Your Subtitle text


LPBC Camper Application
Prior to completing the application below, please carefully review the following statements:

LPBC Emergency Medical Treatment Statement 
The camper described in the application submitted below has my permission to attend camp and to participate in swimming and all other activities.  I understand that in case of serious injury or illness, I will be notified; but if I cannot be contacted, permission is given for emergency treatment of surgery as recommended by the attending physician.  In case of emergency, campers will be taken to Phelps County Regional Medical Center.

LPBC Covenant Agreement 
I understand that the rules and codes of LPBC are necessary for the Christian atmosphere of the camp.  I have read the application and will do all I can to obey these rules, including the dress code, and to be a Christ-like example to all campers and staff.

Little Prairie Bible Camp Head Lice Policy 
Little Prairie Bible Camp is committed to providing every camper the best and safest possible camp experience. Each camper, counselor, and staff member will be examined for head lice upon arrival to camp. If nits (eggs) or lice are present, those infested will be sent home (No exceptions, we’re sorry) and they are not allowed to return for that week. They may return to a later session if they are totally free of nits or lice. We want each camper’s time at camp to be a pleasant and enjoyable experience, so please take the following precautionary measures to see that your camper is ready for the best camp experience:

1. Parents should do a head lice check on their campers two weeks before camp. Administer treatment if detected.
2. Parents should do a head lice check on their campers on the day of departure to make sure no one is infested.We have provided the following information to help you in your head lice check.

What are head lice?
Head lice are small grayish-white insects, which are found in the hair, behind the ears, and on the nape of the neck. They live on human blood and their bites cause itching and scratching. These bites can lead to infection. 

How can they be recognized?
The adult louse is about the size of a sesame seed. They attach their eggs (called nits) to strands of hair close to the scalp. Nits are tiny, pearl gray, oval-shaped specks that are attached firmly to the hair. These may hatch in 1 week, but have been known to survive for 10 days. Frequent scratching of the head is usually the first clue of infestation.

How long does it take from exposure to infestation?
One to two weeks.

When are they contagious?
As long as there are live lice and eggs. For treatment of head lice see:

To download the 2019 Counselor Application - Click Here
To download the 2019 Junior Counselor Application -  Click Here 

LPBC 2019 Online Application For Campers

Please fill out this application completely.

Camper's Name: *
Birthday: *
Age: *
Address: *
City: *
Zip: *
Parent or Guardian Name: *
Telephone Number: *
Email Address: *
Church Preference: *
Home Congregation: *
Have you attended LPBC Before?:
Choose T-Shirt Size (Included in camp fee):
Cost:  $98 per week, except Day Camp
which is $50 per week.
Please check box that
corresponds to the week
you would like to attend camp.
Day Camp  May 28- May 31 (5-2nd Grade)
Session 1
Combined Week June 2-7 (Grades 5-12) 
Session 2
Junior Week June 9-14 (Grades 6-8) 
Session 3
Primary Week June 16-21 (Grades 3-5)
Session 4
Combined Week June 23-28 (Grades 5-12)
Session 5
Senior Week   July 21-27 (Grades 9-12)  Session 6
  Please check the corresponding
box for any conditions that apply to you.
  Heart Condition
Date of last Tetnus shot:
Insurance Company:
Policy Number:
Other Important Medical Instructions:
 I have read and understand the LPBC Emergency Medical Treatment Statement and the LPBC Covenant Agreement.  I will abide by the terms and guidelines stated in both statements.
I Agree
 I have read and understand the Little Prairie Bible Camp Head Lice PolicyI will abide by the terms and guidelines stated in this policy.

I Agree
Parent or Guardian Initials: *

To download the 2019 Counselor Application - Click Here
To download the 2019 Junior Counselor Application - Click Here

Print this form and mail to this address:
P.O.Box 251 Rolla, Missouri 65402

Don’t have Adobe reader? Get it FREE right here!