Just A Girls Registration
Official Registration for "Just A Girls Thing", an overnight event for girls with WayPoint Youth. This form must be filled out by a Parent, or a Student who is 18 years old or older.
The event starts at 7:00pm on Friday, May 12 at WayPoint North, and ends at 5:30pm on Saturday, May 13.
WayPoint North Address:
12719 134th Ave Nw, Gig Harbor, WA, 98329
For Frequently Asked Questions and any other information about this event, including the information above, please visit waypointyouth.com/justagirlsthing.
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The cost of this event is $15 per student.
You can find detailed info about this event at waypointyouth.com/justagirlsthing
Student Info
Student's Name:
*
First Name
Last Name
Student Cellphone (Optional - for texts):
-
Area Code
Phone Number
Student's current Grade:
*
6
7
8
9
10
11
12
Student's Age:
*
Student's Gender:
*
Girl
Female
Any special requests? (Requests will be granted/refused at Lydia's discretion.)
Will this student be bringing any medications to this event?
*
Yes
No
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Student Medication Info
Custody: All medications are maintained with youth staff.
Students may NOT self-administer prescription or over the counter medications, including Tylenol, Ibuprofen, Advil, Cold remedies, decongestants, antihistamines, vitamins, medicated creams and ointments.
Containers: All medications must be in original bottles.
Prescription medications must have pharmacy label with name of patient and drug, dose amount, doctor name and directions. Nonprescription medications and supplements must be in original packaging. All medicine amounts provided should be limited to the supply necessary for the duration of the camper’s stay.
Inhalers: Inhalers must be provided to event staff upon arrival.
After inhaler has been verified and name placed on inhaler it will be distributed to the student for self-use.
Medication Information
We need to know all of the medications your child will be taking at this event. Our staff will see to it that they are administered correctly, on time, at the right dose. Again, we will verify this with you and the student at drop-off.
Name of First Medication:
Dose:
Time/Frequency of Use:
Reason student is taking medication:
Are there additional Medications your student will be taking?
Yes
No
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Additional Medications:
Leave blank any input fields that do not apply.
Name of Second Medication:
Dose:
Time/Frequency of Use:
Reason student is taking medication:
Name of Third Medication:
Dose:
Time/Frequency of Use:
Reason student is taking medication:
Name of Fourth Medication:
Dose:
Time/Frequency of Use:
Reason student is taking medication:
Any additional Medication information:
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Student Medical Information
We want to take care of your student as best we can. It can be helpful to us to have this information so we can watch out for them and make sure their camp experience is as good as it can be! If any of the following overall health issues apply to your student, please let us know in the field below each list. Describe the issue, what we can expect from the student, and how we can help them.
Student's Health Insurance Policy Number
Medical History
Recent Hospitalizations, Surgury, Infectious Diseases
Recurrent or chronic illness
Asthma, shortness of breath, or other respiratory problems
Diabetes, Seizures, Fainting/Dizziness, or Headaches
Sleep problems
Digestive Health issues (Diarrhea/constipation, IBS)
Pain with exercise
Skin problems
Visual/Hearing problems
Any of the above selections, explained:
Mental/Emotional/Social Health
Dealing with and/or being treated for ADD or ADHD
Dealing with and/or being treated for emotional or behavioral difficulties or eating disorders.
Had a significant life event that continues to impact the student's life
Struggling with bullying
Any of the above selections, explained:
List any Food and/or Medication Allergies here. Include what the reaction is to said food/allergy:
Anything else you'd like us to know?
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Parental/Family Info: Do we already have this information?
The following section contains questions for parents, emergency contacts, and asks for doctor info that most likely will apply to all of your students, if you are sending multiple students from the same household. If this is the case, and you've already filled out this info, we'll allow you to bypass it to save you some time.
Your Name (parent/student who is 18+ filling out this form):
*
First Name
Last Name
Your email address:
*
example@example.com
Have you filled this part out before?
*
This is my first time filling this form out for Just a Girls Thing, OR I am only sending one student, OR I am a student who is 18+ and am registering myself only.
I've already filled the parental information out for a previous student for Just a Girls Thing, and it will be the same as the student I'm about to register.
Wait!
The question asked above pertains only to this specific event (Just a Girls Thing). Even if you've filled out a form like this in the past for a different WayPoint event, you still need to check the first time option. Only select the "already filled" option if you've already registered a student for this specific event.
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Parent Info
For you, the parent/adult filling out this form.
Your cellphone number (we will send texts to this number):
*
-
Area Code
Phone Number
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Secondary/Emergency Contact
Another adult we can contact in case of an emergency.
Name:
*
First Name
Last Name
Relationship to Student
*
Cellphone number:
*
-
Area Code
Phone Number
Any other persons you'd like to share info for, please enter names, phone numbers, their relation to the student being registered.
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Family Medical Info
If you are sending multiple students and they have DIFFERENT health care providers, you can write all information here, separated by commas, clearly letting us know which information is for which student. Example: "Stefan's Doctor: Henry Cavil. Carly's Doctor: Winona Ryder."
Health Insurance Company:
Primary Doctor:
Doctor's Phone:
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Student Agreement
ALL STUDENTS must cooperate with all staff! Rules will be reviewed at the first gathering.
*
I understand that my student must cooperate with all staff at this event, and failure to do so will result in the student being sent home.
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Media Recording
From time to time, we at WayPoint Church take photographs and/or video for promotional purposes at events associated with church activities. In print or digital media, images of minors are not referenced with last name nor provide specific identifying information. Images are not sold; they are used exclusively for WayPoint Church’s purposes.
At WayPoint Youth, we love to promote our students and how awesome they are through our social media outlets, such as facebook, instagram, tiktok, and our website. The only people permitted to post on these outlets during camp are youth leaders who understand our policy of always posting with care given to how students are depicted and/or identified in these posts, and not posting things frivolously. WayPoint Youth prides itself in the culture of mutual respect, care, and dignity that our students and leaders share.
By signing below, you acknowledge this and give unrestricted permission to WayPoint Church (WPC) for your student's image to be used in print, video, and digital media at Just a Girls Thing, May 12-13. These images may be used by WPC for a variety of purposes, such as promoting a church/youth event, and may be used without notifying you. Unique identifying information, such as your child's last name, will not be used in conjunction with any video or digital images. If you have questions or objections to this, please reach out to Pastor Drew at dpappas@waypoint-church.org.
Sign here, and date below for Media release:
*
Clear
Today's Date:
*
-
Month
-
Day
Year
Date
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Release of Liability Waiver for LIFT 2023 with WayPoint Youth
I , as parent or guardian of the student(s) registered in this form, by signing below, do hereby give permission for said student(s) to attend activities organized by WayPoint Church (WPC) for Just a Girls Thing on May 12-13, 2023. I will hold harmless WPC, and all participating staff, volunteers, and partnering organizations for any accident or injury resulting from my child’s participation and agree to assume all responsibilities, liabilities incurred from property damage, and personal injury caused by said students(s). I also hereby give staff and volunteers of WPC permission to administer my child’s prescribed medications and over the counter medications as necessary. I further give authority to WPC staff and volunteers to administer any and all medical or emergency treatments necessary and provide health care information as needed in the event of an emergency. Finally, I confirm that all information entered on this form is true and accurate.
Sign here, and date below, indicating you agree with the above Liability Waiver:
*
Clear
Today's Date:
*
-
Month
-
Day
Year
Date
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Make sure you click "submit" and wait for the form to finish loading! Thanks! Parents, check your email for a confirmation. No email = no registration!
Students who are filling out the student interest part of the form: Be sure to follow up with your parents so they can get you registered! We'll hold a spot for you in the meantime.
NOTE:
Parents: If you do not receive a confirmation email from us in the next few hours, please reach out to Lydia Harlander at lydiaharlander@gmail.com
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