Cowboy’s Rest Winter Camp Registration Form 2026

Please select which Cowboy’s Rest Winter Camp your child will be attending.

Camper Information

Gender Grade Date of Birth T-Shirt Size Do you attend a church? Returning Camper

Parent/Guardian Information

Relationship to Camper

Medical Information

Activity Restrictions Allergies (non-food) Food Allergies: Please include severity of allergy, or any symptoms CR should look for. Current Medications

Medical Permissions

Do you give permission for Cowboy’s Rest to administer over-the-counter medications? Yes No
Allergies or preferences regarding medications

In the event of a medical emergency, and I cannot be reached, I hereby give permission to Cowboys Rest Staff to hospitalize, secure proper treatments for, and to order injection, anesthesia, or surgery for the registered camper names on this form. I also agree to pay for any fees incurred, and I understand that Cowboy’s Rest and its staff will not be held responsible or liable for any related expenses.

Permission for Emergency Medical Treatment Yes No
Secondary Emergency Contact #1

Relationship to Camper Secondary Emergency Contact #2

Relationship to Camper

Additional Information

Is there anything you feel would be beneficial for your child’s counselor to know? (Examples: family, emotional, behavioral, social, or sleep concerns; strengths or weaknesses; likes or dislikes.)

Additional Information for Camp Nurse Additional Information for Counselor

Policy, Permissions & Acknowledgements

I (Parent named on this form), grant permission for my child to participate in all Cowboy’s Rest activities.

I agree.

I (Camper Names on this form), will obey all directions and rules given by the Cowboy's rest Staff. If I break any rules, I understand that I could be sent home or not allowed to participate in certain activities during the remainder of camp.

I agree.

Photo/Video Release (for Cowboy’s Rest use only)

I agree.

For our camp programs, we welcome any camper regardless of their gender identity. Our staff is trained to show the love of Jesus to all campers and provide a safe space. To create this environment, we have guidelines to ensure gender issues do not become a disruption at camp. We share these in advance so families can decide whether Cowboy’s Rest is the right fit. If your child identifies as LGBTQ, please discuss these guidelines with them prior to registration to help them feel comfortable.

Campers identifying as LGBTQ must not use camp to pressure others to accept their viewpoint on gender identity. If expression becomes disruptive, we may remove the camper for the good of all.
Conversely, harassment or bullying of any camper is prohibited and will be addressed immediately.
Campers identifying as transgender will be housed with their biological birth gender. Staff will use biological pronouns consistent with housing or simply use the camper’s name.

I agree.

Payment & Signature

Are you attending with a Youth Group? Yes No Payment Type

Partial Payment of $30.00 reserves your spot, pay the balance at camp check-in.

Parent/Guardian ESignature (type full name)

Processing fees are paid for each transaction. Would you like to increase your donation by 3%?

Yes
Total: