Clone of Calvary Kids Children's Camp Registration 24

Calvary Baptist Church

Turn your phone sideways. Please fill the form below to register your child for Children's Camp 24

Participant Information
Name*

First NameLast Name
Please list any allergies or medical issues we should be aware of:
What grade is the child in currently?*
Another child in the same household with the same guardian.

First NameLast Name
Please list any allergies or medical issues we should be aware of:
What grade is the child in currently?
Another child in the same household with the same guardian.

First NameLast Name
Please list any allergies or medical issues we should be aware of:
What grade is the child in currently?

Parent/Guardian Contact Information
Parent / Guardian's Name*

First NameLast Name
Phone Number (Emergency)*

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Photos and Publications: Please check all that apply

I give permission for my child to be photographed in images that may appear for promotion of this event/ministry.Please do NOT take pictures which include my child in any way.
Please mark your agreement to these statements*

I am the legal guardian/parent for the child/children registered.I understand that my child must comply with safety directions at Calvary Baptist Church.If my child fails to comply I am aware that I am required to come and pick them up.

Signature
By signing and submitting this registraiton form, you understand and agree to all policies.

I understand that, in the event that my child requires medical or dental treatment while engaged in the activity, reasonable efforts will be made to contact me; however, if I cannot be reached, I hereby consent and give my permission to the ministry’s sponsor or any adult counselor acting on behalf of the ministry with respect to the Activity, as agent for me, to consent to any X-ray examination, injections, anesthesia, medical, dental, or surgical diagnosis and treatment; and hospital care and treatment advised and supervised by a physician, surgeon, or dentist licensed to practice under the laws of the state where the services are rendered, either as on outpatient or in any hospital. I understand that my insurance coverage for my child will be used as primary coverage in the event medical intervention is needed. Coverage by Calvary Baptist through its accident policy may be available as a backup for what my family’s insurance does not cover. I understand all reasonable safety precautions will be taken at all times by Calvary Baptist and its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I also agree not to hold Calvary Baptist, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred during my student’s participation in the activities and events.

My child has permission to ride in vehicles from Calvary Baptist Church and I understand that all children must comply with safe passenger behaviors or they will no longer be permitted on the vehicles.

The Following items/behaviors are NOT permitted

1. Illegal substances, weapons, or students under the influence of substances.

2. Obscene or offensive language, gestures, or offensive/indecent clothing.

3. Fighting or rough housing, including “playing/kidding”

4. Causing disruptions or distractions from worship and activities .

I have read and understood this form.
Parent/Guardian Signature*

First NameLast Name
Today's Date*

MonthDayYear
Comments and/or Questions:
Should be Empty:

Calvary Baptist Church