Event Registration

Senior High Fall Retreat

November 12 - 14, 2021

Come get recharged for the Lord and renew friendships from summer camp. Open to 9th - 12th graders, college freshmen, and volunteer adults.

Register Now!

Adults (volunteers) are free to attend. Campers (must be in 9th-12th grade or just graduated) are $65. Transportation is not included, so find a friend and carpool! All fees are a suggested donation and are not required.

Please enter the contact information for your group and the number of attendees in your group.

Full Name


Email


Phone

Address




Notes



Number Attending

Adults:
Children:

Total Price
Registration Attending Total
Adults Free!
Campers $65.00
Total Suggested Donation


Medical / Liability Release

I hereby certify the fore-written information is accurate and complete.

Off Camp Release
The above-mentioned camper has my permission to be transported for medical care or to participate in programs conducted off the Ponca Bible Camp grounds.

Liability Release
I give permission for the above-mentioned camper to engage in all camp activities, except as noted by me, and am fully aware of the inherent hazards and assume all risks of loss, damage or injury that may be sustained by him or her. Ponca Bible Camp has my permission to use photographs and videos of child named above taken during camp for promotion purposes. No names will ever be published. I also understand that unclaimed items left behind will be donated to charity after two weeks of the end of my camper's session.

Medical Release
In case of emergency I authorize Ponca Bible Camp to secure proper medical attention for my child as the camp deems necessary including the possible need for hospitalization, injection, surgery, or any other medical treatment according to the attending physician or other medical professional. I understand Ponca Bible Camp is at least thirty minutes from a fully equipped hospital facility.

Photo Release
I grant to Ponca Bible Camp the irrevocable and unrestricted right to produce photographs and video taken of my child while at camp for any lawful purpose including publication, promotion, illustration, advertising, trade, or historical archive in any manner or in any medium. I hereby release Ponca Bible Camp and its legal representatives from liability for any violation or claims relating to said images or video.

Parent/Guardians Signature
By signing below, I signify that I have read, understand, and agree to the above stated releases.
Click and hold to sign in the box, or just draw on a touch device



Please review the information above and confirm everything is entered correctly.
Donation

News

The 2021 Fall Retreat is coming!  November 12-14.
Register Now »