TNBC Bible Detailed Registration Form

TNBC Camper Registration

Please complete the form for each child attending the event.
Child Information
Child's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Attendees must be going into 1st - 6th grades.
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Home Number
Cell Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Trinity-Northbrook Baptist Church during the selected camp. In exchange for the acceptance of said child’s candidacy by Trinity-Northbrook Baptist Church, I assume all risks and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Trinity-Northbrook Baptist Church and all its respective officers, agents, volunteers, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Trinity-Northbrook Baptist Church. including all teachers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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TNBC Camper Registration