Upload
others
View
0
Download
0
Embed Size (px)
Citation preview
choctawnation.comchoctawnationculture.com
For more information call theSummer Youth Camp Program
Kevin Gwin, Javen Henson, Max White,Curtis Steve, Sam Steve or Malinda Steve at
1-800-522-6170
The Choctaw Nation of Oklahoma Youth Events Department will be hosting new athletic events throughout the year, known as the
Futures Showcase Series.
If you are a competitive high school athlete looking to work with regional college coaches at a high level, keep an eye out for a
showcase in your sport.
Information can be found at choctawnation.com or you may contact Javen Henson at [email protected] with any questions.
CULTURAL EVENTS & SUMMER CAMPS
C O N T A C T L I S TName Cell Number Office Number
Kevin Gwin 580-775-3982 580-924-8280 ext. 2517
Javen Henson 580-775-4075 580-924-8280 ext. 2739
Curtis Steve 580-775-2005 580-924-8280 ext. 2332
Max White 580-924-8280
Malinda Steve 580-924-8280 ext. 2740
Sam Steve 580-924-8280 ext. 2741
* Once camps start, please call cell phone numbers to contact employees.
Online registration is available at www.choctawsummercamps.com only if your child
has attended camps in previous years and has a CDIB & membership card on file.
New applicants MUST send copies of theirChoctaw Membership Card & CDIB.
PLEASE CONTACT US WITHANY QUESTIONS.
All first time applicants must include a copy of theChild’s CHOCTAW CDIB and MEMBERSHIP CARD.
Applications will not be accepted without these documents.
*All participants must have a Choctaw CDIB & Membership Card or be a child of an employee of Choctaw Nation to attend.
DEADLINES FOR EACH CAMPARE AS FOLLOWS:
Golf CampFriday, March 24th
Baseball, Softball, Wildlife Conservation,Stickball,Cultural Enrichment,Basketball, & Football Camp
Friday, April 14th
This will allow us to get our suppliesand equipment in time for each camp!
The camp is open to female students ONLY ages 8 to 18.
This year the camp will be conducted by college coaches and players from local colleges.
Students will be instructed in areas of hitting, pitching, and fielding. Emphasis will be placed on giving each camper the proper instruction that will help improve their level of play and decrease their potential for injury. They will also be shown how setting goals and self-discipline will not only help their playing ability, but will help them in their everyday lives off the field.
This is a day camp, splitting the north and south districts of the Choctaw Nation. Lunch and drinks will be provided for each day of camp.
Participants will be offered bus transportation on designated bus routes.
S O F T B A L L
South CampTuskahoma, OK(Districts 1, 2, 7, 8, 9, 10)June 12 - 13, 20179:00 am - 3:00 pm
North Camp Tuskahoma , OK(Districts 3, 4, 5, 6, 11, 12)June 15 - 16, 20179:00 am - 3:00 pm
G O L F
South CampChickasaw Pointe, Kingston, OK(Districts 1, 2, 7, 8, 9, 10)June 5 - 6, 2017 • 9:00 am - 3:00 pm
North Camp Arrowhead, Canadian, OK(Districts 3, 4, 5, 6, 11, 12)June 8 - 9, 2017 • 9:00 am - 3:00 pm
The camp is open to all students ages 10 to 18.
This year the camps will be held at two different courses, splitting the north and south districts of the Choctaw Nation. The north camp will be held at Arrowhead Golf Course in Canadian on June 6th & 7th and the south camp will be held at Chickasaw Pointe in Kingston on June 9th & 10th.
The camps will be instructed by ESPN Golf Schools Director of Instruction, Ed Bowe. The staff and instructors are motivated to teach each participant whether it be a first time golfer or an advanced golfer.
Food and drinks will be provided while at camp. There will be a tournament held for the advanced golfers.
Participants will be offered bus transportation on designated bus routes. This will NOT be an overnight camp.
S T I C K B A L LThe camp is open to all students ages 8 to 18.
Stickball has always been an exciting and competitive game played by many tribal people of the Southeast and has always been an important game to the Choctaws.
Students will be taught the fundamentals of stickball by teaching the history behind the game and how it is important to Choctaw culture. The youth will be taught how to throw, catch, and score a goal in the Choctaw style. Social and exhibition types of play will be taught as well as the rules and field positions for each.
Instruction will be done by Coaches from the Choctaw Nation Stickball team with assistance from skilled local players. This is a day camp on the grounds of Tuskahoma. All campers will receive lunch and drinks each day of the camp.
Participants will be offered bus transportation on designated bus routes.
North CampTuskahoma, OK(Districts 3, 4, 5, 6, 11, 12)June 1 - 2, 2017 • 9:00 am - 3:00 pm
South CampTuskahoma, OK(Districts 1,2, 7, 8, 9, 10)May 30 - 31, 2017 • 9:00 am - 3:00 pm
W I L D L I F E C O N S E R V A T I O NThe camp is open to all students ages 10 to 18.
Students will be instructed in a variety of topics including; firearm safety, wildlife identification, wildlife conservation, & hunter responsibility. Students will participate in a hunter education class, and they will be provided with the opportunity to take the hunter safety test. Upon passing the test, students will receive their hunter safety cards. Other activities will be available including; fishing ATV riding, and skeet shooting.
