MYC 2026 Online Registration Form

  • *Complete One Form Per Camper!*

  • MYC 2026 Online Registration Form

    *Be sure to “like” & “follow” us at our official Facebook page: www.facebook.com/midwestyouthcamplaverne for all camp information, updates, and events!*

    **Please Note our Updated Camper Age Requirements due to capacity restrictions!!!**

    MYC JUNIOR CAMP:
    Dates: May 31st - June 4, 2026 | Sign in is May 31st from 2pm-4pm, Check-out is June 4th at 12pm
    Ages: Going into 3rd Grade - Going into 7th Grade
    *Age 12 can no longer attend both camps due to capacity limitations.

    MYC SENIOR CAMP:
    Dates: June 7-12, 2026 | Sign in is June 7 from 2pm-4pm, Check-out is June 12 at 12pm
    Ages: Going into 8th Grade - Just graduated H.S.

    Camp Directors: Landry & Kayla Caldwell, call or text 806-418-9210
    Mailing address: (if mailing payment or forms) P.O. Box 11, Follett, TX 79034

    LOCATION: 461 Golf Course Road (aka 0220 Transport Road), Laverne, OK

    CAMP COST:
    - EARLY BIRD PRICE (Before May 1st 2026) 125 per person / 115 for each additional sibling
    - REGULAR PRICE (After May 1st 2026) 150 per person / 140 for each additional sibling

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  • Gender*
  • Date Of Birth*
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  • Format: (000) 000-0000.
  • I give my permission to camp staff or volunteers to administer the following OTC medications without first contacting me: *
  • As parent/guardian, I hereby give permission to MYC volunteer staff to seek emergency medical care on behalf of my child. MYC volunteer staff, directors, and/or board members will not be held responsible for any accidents that may occur or medical expenses that may arise. *
  • Will your child be requiring prescription medications while at camp? (If yes, please fill out the next section of the form)*

  • I understand that it is my responsibility to give medication to the camp staff in the original prescription or over-the-counter containers, clearly labeled, with a completed Medication Waiver and Dispensing Consent Form that includes written instructions for use and storage for each medication.

    In all cases, the recommended dosage of any medication will not be exceeded. If after administering medication there is an adverse reaction, I give my permission to the Midwest Youth Camp staff to seek advanced medical services, and I agree to be responsible for payment of any and all medical services rendered. I hereby fully release or discharge the Midwest Youth Camp (MYC) from any and all claims from injuries, damages, or losses due to the administering of medication.

    I hereby acknowledge that the information on this form provided for the dispensing of medication for my child, ward, or family member is accurate. I also understand that it is my responsibility to inform the agency of any changes in the dispensing of medication. In all cases, medication dispensing can only be changed or modified by completing another Medication Waiver and Dispensing Consent Form.

  • My student has permission to be photographed/videoed on behalf of MYC to be used on social media or other promotional content. *

  • Camper Check in/Check Out Sheets

    If a student/camper needs to leave for school or sports related events, doctors appointments, or otherwise agreed-upon event, please let the camp directors know. Campers will need to check out with camp directors each time they leave campus, and check back in upon arrival back at camp.

  • As parent/guardian, I give my permission for my student to leave campus during the day for pre-scheduled camp-related activities and/or events under the supervision of camp staff and directors. *

  • ALTERED DROP-OFF OR PICK-UP PLAN:

    Parents/Church leaders will need to inform the student's counselor AND Camp Directors of change to drop-off or pick-up.
    Student will need to register with Camp Directors if they are arriving later to camp.
    Student will need to check-out with Camp Directors if they are leaving camp early.


    LEAVING CAMP TEMPORARILY:

    Parents/Church leaders will need to inform the student's counselor AND Camp Directors of need to leave campus temporarily for any reason.
    Student will need to check-out with Camp Directors before they leave campus.
    Student will need to check back in with Camp Directors immediately upon arriving back to campus.


    LEAVING CAMP BECAUSE OF ILLNESS:

    Parents/Guardians will be informed of student illness as soon as it is determined by the on-campus nurse that the student is too ill/injured to stay at camp.
    Parent/Guardian/Church leader will need to check-out with Camp Directors to take the student home.


