BLAST Camp Online Registration Form 2026  Week 2: July 20th - July 24th

Dear Parent/Guardian, 

 We are excited to welcome your child to our upcoming BLAST Camp 2026! To ensure a safe and enjoyable experience for all participants, we ask that you complete and return this registration form. This form includes important information regarding emergency contacts, medical needs, and consent for participation in camp activities. Please review it carefully and reach out with any questions.  

PLEASE NOTE: This form is only for Week 2 of BLAST Camp. If you would like your child to attend Week 1, you must complete the separate Week 1 form available on our website at VFYOK.org

  • Location: Claremore Community Center
  • Time: 9am-4pm
  • Date: July 20th - July 24th
  • Ages: 4th - 8th 
  • Cost: $100
  • PICK-UP IS AT 4:00 at Claremore Community Center!
*PLEASE HAVE REGISTRARION FEE READY BY 07/20/26 PAYMENT CAN BE MADE AT CHECK-IN, WE ACCEPT CASH OR CHECK, WITH CHECK BEING MADE PAYABLE TO VOLUNTEERS FOR YOUTH

More about us!

The BLAST After School Program under Volunteers for Youth - a non profit organization geared towards positively impacting the lives of youth in Rogers County, offers a fun and engaging space for junior high students (grades 6th–8th) at the Claremore Community Center. The facility includes a full-size gym and a rec room with a variety of games. We ensure your child has a safe space until pick-up.

If you need more information please contact Carley Fields, BLAST Program Director at carley.f@vfyok.org
Sign in to Google to save your progress. Learn more
Email *
Your child's name (Please complete a separate form for each child you wish to register) *
Your child's grade *
Your child's t-shirt size. (PLEASE NOTE THE SHIRTS WILL BE IN YOUTH SIZES, IF YOUR CHILD NEEDS A DIFFERENT SIZE PLEASE ENTER THEIR SIZE IN 'OTHER') *
Your name and relationship to child: *
Your cell phone number: *
Who else can pick your child up from camp? List all that apply with phone numbers. *
Emergency contact #1 (Include name, relationship to child, and phone number): *
Emergency contact #2 (Include name, relationship to child, and phone number):
Please state any present medication, allergies, medical conditions, sensitivities, etc. for your child along with any instructions regarding these sensitivities:  *
AUTHORIZATION FOR EMERGENCY CARE TO MINOR STUDENTS 

I am the ____ Father ____Mother:____ Legal Guardian____ of the above-named student and I hereby authorize the BLAST staff or his/her duly authorized agents to consent for me to any emergency X-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital supervision upon the advice of a physician, surgeon or dentist licensed under the laws of the State of Oklahoma. 
 *
By typing your name, you are noting that your child has permission to participate in all the BLAST sponsored or endorsed activities during the 2026 BLAST Summer Camp. Volunteers for Youth, the City of Claremore, Claremore Park and Recreation Department, and their officers, Council Members, Board Members, staff, employees, volunteers, agents, and licensees are hereby released from any and all liability or responsibility for any injury that may occur to your child, to you, to your spouse, to any of your other children, resulting directly or indirectly from your child's participation in the BLAST activities including but not limited to, transportation, group or individual activities, concession facilities, and otherwise. We shall abide by the rules and regulations regarding participation and the building rules of the Claremore Community Center. Failure to abide by the BLAST Program's rules may result in dismissal from BLAST Camp. *
Media Release Authorization
I grant permission to Volunteers for Youth to use my image (photographs and or video) for use in media publications including videos, email blasts, brochures, newsletters, magazines, general publications, website.  I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and waive any right to royalties or other compensation arising from or related to the use of the image(s).

I am the parent or legal guardian of the above named child.  I have read this release and fully understand the contents, meaning and impact of this release.  I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.
 *
Required
Transportation Permission

I permit my child to communicate with and be transported by the designated Volunteers For Youth staff member(s).
Communication and transportation will surround program involvement or a designated extracurricular activity. Information such as upcoming events, requirements of the program, and helpful resources maybe be communicated via text or phone call. 

By clicking "I agree" below, you acknowledge and agree to the terms of this statement.  
 *
Required
Would you like to receive promotional emails about future BLAST After School Program events and activities?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms