2026 Spec

Camper Name*

First NameLast Name

Date of Birth*

Date

MaleFemaleOther

If Other is selected for Gender, please provide more info. *

9th10th11th12th

T-Shirt Size*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Camper Email

example@example.com

Camper Mobile Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

#1 Parent/Legal Guardian Name*

First NameLast Name

#1 Parent/Legal Guardian Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

#1 Parent/Legal Guardian Email*

example@example.com

#2 Parent/Legal Guardian Name

First NameLast Name

#2 Parent/Legal Guardian Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

#2 Parent/Legal Guardian Email

example@example.com

Emergency Contact's Name*

First NameLast Name

Emergency Contact's Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Other Persons Authorized by Parent/Guardian to transport Registrant home upon conclusion of Event:

YesNo

If Yes, please provide more information. *

Medical History*

Rows	Yes	No
Are you allergic to any foods, latex, medications, etc?
Are you presently under a physician's care for any acute/chronic medical condition?
Are you currently taking any medication?
Have you recently been exposed to a contagious disease or illness?

Please provide more information for any of the Yes values

Please list all mental health and/or physical conditions, if any.

VegeterianGluten-FreeDairy-FreeOther

Family Physician's Name*

First NameLast Name

Family Physician's Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Front of Insurance Card*

Back of Insurance Card*

Please read each of the following Release and Consent Statements and sign below. Your signature indicates your consent.

Consent to Medical Treatment

As the Registrant, or if under the age of 18 (19 in Alabama, Alaska, Wyoming, and Nebraska, 21 in Pennsylvania, Puerto Rico, Mississippi, and Colorado), the parent or legal guardian of the Registrant listed on this form, I give permission to Community of Christ to transport the Registrant to a physician or hospital and hereby authorize medical treatment, including but not limited to emergency surgery or medical treatment, and I will assume the responsibility for payment of all expenses and bills resulting from medical treatment. Community of Christ personnel may administer prescription medication as needed during the Event, and I agree that if the Registrant has an illness on the day the Event begins that could be harmful to him/her or to others, he/she will not be allowed to begin the Event.

Consent to Participate in Event Activities

As the Registrant, or as parent/guardian of the Registrant, I do for myself and on behalf of the Registrant, if said Registrant is not 18 years of age or older (19 in Alabama, Alaska, Wyoming and Nebraska, 21 in Pennsylvania, Puerto Rico, Mississippi and Colorado), specifically consent to the participation in all activities offered at the Event.

Any activities to which I do not consent are listed here:

Waiver and Release of Liability

In consideration for acceptance for my participation in the Event, or as parent/guardian of the Registrant, I do for myself and on behalf of the Registrant, if said Registrant is not 18 years of age or older (19 in Alabama, Alaska, Wyoming and Nebraska, 21 in Pennsylvania, Puerto Rico, Mississippi and Colorado), hereby release, forever discharge and agree to hold harmless Community of Christ and its affiliated organizations, lessors, lessees, officers, representatives, subordinate units, contractors, campgrounds, Event directors, staff, priesthood, agents, volunteers, participants, and employees thereof from any and all damages (including consequential damages), liability, claims, judgments, penalties, obligations, fines, causes of action, demands, losses, costs, and expenses (including without limitation reasonable attorneys’ fees and court costs) for personal injury, sickness or death based upon ordinary negligence, as well as property damage and expenses of any nature whatsoever which may be incurred by the parent/guardian and the Registrant occurring while Registrant is participating in the Event or arising thereafter, and further agree to hold harmless and indemnify said organizations and their lessors, lessees, officers, representatives, subordinate units, contractors, campgrounds, Event directors, staff, priesthood, agents, volunteers, participants, and employees for any liability sustained by them as the result of the negligent, willful or intentional acts of said Registrant during the Event, including expenses incurred attendant thereto.

Photo Release

In consideration for acceptance for my participation in the Event, or as parent/guardian of the Registrant, I do for myself and on behalf of the Registrant, if said Registrant is not 18 years of age or older (19 in Alabama, Alaska, Wyoming and Nebraska, 21 in Pennsylvania, Puerto Rico, Mississippi and Colorado), hereby give consent to and authorize the taking of photographic, audio or video recordings in which the Registrant may appear; and hereby waive all right of privacy in and to any of said pictures or tapes and authorize the use of the recordings by Community of Christ for any and all official resource, use or purpose including but not limited to print, film, or electronic media and reproduction or digital representation of every description on the internet/world wide web.

Event Rules

The use or possession of alcohol, tobacco (in any form whether smoked or smokeless), illegal drugs (in any form), marijuana and firearms is absolutely prohibited on all Church property.

STATEMENT OF CONSENT AND RELEASE

I, the undersigned, have read and consent to the rules, guidelines, and releases specified in this form. I have read, understand, and agree to abide by the Event Rules.

Typing name below indicates signature.

Registrant's Name or Parent/Legal Guardian if Registrant is under 18 (19 in Alabama, Alaska, Wyoming, and Nebraska, 21 in Pennsylvania, Puerto Rico, Mississippi, and Colorado)*

First NameLast Name

Please choose from the options below to indicate if you wish to pay by debit/credit card, or by check. Checks can be mailed in advance, or brought with you to the camp.

Spectacular Camp Fee

$495 per camper (6/30 or before)

$595 per camper (7/1 or later)

PAY BY CHECK

If you choose to pay by check, your registration will be complete when you click the "submit" button. You may either bring a check with you to camp, or you may mail it in advance.

Please make checks payable to: Midlands Mission Center

Mailing address for checks:

Midlands Mission Center

7615 N Platte Purchase Dr
Kansas City MO 64118

CREDIT/DEBIT CARD

If you choose to pay by debit/credit card you will be directed to PayPal after clicking the submit button. Here you can proceed with your payment.

You do not have to, nor do you need to, create a PayPal account to continue.

If you close the PayPal screen without making a payment, your registration will not process. If you do not receive a confirmation email after submitting this form, your registration was not processed and you are not registered. If you have difficulty with PayPal, please email mcfoteam@midlandsmc.org to make other arrangements.

Which congregation is providing your campership, if any?

Email Address for Registration Confirmation*

example@example.com

My Products

Pay by Check (Spec)

Bring or mail a check

$ Free

Credit/Debit Card (Spec) *before June 30, 2026

Spectacular Full Payment

$495.00

Credit/Debit Card (Spec) *July 1, 2026 or later

Spectacular Full Payment

$595.00

Home Congregation Campership (Spec)

100% of the registration fee will be paid by your home congregation.

$ Free

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Spectacular 2026

Spectacular is for campers that completed 9th, 10th, 11th, or 12th Grade in Spring 2026.

Release and Consent

Payment