Instruction will be provided by trained wildlife experts.
Participants will be offered bus transportation on designated bus routes.
North CampTuskahoma, OK(Districts 3, 4, 5, 6, 11, 12)May 25 - 26, 2017 • 9:00 am - 3:00 pm
South CampTuskahoma, OK(Districts 1,2, 7, 8, 9, 10)May 22 - 23, 2017 • 9:00 am - 3:00 pm
The camp is open to male students only ages 8 to 18.
The camp will be conducted by Day of Champions football staff and former Big XII players and former NFL coaches. Campers will receive instruction in areas of offensive drills, defensive drills, and Sooner ball.
Lunches and drinks will be provided. This is a 2-day camp on the grounds at Tuskahoma.
Participants will be offered bus transportation on designated bus routes.
9:00 am - 3:00 pm • All Districts • June 28 - 29, 2017 • Tuskahoma , OK
F O O T B A L L
The camp is open to male students ONLY ages 8 to 18.
The camp will be instructed by college and high school coaches from Southeastern Oklahoma.
Students will be instructed in the areas of hitting, pitching, and fielding. Emphasis will be placed on giving each camper the proper instruction that will help improve their level of play and decrease their potential for injury.
This is a day camp, splitting the north and south districts of the Choctaw Nation. All campers will receive lunch and drinks each day of the camp.
Participants will be offered bus transportation on designated bus routes.
B A S E B A L L
B A S K E T B A L LThe camp is open to all students ages 8 to 18.
Learn fundamental skills of basketball to use throughout the school career with the ultimate goal of playing college level basketball.
Picking up tips from high school head coaches and former university players, this is a day camp at 12 sites. Participants will be pro-vided with lunch and drinks. No bus transportation will be offered for this camp.
9:00 am - 3:00 pm
North Camp Tuskahoma , OK(Districts 3, 4, 5, 6, 11, 12)June 22 - 23, 2017 • 9:00 am - 3:00 pm
South CampTuskahoma , OK(Districts 1, 2, 7, 8, 9, 10)June 19 - 20, 2017 • 9:00 am - 3:00 pm
South CampTuskahoma, OK(Districts 1, 2, 7, 8, 9, 10)July 31 - August 1, 2017 • 9:00 am - 3:00 pm
The camp is open to all students ages 8 to 18.
Join us for an exciting opportunity to learn more about Choctaw heritage and culture.
During this camp, the focus will be on archery, arts and crafts, storytelling and Choctaw language.
This will be a day camp on the grounds at Tuskahoma from 9:00 am to 3:00 pm.
Camp 1 will be held May 31 - June 1 for the South Districts 1, 2, 7, 8, 9, 10. Camp 2 will be held June 2 - 3 for the North Districts 3, 4, 5, 6, 11, 12. Lunches and drinks will be provided each day of camp.
Participants will be offered bus transportation on designated bus routes.
This will NOT be an overnight camp.
C U L T U R A L E N R I C H M E N T
North Camp Tuskahoma, OK(Districts 3, 4, 5, 6, 11, 12)August 2 - 3, 2017 • 9:00 am - 3:00 pm
Choctaw Nation of Oklahoma
WILDLIFE CONSERVATION CAMP
DEADLINE FOR APPLICATION IS APRIL 14, 2017
TUSKAHOMA COUNCIL GROUNDS
SOUTH CAMPDISTRICTS 1, 2, 7, 8, 9, 10
TUSKAHOMA
May 22 - 23
9:00 am - 3:00 pm
NORTH CAMPDISTRICTS 3, 4, 5, 6, 11, 12
TUSKAHOMA
May 25 - 26
9:00 am - 3:00 pm
WILDLIFE CONSERVATION CAMPBUS SCHEDULE
All Times Are Approximate Times.
Please have the camper at the pick-up location at least 15 minutes prior to departure time.Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
SOUTH CAMPDistricts 1, 2, 7, 8, 9, 10
May 22 - 23
Departing ReturningBUS 1
Rock Creek High School 6:45 A.M. 5:25 P.M.
Bennington High School 6:55 A.M. 5:15 P.M.
Boswell High School 7:10 A.M. 5:00 P.M.
Soper High School 7:25 A.M. 4:45 P.M.
Antlers Field Office 7:55 A.M. 4:15 P.M.
BUS 2
Idabel Field Office 6:45 A.M. 5:35 P.M.
Valliant (Doc Store) 7:10 A.M. 5:10 P.M.
Fort Towson High School 7:30 A.M. 4:50 P.M.
Hugo Community Center 7:45 A.M. 4:35 P.M.
BUS 3
Broken Bow Field Office 7:00 A.M. 5:45 P.M.
Wright City Field Office 7:30 A.M. 5:15 P.M.
BUS 4
Durant Headquarters 6:45 A.M. 5:40 P.M.
Caddo Dairy Queen 7:05 A.M. 5:20 P.M.
Atoka Travel Plaza 7:30 A.M. 4:55 P.M.
Stringtown Travel Plaza 8:00 A.M. 4:45 P.M.
NORTH CAMPDistricts 3, 4, 5, 6, 11, 12
May 25 - 26
Departing ReturningBUS 1
Smithville Field Office 7:30 A.M. 5:00 P.M.
