users.

I understand that the following rules are to be observed at all times, and I agree that I, and my child(ren), will abide by these rules:

(1) All children are directed to use care with their fishing hooks, and other equipment so as to avoid injuries to others.

(2) No guns or other weapons of any kind will be brought on to or used at Texoma Youth Camp.

(3) All children under 18 years of age shall wear a life preserver (floatation device) when in any boat used in connection with visiting the Camp.

(4) No alcoholic beverages will be permitted on the property.

(5) Any other authorized rule or instruction given by staff members while at camp.

The parent/guardian of the child(ren) named in this release herewith authorizes any doctor, hospital or other medical provider and assistants of any provider relying upon this form to furnish any emergency and related medical treatment to the child(ren) named below. No warranty has been made or is implied as to the results to be obtained by any medical treatment and provider and provider's assistants are third party beneficiaries of this Release.

I also give Texoma Youth Camp, Seagoville COC, Landmark COC, Rockwall and Brin COC, Meadow View COC, Eastgate COC, and Crandall COC permission to publish in print, electronic, or video format the likeness or image of my child. I release all claims against these entities with respect to copyright ownership and publication including any claim for compensation related to use of the materials.

(Please type your name below to sign)

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SEAGOVILLE COC CAMP EXPECTATIONS

1ST OFFENSE: SENT HOME
-Possession or use of alcohol, tobacco, vapes, drugs, pornography
-Kissing or more intense forms of sexual contact
-Fighting
-Theft of any kind
-Vulgar or obscene talk (especially towards the opposite sex)
-Any major issue/concern resulting from a mental health disorder
-A blatant disregard for rules or authority

1ST OFF: WARNING / CALL HOME, 2ND OFF: SENT HOME
-Failure to comply with dress code
-Cursing
-Soft forms of PDA (hand holding, cuddling, etc.)
-Any other violation of camp rules

DRESS CODE
-Shorts must be longer than your fingertips with arms at your side
-No halter tops, cropped tops, low cuts, spaghetti straps, biker shorts, or sleeveless shirts with large arm holes (girls and boys)
-No clothing with inappropriate wording or graphics
-Clothing worn while swimming has the same restrictions

DO NOT BRING
-Fireworks, firearms, matches, knives, radios, tablets
-Cell phones stay in the cabins

(Please type your name below to sign)
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PARENT: I have read and understand all that is expected of my child while at Texoma Youth Camp. I also understand that if he/she chooses not to comply with these rules, they could be sent home and their application could be rejected in the future.

 *
(Please type your name below to sign)

CAMPER: I have read and understand all that is expected of me while at Texoma Youth Camp. I also understand that if I choose not to comply with these rules, I could be sent home and my application could be rejected in the future.

 *
(Please have your camper type their name below to sign)
You are not fully registered until payment is made here *
A copy of your responses will be emailed to the address you provided.
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