Florida College Missouri Summer Camp

Please take time to complete the form accurately.
A separate form must be completed for each camper even if they are in the same family.


Camper Information

ONLY numbers: 1234567890
For the camp directory, NOT camp communication.
For the camp directory, NOT camp communication.
xx/xx/xxxx
example: 5' 5"
example: 125

Parent (Primary Guardian) Contact

example: John & Jane Doe
NOTE: If your address is the same as the camper's listed above, please skip to Primary Phone
ONLY numbers: 1234567890
ONLY numbers: 1234567890
ONLY numbers: 1234567890

Alternate Emergency Contact

example: John Doe
ONLY numbers: 1234567890
ONLY numbers: 1234567890

Camper Medical Information

If so, please mail a note from the campers physician with permission to attend camp along with an explanation of what to do in case of an emergency.
This is required prior to camp. If your camper does not receive immunizations please contact the Directors with that information.

Parent Signature

In consideration of the acceptance of this applicant, I, the parent or guardian, consent to the applicant’s participation in Florida College Missouri Camp.

I affirm my child’s health allows him/her to safely attend camp, and that he/she is not under a physician’s care for any undisclosed condition that might endanger his/her health or that of other participants. I recognize the inherent risk of injury from any camp activity.

I agree to be financially responsible for any and all medical treatment.

I agree to read and discuss the camp rules with my camper(s). I understand that those who break the rules may be sent home at their parent's expense.

I understand that my camper(s) will likely appear in pictures and/or videos that may be sold for profit and may be displayed on the camp website or other social media.