Mailing Address, City, State, Zip Code

This year, t-shirts will be issued to campers and CITs at no additional cost.

PRICE PER CAMPER, PER SESSION = $425  / EARLY REGISTRATION PRICE = $375 / SIBLING DISCOUNT = 15% / MULTIPLE SESSION DISCOUNT = 15% (*Sibling Discounts & Multi-Session Discounts cannot be combined)

Please provide the company, name of the person who is primarily insured, the policy number, and the group number

Are there any medical conditions of which we need to be made aware? Please explain.

NOTE:  The taking of prescription medication is the responsibility of the individual taking the medication and/or that individual’s parent or guardian. A Health Officer will be available during each session, and all medications (prescription and otherwise) must be turned in to the Health Officer upon arrival.

Due to the nature of activities during the June 2019 summer camp sessions, each camper and CIT will be required to bring shoes and clothing that is appropriate for hiking in rocky terrain. As a reminder, McKenna Ranch is a Christian organization; campers, CITs, counselors, and staff members are asked to dress modestly at all times.

The activities at McKenna Ranch Camp involve challenging the camper to experience and learn a variety of different skills.  These activities are taught by mature, experienced instructors and safety is stressed with utmost importance.  Activities may include: hiking, mountain climbing, overnight camping, swimming, dart board, sling shot, horseshoes, whittling,  leather crafts, camp crafts, Indian lore, and natural sciences.  Although many of these activities are inherently dangerous, every effort will be made to ensure the safety of every camper.

The McKenna Ranch Camp is a Christian youth camp, privately owned and operated, on the McKenna Ranch, in Del Rio, TX.  Each camper is taught and instructed from the Bible (God’s Holy Word) and challenged with life lessons and memorization of scripture. We hold our campers, counselors, and staff to a high moral standard. Behavior that is destructive, manipulative, violent, reckless, or in any way inappropriate will NOT be tolerated.  If safety and/or behavior standards  are not followed by a particular camper, counselor, or staff member, then he/she will not be allowed to participate and will be removed from camp. McKenna Ranch Camp reserves the right to dismiss any camper for misconduct or disobedience to camp rules.  In the case of a camper dismissal, the parent or guardian would be required to pick up the camper immediately.    

I hereby assign and grant to the McKenna Ranch  the right and permission to use and publish the photographs/film/videotapes/electronic representations and/or sound recordings made of me or my child at all camp activities, and I hereby release the McKenna Ranch and the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all liability from such use and publication.  I hereby authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage, and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the McKenna Ranch, and I specifically waive any right to any compensation I may have for any of the foregoing.

Due to the regulations set forth by the Texas State Department of Health and Human Services, McKenna Ranch must keep a copy of health records for each camper. Please be aware that campers will not be allowed to attend camp unless they provide a copy of these records. Upon arrival, these records must be presented to the Health Officer.  

For those paying via CHECK- An emailed statement from McKenna Ranch (camptheranch@gmail.com) will be sent to you upon submission of this form. Payment MUST be received within 7-10 days. For those paying via PAYPAL - An emailed money request will be sent to you. You do not need to have a PayPal account in order to complete payment. Payment must be received within 5-7 days.

If you will be registering more than one camper or CIT and wish to take advantage of the sibling discount, please specify the names of the additional children you will be enrolling.

In case of an emergency involving me or my child, I understand that every effort will be made to contact the individual listed as the emergency contact person. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me or my child. Medical providers are authorized to disclose protected health information to the adult in charge, camp medical staff, camp management, and/or any physician or health care provider involved in providing medical care to the participant. Protected Health Information/Confidential Health Information PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, etc. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities. I have carefully considered the risk involved and give consent for myself and/or my child to participate in camp activities. I approve the sharing of the information on this form with McKenna Ranch volunteers and professionals who need to know of medical situations that might require special consideration for the safe conducting of all activities at McKenna Ranch.I release the McKenna Ranch, its owner Kathryn McKenna Mueller, the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.

"By typing my name in the space below, I acknowledge that the information provided in this form is true and correct to the best of my knowledge. I have read, accepted, and understand the McKenna Ranch Camp's safety and behavior policy. I understand that by submitting this form, I am registering my child for McKenna Ranch Camp during June 2019, and I am responsible for all fees associated with this enrollment."

"By typing my name in the space below, I acknowledge that I have read, accepted, and understand the McKenna Ranch Camp's safety and behavior policy."