Talihina Field Office 8:30 A.M. 4:00 P.M.
BUS 2
Stigler Field Office 6:45 A.M. 5:50 P.M.
Spiro Field Office 7:30 A.M. 5:05 P.M.
Poteau Field Office 8:00 A.M. 4:35 P.M.
BUS 3
Coalgate Field Office 6:45 A.M. 5:45 P.M.
McAlester Field Office 7:50 A.M. 4:40 P.M.
VAN
Wilburton Field Office 8:00 A.M. 4:20 P.M.
WEAR APPROPRIATE SHOES.NO FLIP-FLOPS OR SANDALS
Office Info
_________________________
_________________________
Bus Rider: yes / no
Pick-up Location:_______________________________
See attached schedule
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIB
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
I do hereby release the Oklahoma Department of Wildlife, to the minor named herein, for the purpose of instruction and safe handling of firearms, target shooting and related activites.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
CAMP LISTINGSelect the camp you will be attending. Ages 10 - 18. Deadline: April 14, 2017
Please completeBus Rider Info!
South Camp - Tuskahoma, OK(Districts 1, 2, 7, 8, 9, 10)May 22 - 23, 2017Camp: 9:00 am - 3:00 pm
North Camp - Tuskahoma, OK(Districts 3, 4, 5, 6, 11, 12)May 25 - 26, 2017Camp: 9:00 am - 3:00 pm
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
Choctaw Nation of OklahomaWILDLIFE
CONSERVATION CAMPDeadline: April 14, 2017
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
Choctaw Nation of Oklahoma
STICKBALL CAMPDEADLINE FOR APPLICATION IS APRIL 14, 2017
TUSKAHOMA COUNCIL GROUNDS
SOUTH CAMPDISTRICTS 1, 2, 7, 8, 9, 10
TUSKAHOMA
May 30 - 31
9:00 am - 3:00 pm
NORTH CAMPDISTRICTS 3, 4, 5, 6, 11, 12
TUSKAHOMA
June 1 - 2
9:00 am - 3:00 pm
STICKBALL CAMPBUS SCHEDULE
All Times Are Approximate Times.
Please have the camper at the pick-up location at least 15 minutes prior to departure time.Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
SOUTH CAMPDistricts 1, 2, 7, 8, 9, 10
May 30 - 31
Departing ReturningBUS 1
Rock Creek High School 6:45 A.M. 5:25 P.M.
Bennington High School 6:55 A.M. 5:15 P.M.
Boswell High School 7:10 A.M. 5:00 P.M.
Soper High School 7:25 A.M. 4:45 P.M.
Antlers Field Office 7:55 A.M. 4:15 P.M.
BUS 2
Idabel Field Office 6:45 A.M. 5:35 P.M.
Valliant (Doc Store) 7:10 A.M. 5:10 P.M.
Fort Towson High School 7:30 A.M. 4:50 P.M.
Hugo Community Center 7:45 A.M. 4:35 P.M.
BUS 3
Broken Bow Field Office 7:00 A.M. 5:45 P.M.
Wright City Field Office 7:30 A.M. 5:15 P.M.
BUS 4
Durant Headquarters 6:45 A.M. 5:40 P.M.
Caddo Dairy Queen 7:05 A.M. 5:20 P.M.
Atoka Travel Plaza 7:30 A.M. 4:55 P.M.
Stringtown Travel Plaza 8:00 A.M. 4:45 P.M.
NORTH CAMPDistricts 3, 4, 5, 6, 11, 12
June 1 - June 2
Departing ReturningBUS 1
Smithville Field Office 7:30 A.M. 5:00 P.M.
Talihina Field Office 8:30 A.M. 4:00 P.M.
BUS 2
Stigler Field Office 6:45 A.M. 5:50 P.M.
Spiro Field Office 7:30 A.M. 5:05 P.M.
Poteau Field Office 8:00 A.M. 4:35 P.M.
BUS 3
Coalgate Field Office 6:45 A.M. 5:45 P.M.
McAlester Field Office 7:50 A.M. 4:40 P.M.
VAN
Wilburton Field Office 8:00 A.M. 4:20 P.M.
WEAR APPROPRIATE SHOES.NO FLIP-FLOPS OR SANDALS
Office Info
_________________________
_________________________
Bus Rider: yes / no
Pick-up Location:_______________________________
See attached schedule
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIB
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
CAMP LISTINGSelect the camp you will be attending. Ages 8 - 18. Deadline: April 14, 2017
Please completeBus Rider Info!
South Camp - Tuskahoma, OK(Districts 1, 2, 7, 8, 9, 10)May 30 - 31, 2017Camp: 9:00 am - 3:00 pm
North Camp - Tuskahoma, OK(Districts 3, 4, 5, 6, 11, 12)June 1 - 2, 2017Camp: 9:00 am - 3:00 pm
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
Choctaw Nation of Oklahoma
STICKBALL CAMPDeadline: April 14, 2017
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Sticks (Circle One) Throws: Right Left
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any
responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
Choctaw Nation of Oklahoma
GOLF CAMPAGES 10 - 18
SOUTH CAMP
Districts 1, 2, 7, 8, 9, 10
Chickasaw Pointe - Kingston, OK
Camp
June 5, 2017 9:00 am - 3:00 pm
June 6, 2017 9:00 am - 3:00 pm
DEADLINE FOR APPLICATION IS MARCH 24, 2017
AGES 10 - 18NORTH CAMP
Districts 3, 4, 5, 6, 11, 12
Arrowhead Golf Course - Canadian, OK
Camp
June 8, 2017 9:00 am - 3:00 pm
June 9, 2017 9:00 am - 3:00 pm
GOLF CAMPBUS SCHEDULE
All Times Are Approximate Times.
Please have the camper at the pick-up location at least 15 minutes prior to departure time.Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
SOUTH CAMPAges 10 - 18June 5 & 6
Chickasaw Pointe - Kingston, OK
Departing ReturningBUS 1
Antlers Field office 7:30 A.M. 4:45 P.M.
Soper High School 8:00 A.M. 4:15 P.M.
Boswell High School 8:15 A.M. 4:00 P.M.
Bennington High School 8:30 A.M. 3:45 P.M.
Rock Creek High School 8:40 A.M. 3:35 P.M.
BUS 2
Idabel Field Office 7:00 A.M. 5:15 P.M.
Valliant (Doc’s Store) 7:25 A.M. 4:50 P.M.
Fort Towson High School 7:45 A.M. 4:30 P.M.
Hugo Community Center 8:00 A.M. 4:15 P.M.
BUS 3
Broken Bow Field Office 7:00 A.M 5:45 P.M.
Wright City Field Office 7:30 A.M. 5:15 P.M.
BUS 4
Stringtown Travel Plaza 8:00 A.M. 4:10 P.M.
Atoka Field Office 8:15 A.M. 4:00 P.M.
Caddo Dairy Queen 8:30 A.M. 3:35 P.M.
Durant Headquarters 8:45 A.M. 3:20 P.M.
NORTH CAMPAges 10 - 18June 8 & 9
Arrowhead Golf Course - Canadian, OK
Departing Returning
BUS 1
Smithville Field Office 6:00 A.M. 6:35 P.M.
Talihina 7:00 A.M. 5:35 P.M.
Wilburton Field Office 8:00 A.M. 4:35 P.M.
BUS 2
Poteau Field Office 6:45 A.M. 5:30 P.M.
Spiro Field Office 7:15 A.M. 5:00 P.M.
Stigler Field Office 8:00 A.M. 4:15 P.M.
BUS 3
Coalgate Field Office 7:30 A.M. 4:35 P.M.
McAlester 8:30 A.M. 3:35 P.M.
CAMP LISTING Select the camp you will be attending. Ages 10 - 18. Deadline: March 25, 2017
NO FLIP-FLOPSOR SANDALS
North Camp - Arrowhead, Canadian, OK(Districts 3, 4, 5, 6, 11, 12)June 8 & 9
9:00 am - 3:00 pm
South Camp - Chickasaw Pointe, Kingston, OK(Districts 1, 2, 7, 8, 9, 10)June 5 & 6
9:00 am - 3:00 pm
Office Info
_________________________
_________________________
Bus Rider: yes / no
Pick-up Location:_______________________________
See attached schedule
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIB
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
Please completeBus Rider Info!
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
Choctaw Nation of Oklahoma
GOLF CAMPDeadline: March 24, 2017
NOT AN OVERNIGHT CAMP
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Golf Clubs (Circle One): Left Handed Right Handed (considering golf clubs) Do you have clubs? Y N*If camper received clubs at previous camps he/she must bring them to this camp. We will check master list from previous camps to see if they have been assigned clubs in past camps.
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any
responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
Choctaw Nation of Oklahoma
SOFTBALL CAMP
SOUTH SOFTBALL CAMPDistricts 1, 2, 7, 8, 9, 10
TUSKAHOMA, OKJune 12 - 13
9:00 am - 3:00 pm
NORTH SOFTBALL CAMPDistricts 3, 4, 5, 6, 11, 12
TUSKAHOMA, OKJune 15 - 16
9:00 am -3:00 pm
DEADLINE FOR APPLICATION IS APRIL 14, 2017For Female Students Only
All Times Are Approximate Times.
Please have the camper at the pick-up location at least 15 minutes prior to departure time.Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
SOFTBALL CAMPBUS SCHEDULE
SOUTH CAMPDistricts 1, 2, 7, 8, 9, 10
TUSKAHOMA, OK
June 12 - 13
Departing ReturningBUS 1
Rock Creek High School 6:45 A.M. 5:25 P.M.
Bennington High School 6:55 A.M. 5:15 P.M.
Boswell High School 7:10 A.M. 5:00 P.M.
Soper High School 7:25 A.M. 4:45 P.M.
Antlers Field Office 7:55 A.M. 4:15 P.M.
BUS 2
Idabel Field Office 6:45 A.M. 5:35 P.M.
Valliant (Doc Store) 7:10 A.M. 5:10 P.M.
Fort Towson High School 7:30 A.M. 4:50 P.M.
Hugo Community Center 7:45 A.M. 4:35 P.M.
BUS 3
Broken Bow Field Office 7:00 A.M. 5:45 P.M.
Wright City Field Office 7:30 A.M. 5:15 P.M.
BUS 4
Durant Headquarters 6:45 A.M. 5:40 P.M.
Caddo Dairy Queen 7:05 A.M. 5:20 P.M.
Atoka Travel Plaza 7:30 A.M. 4:55 P.M.
Stringtown Travel Plaza 8:00 A.M. 4:45 P.M.
NORTH CAMPDistricts 3, 4, 5, 6, 11, 12
TUSKAHOMA, OK
June 15 - 16
Departing ReturningBUS 1
Smithville Field Office 7:30 A.M. 5:00 P.M.
Talihina Field Office 8:30 A.M. 4:00 P.M.
BUS 2
Stigler Field Office 6:45 A.M. 5:50 P.M.
Spiro Field Office 7:30 A.M. 5:05 P.M.
Poteau Field Office 8:00 A.M. 4:35 P.M.
BUS 3
Coalgate Field Office 6:45 A.M. 5:45 P.M.
McAlester Field Office 7:50 A.M. 4:40 P.M.
VAN
Wilburton Field Office 8:00 A.M. 4:20 P.M.
South Camp - Tuskahoma, OK
(Districts 1, 2, 7, 8, 9, 10)
June 12 - 13, 2017
Camp: 9:00 am - 3:00 pm
CAMP LISTINGSelect the camp you will be attending. Ages 8 - 18. Deadline: April 14, 2017
North Camp - Tuskahoma, OK
(Districts 3, 4, 5, 6, 11, 12)
June 15 - 16, 2017
Camp: 9:00 am - 3:00 pm
WEAR APPROPRIATE SHOES.NO FLIP-FLOPS OR SANDALS
Please completeBus Rider Info!
Office Info
_________________________
_________________________
Bus Rider: yes / no
Pick-up Location:_______________________________
See attached schedule
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIB
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
Choctaw Nation of Oklahoma
SOFTBALL CAMPDeadline: April 14, 2017
For Female Students Only
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any
responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Glove (Circle One) Throws: Left Handed Right HandedBring Glove to Camp.
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
Choctaw Nation of Oklahoma
BASEBALL CAMP
SOUTH BASEBALL CAMPDISTRICTS 1, 2, 7, 8, 9, 10
TUSKAHOMA, OKJune 19 - 20, 20179:00 am - 3:00 pm
NORTH BASEBALL CAMPDISTRICTS 3, 4, 5, 6, 11, 12
TUSKAHOMA, OKJune 22 - 23, 20179:00 am - 3:00 pm
DEADLINE FOR APPLICATION IS APRIL 14, 2017For Male Students Only
BASEBALL CAMPBUS SCHEDULE
All Times Are Approximate Times.
Please have the camper at the pick-up location at least 15 minutes prior to departure time.Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
SOUTH CAMPDistricts 1, 2, 7, 8, 9, 10
TUSKAHOMA, OK
June 19 - 20
Departing ReturningBUS 1
Rock Creek High School 6:45 A.M. 5:25 P.M.
Bennington High School 6:55 A.M. 5:15 P.M.
Boswell High School 7:10 A.M. 5:00 P.M.
Soper High School 7:25 A.M. 4:45 P.M.
Antlers Field Office 7:55 A.M. 4:15 P.M.
BUS 2
Idabel Field Office 6:45 A.M. 5:35 P.M.
Valliant (Doc Store) 7:10 A.M. 5:10 P.M.
Fort Towson High School 7:30 A.M. 4:50 P.M.
Hugo Community Center 7:45 A.M. 4:35 P.M.
BUS 3
Broken Bow Field Office 7:00 A.M. 5:45 P.M.
Wright City Field Office 7:30 A.M. 5:15 P.M.
BUS 4
Durant Headquarters 6:45 A.M. 5:40 P.M.
Caddo Dairy Queen 7:05 A.M. 5:20 P.M.
Atoka Travel Plaza 7:30 A.M. 4:55 P.M.
Stringtown Travel Plaza 8:00 A.M. 4:45 P.M.
NORTH CAMPDistricts 3, 4, 5, 6, 11, 12
TUSKAHOMA, OK
June 22 - 23
Departing ReturningBUS 1
Smithville Field Office 7:30 A.M. 5:00 P.M.
Talihina Field Office 8:30 A.M. 4:00 P.M.
BUS 2
Stigler Field Office 6:45 A.M. 5:50 P.M.
Spiro Field Office 7:30 A.M. 5:05 P.M.
Poteau Field Office 8:00 A.M. 4:35 P.M.
BUS 3
Coalgate Field Office 6:45 A.M. 5:45 P.M.
McAlester Field Office 7:50 A.M. 4:40 P.M.
VAN
Wilburton Field Office 8:00 A.M. 4:20 P.M.
South Camp - Tuskahoma, OK
(Districts 1, 2, 7, 8, 9, 10)
June 19 - 20, 2017
Camp: 9:00 am - 3:00 pm
CAMP LISTINGSelect the camp you will be attending. Ages 8 - 18. Deadline: April 14, 2017
North Camp - Tuskahoma, OK
(Districts 3, 4, 5, 6, 11, 12)
June 22 - 23, 2017
Camp: 9:00 am - 3:00 pm
WEAR APPROPRIATE SHOES.NO FLIP-FLOPS OR SANDALS
Please completeBus Rider Info!