    LEAVING CAMP BECAUSE OF BEHAVIOR: (Every effort will be made to keep kids at camp if feasible.)

    Parents/Guardians will be informed of student behavior issues as soon as it is determined by the Camp Directors that the infraction is too severe to stay at camp.
    Parent/Guardian/Church leader will need to check-out with Camp Directors to take the student home.


    LEAVING CAMP BECAUSE OF HOMESICKNESS: (Every effort will be made to keep kids at camp if feasible.)

    Parents/Guardians will be informed of the student's homesickness as soon as it is determined by the Camp Directors that the student is too homesick to stay at camp.
    Parent/Guardian/Church leader will need to check-out with Camp Directors to take the student home.

  • Camper Expectations

    1. Remember, any rules we put in place as directors are for the good and safety of you, other people at camp, and for the overall operation of the camp. We aren't here to make things difficult for you, we're here to create opportunities for you to meet Jesus in a special way that you can't get anywhere else. It's a special place, with special people, and the Lord has done AMAZING things here - we want that to happen for you, too.


    2. Please turn in your car keys and cell phones to the directors to be locked up for this week. PLEASE don't try to sneak a phone. Your counselors will know, the directors will know, your parents will know - just don't make it a thing. Remember, Jesus is why we are here. You will get out of camp what you put into it; don't miss this opportunity. You will get both your keys and your cell phones back at check-out time on Friday. Calls can be made/received through a camp phone for emergencies as needed.


    3. Your counselors are in charge. They have guidelines and rules they have to follow, too. Be respectful of them, and any other adults at camp. These adults love you and have made sacrifices in their own lives to be here with you - because they WANT to. Honor their devotion to you and Jesus.


    4. Please keep track of your belongings while at camp, if anything is lost or stolen, it is not the camp's responsibility.


    5. Please turn in any medications you need to the camp directors when you check-in for camp. Be responsible and take your medications daily (those of you who have prescriptions.)


    6. Please do your best to keep every part of camp clean and taken care of. Treat buildings, equipment, and facilities with care so that we can keep it a great camp for years to come. Any damage done to the camp will be your (or your parents') responsibility.


    7. Set your minds on things above. Be honorable in your speech and treatment of others. Try and get along, even when you're hot and tired. If you can't be kind, step away for awhile with your counselor's approval. All major issues will be directed to the camp directors.


    8. Use common sense when dressing yourself for the day or for activities. If you're questioning whether it's appropriate or not, then just don't wear it. T-shirts are to be worn over swimsuits to and from the water slide, and over two-piece suits at all times.


    9. Anything that is off-limits at school, is also off-limits here: No fighting, weapons, knives, smoking/vaping, drugs, alcohol, etc. Again, if you have to ask, just don't bring it.


    10. Please, No PDA - You may "love" them, but that doesn't mean you need to touch them while at camp. Seriously, just keep your hands to yourselves - don't make it weird.


    11. We all love a good prank, besides, they make the best camp memories. HOWEVER, pranks should never result in bodily injury or any kind of damage to property. If you think it might be going too far, then it probably is.


    12. If you are leaving campus at ANY time, we need to know about it from a parent or church leader FIRST. You will have to check out, and then check back in, with camp administration.

    If you can't stay within these expectations, you can be sent home.

  • How will you be paying?*

  • Online Payment Options

    **Online payment is NOT required.** You may still choose to send payment by mail OR you may pay in-person at camp registration.

    ** THIS SECTION NOT REQUIRED!**

    If you are choosing to pay online and you have multiple children, and would like to pay online for all of them at once, please input all payment information with the FIRST child's registration form and pay for all kids at one time. When filling out individual forms for additional children, you can then just skip the payment portion on additional applications.

  • Will you be paying for all siblings together?

  • Snack Shack Cards

    ** All Snack Shack Card payments will be made in-person at the time of registration **

     

  • Student/Camper Payments

    prevnext( X )
        Pre-Registration - $150.00

        Price for the first camper if paid before May 1st

        $150.00$150.00
          
        Additional Sibling Pre-Registration $125.00

        Price for each additional sibling if paid before May 1st

        $125.00$125.00
          
        Total
        $0.00$0.00
        Debit or Credit Card
      • Should be Empty: