PPP Camp 2025 Child Registration Form (MSK)

MSK PowerPlus Preteen Camp 2025 Child Registration Form

@ Pineywoods Baptist Encampment
General Information
Child's Name:*

First NameLast Name
Choose one:*

boygirl
Grade Completed*
Tshirt Size:*
Birthday:*

MonthDayYear
Date
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Allergies, Medical & Special Needs:
To be prepared for all of the medication needs, please list ALL of the meds you'll be sending with your child(ren). If it's not listed here, it won't be able to come. (If something needs to be added, please contact Kathy)
If necessary, in spaces below... (1) list any medications your child is bringing (2) whether its to be taken AM or PM (3) whether or not it is required to take, or being brought just in case
Parent 1 Name:*

First NameLast Name
Parent 1 Phone Number:*
Please enter a valid phone number.
Parent 1 Email:*
example@example.com
Parent 2 Name:

First NameLast Name
Parent 2 Phone Number:
Please enter a valid phone number.
Parent 2 Email:
example@example.com
I understand that photos/videos of my child may be used for various church publications & promotions.*

I agree
What church do you attend?
How did you hear about our camp?
Who was your child invited by?
Activity Authorization & Medical/Liability Release
I, blanks* (parent's name) am the parent/legal guardian and give permission for blank* (child's name) to participate in the MSK PowerPlus Preteen Camp with First Baptist Church, Conroe. I understand that my student could/will travel on the church buses, rented vans or in sponsor vehicles with adult chaperones.
Emergency Contact: (not parents listed above)*

First NameLast Name
Emergency Contact Phone Number:*
Please enter a valid phone number.
Emergency Contact Relationship:*
I agree to release and hold harmless First Baptist Church, Conroe, it’s officers, directors, staff, employees, volunteers, or members, from any liability, claim or demand, of any nature, which may be incurred while participating in the above-referenced activity or during such time period. I hereby authorize any medical treatment, including, but not limited to, emergency surgery or medical treatment, and I hereby agree to assume all responsibility for any medical treatment expenses, if any.
I have read and understand the above and foregoing rules of conduct for participants and the release of liability/medical release form, and agree that I/the participant must abide by same and the directions of the leadership during the activities this act covers. I hereby agree to said release of liability/indemnity agreements contained herein.
Signature of Parent/Legal Guardian:*

Clear
Date Signed:*

MonthDayYear
Date
Comments:
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PowerPlus Preteen Camp - Registration
$75.00

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MSK PowerPlus Preteen Camp 2025 Child Registration Form

General Information

Activity Authorization & Medical/Liability Release