Office Info
_________________________
_________________________
Bus Rider: yes / no
Pick-up Location:_______________________________
See attached schedule
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIB
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
Choctaw Nation of Oklahoma
BASEBALL CAMPDeadline: April 14, 2017
For Male Students Only
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any
responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Glove (Circle One) Throws: Left Handed Right HandedBring Glove to Camp.
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
Choctaw Nation of Oklahoma
FOOTBALL CAMP
ALL DISTRICTSTuskahoma, OK
June 28- 29, 2017Registration: 8:00 am - 9:00 am
Camp: 9:00 am - 3:00 pm
DEADLINE FOR APPLICATION IS APRIL 14, 2017For Male Students Only
FOOTBALL CAMPBUS SCHEDULE
All Times Are Approximate Times.
Please have the camper at the pick-up location at least 15 minutes prior to departure time.Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
ALL DISTRICTSJune 28- 29
Departing ReturningBUS 1
Rock Creek High School 6:45 A.M. 5:25 P.M.
Bennington High School 6:55 A.M. 5:15 P.M.
Boswell High School 7:10 A.M. 5:00 P.M.
Soper High School 7:25 A.M. 4:45 P.M.
Antlers Field Office 7:55 A.M. 4:15 P.M.
BUS 2
Idabel Field Office 6:45 A.M. 5:35 P.M.
Valliant (Doc Store) 7:10 A.M. 5:10 P.M.
Fort Towson High School 7:30 A.M. 4:50 P.M.
Hugo Community Center 7:45 A.M. 4:35 P.M.
BUS 3
Broken Bow Field Office 7:00 A.M. 5:45 P.M.
Wright City Field Office 7:30 A.M. 5:15 P.M.
BUS 4
Durant Headquarters 6:45 A.M. 5:40 P.M.
Caddo Dairy Queen 7:05 A.M. 5:20 P.M.
Atoka Travel Plaza 7:30 A.M. 4:55 P.M.
Stringtown Travel Plaza 8:00 A.M. 4:45 P.M.
Departing ReturningBUS 5
Smithville Field Office 7:30 A.M. 5:00 P.M.
Talihina Field Office 8:30 A.M. 4:00 P.M.
BUS 6
Stigler Field Office 6:45 A.M. 5:50 P.M.
Spiro Field Office 7:30 A.M. 5:05 P.M.
Poteau Field Office 8:00 A.M. 4:35 P.M.
BUS 7
Coalgate Field Office 6:45 A.M. 5:45 P.M.
McAlester Field Office 7:50 A.M. 4:40 P.M.
VAN
Wilburton Field Office 8:00 A.M. 4:20 P.M.
Tuskahoma GroundsJune 28 - 29, 2017 • Registration: 8:00 am - 9:00 am • Camp: 9:00 am - 3:00 pm
CAMP LISTINGALL DISTRICTS WILL ATTEND THE SAME CAMP. Ages 8 - 18. Deadline: April 14, 2017
CAMPER MUST WEAR APPROPRIATE SHOESNO FLIP-FLOPS OR SANDALS
CAMPER WILL NOT BE ALLOWED TO PLAY BAREFOOT THIS YEAR
Office Info
_________________________
_________________________
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIBALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
Bus Rider: yes / no
Pick-up Location:_______________________________
See attached schedule
Please completeBus Rider Info!
For Male Students Only
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
Choctaw Nation of Oklahoma
FOOTBALL CAMPDeadline: April 14, 2017
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any
responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
Choctaw Nation of Oklahoma
BASKETBALL CAMPIDABEL or
BROKEN BOWJuly 6 - 7 • 9:00 am - 3:00 pm
SOSU orSOPER HIGH SCHOOL
July 10 - 11 • 9:00 am - 3:00 pm
COALGATE orTUSHKA HIGH SCHOOL
July 13 - 14 • 9:00 am - 3:00 pm
CARL ALBERT STATE COLLEGE orHEAVENER HIGH SCHOOL
July 17 - 18 • 9:00 am - 3:00 pm
RATTAN HIGH SCHOOL orTALIHINA HIGH SCHOOL
July 20 - 21 • 9:00 am - 3:00 pm
MCALESTER HIGH SCHOOL orWILBURTON HIGH SCHOOL
July 24 - 25 • 9:00 am - 3:00 pm
DEADLINE FOR APPLICATION IS APRIL 14, 2017
NO BUSSING SCHEDULE
FOR BASKETBALL
CAMP LISTINGSelect the camp you will be attending. Ages 8 - 18. Deadline: April 14, 2017
Registration: 8:00 am - 9:00 am
NO BUSSING SCHEDULE
JULY 10 - 11 • 9:00 AM - 3:00 PM
SOSU
Soper High School
JULY 17 - 18 • 9:00 AM - 3:00 PM
Carl Albert State College
Heavener High School
JULY 24 - 25 • 9:00 AM - 3:00 PM
McAlester High School
Wilburton High School
JULY 13 - 14 • 9:00 AM - 3:00 PM
Tushka High School
Coalgate High School
JULY 20 - 21 • 9:00 AM - 3:00 PM
Rattan High School
Talihina High School
JULY 6 - 7 • 9:00 AM - 3:00 PM
Idabel High School
Broken Bow Sports Complex
CAMPER MUST WEAR APPROPRIATE SHOESNO FLIP-FLOPS OR SANDALS
CAMPER WILL NOT BE ALLOWED TO PLAY BAREFOOT THIS YEAR
Office Info
_________________________
_________________________
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIB
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
Choctaw Nation of Oklahoma
BASKETBALL CAMPDeadline: April 14, 2017
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any
responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
Choctaw Nation of Oklahoma
CULTURALENRICHMENT CAMP
JULY 31 - AUGUST 1, 2017SOUTH CAMP
Ages 8 - 18(Districts 1, 2, 7, 8, 9, 10)
9:00 am - 3:00 pm
AUGUST 2 - 3, 2017NORTH CAMP
Ages 8 - 18(Districts 3, 4, 5, 6, 11, 12)
9:00 am - 3:00 pm
DEADLINE FOR APPLICATION IS APRIL 14, 2017TUSKAHOMA COUNCIL GROUNDS
NOT AN OVERNIGHT CAMP
CULTURAL ENRICHMENT CAMPBUS SCHEDULE
All Times Are Approximate Times.
Please have the camper at the pick-up location at least 15 minutes prior to departure time.Also, please arrive 15 minutes prior to the returning time to pick-up the camper.
SOUTH CAMPDistricts 1, 2, 7, 8, 9, 10
TUSKAHOMA, OK
July 31 - August 1
Departing ReturningBUS 1
Rock Creek High School 6:45 A.M. 5:25 P.M.
Bennington High School 6:55 A.M. 5:15 P.M.
Boswell High School 7:10 A.M. 5:00 P.M.
Soper High School 7:25 A.M. 4:45 P.M.
Antlers Field Office 7:55 A.M. 4:15 P.M.
BUS 2
Idabel Field Office 6:45 A.M. 5:35 P.M.
Valliant (Doc Store) 7:10 A.M. 5:10 P.M.
Fort Towson High School 7:30 A.M. 4:50 P.M.
Hugo Community Center 7:45 A.M. 4:35 P.M.
BUS 3
Broken Bow Field Office 7:00 A.M. 5:45 P.M.
Wright City Field Office 7:30 A.M. 5:15 P.M.
BUS 4
Durant Headquarters 6:45 A.M. 5:40 P.M.
Caddo Dairy Queen 7:05 A.M. 5:20 P.M.
Atoka Travel Plaza 7:30 A.M. 4:55 P.M.
Stringtown Travel Plaza 8:00 A.M. 4:45 P.M.
NORTH CAMPDistricts 3, 4, 5, 6, 11, 12
TUSKAHOMA, OK
August 2 - 3
Departing ReturningBUS 1
Smithville Field Office 7:30 A.M. 5:00 P.M.
Talihina Field Office 8:30 A.M. 4:00 P.M.
BUS 2
Stigler Field Office 6:45 A.M. 5:50 P.M.
Spiro Field Office 7:30 A.M. 5:05 P.M.
Poteau Field Office 8:00 A.M. 4:35 P.M.
BUS 3
Coalgate Field Office 6:45 A.M. 5:45 P.M.
McAlester Field Office 7:50 A.M. 4:40 P.M.
VAN
Wilburton Field Office 8:00 A.M. 4:20 P.M.
Office Info
_________________________
_________________________
CAMP LISTINGSelect the camp you will be attending. Ages 8 - 18. Deadline: April 14, 2017
Bus Rider: yes / no
Pick-up Location:_______________________________
See attached schedule
South Camp - Ages 8 - 18
Tuskahoma Grounds
July 31 - August 1, 2017
Camp: 9:00 am - 3:00 pm
North Camp - Ages 8 - 18
Tuskahoma Grounds
August 2 - 3, 2017
Camp: 9:00 am - 3:00 pm
ATTACH COPY OF CHOCTAW MEMBERSHIP CARD AND CDIB
Please complete
Bus Rider Info!
ALL CAMPERS MUST PARTICIPATE! PLEASE NOTIFY CAMP STAFF IF CHILD WILL BE PICKED UP EARLY.
Choctaw Nation of Oklahoma
CULTURAL ENRICHMENT CAMPDeadline: April 14, 2017
INSTRUCTIONS:Complete Application and Sign.
Mail to: Choctaw Summer Camp • c/o Kevin Gwin • PO Box 1210 • Durant, OK 747011-800-522-6170 • Fax: 580-920-9046
NOT AN OVERNIGHT CAMP
CONSENT: I authorize a representative of the Choctaw Nation Staff, Camp Director, and Instructor to seek medical treatment for my child, if I am not present, while participating in this camp. In consideration of the sponsors and facility owner accepting this application, I hereby release and waiver all rights to any claim for damages and/or injury my child may suffer while participating in this camp. I understand and agree that medical or other services rendered to my child by the camp sponsors/facility owner is not an admission of liability or continued services.
