ROCKY RAILWAY 2022 Vacation Church Camp Registration

ROCKY RAILWAY 2022 Vacation Church Camp Registration

Please fill out the form carefully for registration. Our team of dedicated volunteers have been praying for your children continuously throughout this pandemic and are so very excited to start this program up again. Please let us know how we can serve your families' spiritual needs in any way and if there are any questions, queries or requests you'd like to ask of us in the additional comments section at the end of your registration form.
Camper 1 Name

First Name Middle Name Last Name
Camper 1 Shirt Size (Please be as specific as possible)
Would you like to pre-order the Rocky Railway Sing and Play Express Music ahead of time to have for your child to play as much as they want after Vacation Church Camp ($5.00) ! They're sure to love the fun tunes we’ll be singing and dancing to all week! No need to pay until you receive the item and are completely satisfied with the product.

Yes please No, thank you
Birth Date

Month Day Year
Camper 2 Name

First Name Middle Name Last Name
Camper 2 Shirt Size (Please be as specific as possible)
Birth Date

Month Day Year
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian Name 1

First Name Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Parent/ Guardian Name 2

First Name Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Information

First Name Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Additional Comments
First Parish Church Medical Release Form

My child (child 1) has the following medical conditions you should be aware of blanks . Please follow these instructions to address above mentioned medical condition: 2. If a parent/guardian cannot be reached, I consent to emergency medical care being given to my child by a trained staff member or medical professional.

I, the undersigned, do hereby release, forever discharge and agree to hold harmless Christ Church, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the children/youth activities and childcare.

Signature (Please Sign Below):
First Parish Church, East Derry NH Medical Release Form

My child (child 2) has the following medical conditions you should be aware of blanks . Please follow these instructions to address above mentioned medical condition: 2. If a parent/guardian cannot be reached, I consent to emergency medical care being given to my child by a trained staff member or medical professional.

I, the undersigned, do hereby release, forever discharge and agree to hold harmless Christ Church, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the children/youth activities and childcare.

Signature (Please Sign Below):
Signature

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First Parish Church, East Derry, NH Photo Release Form

Date: Date
Release is granted for:
___ Specific Event Only____________________   Type a label
___ Any and all public events at First Parish Church, East Derry NH
I give permission for photographs of the persons listed below to be used in publications of First Parish Church
(including the church website and Facebook pages.) I understand that these photos may be viewed by anyone
but no identifying information will be displayed.

I am the parent or legal guardian of the following child(ren) under 18 years of age, and I give permission for
their images to be used.
Child's (Children's) names:
Type a label
Type a label

Signature (Please Sign Below):{signature}
Signature

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Should be Empty: