Family Camp Medical Release Form

Family Camp Medical Release Form
Child's Name*

First NameLast Name
Current Age*
MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Emergency Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
List Allergies and/or Special Needs
My child: Student's Name Here may participate in all FBC Family Camp events for the 2023 camp session. As a parent or guardian, I authorize an adult camp representative to make legal decisions, medical decisions, or otherwise concerning said minor during the time of FBC Family Camp events. I hereby release Fruitland Bible Camp and its sponsors of any legal responsibilities and liability in the event of an accident or injury. As a parent or guardian, I have carefully and truthfully provided all the information requested and give my permission for my child to participate in FBC Family Camp events for the 2023 camp session. Both my child and I understand that he/she will be expected to obey the rules, regulations and policies of Fruitland Bible Camp.
Parent/Guardian Signature*

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