PHOTO LIABILITY: In signing this registration form, I acknowledge and agree to allow the Choctaw Nation of Oklahoma the right to use, without compensation to me, my child’s likeness for advertising, promotional, or public purposes. I hereby release the Choctaw Nation of Oklahoma from any
responsibility, liability or loss that I may incur as a result of using my child’slikeness, including, but not limited to, any right of privacy.
Signature of Parent / Guardian _______________________________________________ Date _________________________________
Name: ______________________________________________________________________________Phone: ___________________________________
Address: _______________________________________________________City: ________________________ State: _________ Zip: _______________
Age:_________________Date of Birth:__________________________________ Male / Female
Circle T-Shirt Size: Youth (10 - 12) (14 - 16) ; Adult (Small) (Medium) (Large) (X-Large) (2X-Large) (3X-Large)
Have you attended any of our camps? Y N List the camp & how many years: ___________________________________________________
Do you have insurance? Y N List insurance information: _____________________________________________________________________
Emergency contact person & phone #: __________________________________________________________________________________________
Medical Information: __________________________________________________________________________________________________________
Choctaw Nation of OklahomaAttention: Cultural Events-Summer CampsP.O. Box 1210Durant, Oklahoma 74702
PLACE
STAMP
HERE
See Ya At Camp!Registration Forms available online at
choctawnationculture.comor choctawnation.com
New applicants must send copy of CDIB &Choctaw Membership Cards
CHOCTAW NATION OF OKLAHOMATRIBAL DISTRICTS
Ti
Tom
Ury
Ord
Gay
Dow
Moon
Hoyt
Wade
Ulan
Star
Slim
Rufe
Lula
Lodi
Lane
Kent
Hugo
Goss
Dela
Cook
CobbCade
Burg
Blue
Adel
Weeks
Walls
Utica
Unger Swink
Speer
Soper
Sobol
Reams
Olney
Oleta
Mekko
Matoy
Krebs
Kiowa
Kinta
Jumbo
Grant
GowenFrink
Flora
Ethel
Drumb
Daisy
Citra
Caney
Cairo
Caddo
Bruno
Bluff
Banty
Bache
Atoka
Apple
Allen
Harris
Milton
Yanush
Wilson
Wesley
Wadena
Virgil
Tushka
Tupelo
Stuart
ShultsShoals
Scipio
Sawyer
Sardis
Redden
Rattan
Pirtle
Parker
Panola
Norris
Nelson
MoyersMiller
Messer
Mayhew
Lehigh
Kosoma
Jaydee
Idabel
Huskey
Hughes
Hamden
Halley
Golden
Glover
Garvin
Folsom
Finley
Felker
Farris
Durant
Dunbar
Duland
Divide
DenmanDegnan
Darwin
Counts
Cloudy
Carbon
Calvin
Calera
Brewer
Bowers
Blanco
Bengal
Atwood
Albion
Stigler
Hughart
Garland
Wasseta
Sunkist
Stanley
Roberta
Ringold
Redland
QuintonPanther
Lequire
Leflore
Kenefic
Kellond
Higgins
Haywood
Eubanks
Crystal
Crowder
Compton
Coleman
Clarita
Burwell
Boswell
Boehler
Blocker
Bentley
Belzoni
Ashland
Arpelar
Antlers
Allison
Alikchi
Goodlake
Eastport
Longtown
Canadian
Valliant
Talihina
ReynoldsPine Top
Phillips
Oak Hill
Kiamichi
Hopewell
Coalgate
Cabaniss
Bokchito
Shinewell
Goodwater
LafayetteIndianola
Wardville
Wapanucka
Tuskahoma
Pritchard
Pittsburg
Millerton
McCurtain
McAlester
Lone Pine
Lake West
High Hill
Greenwood
Frogville
Armstrong
Whitefield
Sams PointEnterprise
Stringtown
Rock Creek
North Pole
Negro Bend
Mount Zion
Hartshorne
Crossroads
Centrahoma
Bug Tussle
Bennington
Shady
Old Allison
Featherston
Thule
Ward Springs
Russellville
Farmers Hill
Pleasant Hill
Bristow Point
North McAlester
Bromide Junction
Pine Knot Crossing
Half Bank Crossing
Arkoma
Bashe
Cedars
Pocola
Jenson
Braden
Spiro
TuckerCowlington
WardCartersvilleKeota
Star
Bokoshe
Red Hill
Tamaha
PanamaTahona
Williams
Cameron
Hill
PointLathamDog Creek
NeffGilmorePoteau
MonroeYerby
Howe
HiawathaLoving
HeavenerPetros
HodgenConserReichert
Glendale
WisterVictor
Haw CreekZoe
Page Fogel
Big CedarMuse
LenoxWhitesboro
OctaviaZafra
BeachtonSmithville
WatsonPlunketvilleNani-chito
LudlowHonobia
Fewell
Nolia
Clebit Battiest
Bethel
SherwoodMount Herman
UltimaEagletownTiner
Smith - Lee
Clayton
Wilburton
Broken Bow
5
6
9
7
1112
1
10
8
4
2
3
McCurtain County
LeFlore County
Haskell County
Latimer County
Pushmataha County
Choctaw County
Bryan County
Atoka County
Pittsburg County
Hughes County
Coal County
Online registration is available at www.choctawsummercamps.com only if your child has
attended camps in previous years and has a CDIB & membership card on file.