Oklahoma Conference of Seventh Day Adventists
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Account Type

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Primary Contact for account

Enter the information for the primary contact for this account. This person must be an adult.
First Name:

Last Name:

Middle Initial:
Nickname:
Gender:
Birth Date:

mm / dd / yyyy
Address:

City:

State / Province:
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Zip / Postal Code:

Primary Phone
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Alternate Phone:
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Ext.



Alternate Phone 2:
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E-mail Address:
*
Confirm E-mail Address:
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Roles:
Please check all that apply


Additional Contact for account

Add an additional contact for this account by completing the information below.
This person is:
First Name:
Last Name:
Middle Initial:
Nickname:
Gender:
Birth Date:

mm / dd / yyyy
Address:
 
City:
State / Province:
Zip / Postal Code:
Primary Phone:


Alternate Phone:
Alternate Phone Ext:

Alternate Phone 2:

E-mail Address:
Confirm E-mail Address:

Roles:
Please check all that apply





Additional Information

Please provide the following information
I acknowledge that while we are at Camp Camp Wewoka, Wewoka, OK, my family / I may be photographed by a still or video camera. I authorize Camp Wewoka to utilize our photographic image without identification in its brochures and advertisements in any media, including Camp Wewoka's website. In giving my consent, I hereby release and hold harmless Camp Wewoka and its agents from any and all responsibility of liability relating to the use of the photographs. I understand that neither my family nor I will receive compensation should any photograph authorized hereunder be used.
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Login Information

The username and password must consist only of letters and/or numbers.  No special characters or spaces are allowed.
Username:
Password:
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Confirm Password:
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P.O. Box 32098 • Oklahoma City • OK • 73123 • 405-721-6110
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