Character Camp Aviation Lab Week

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Participant Name* This field is required.
First Name
Last Name
2
Gender* This field is required.
Please Select
Please Select
Male
Female
N/A
3
Age* This field is required.
4
Date of Birth* This field is required.
Month
Day
Year
5
Allergies* This field is required.If any allergies, please list reaction (Ex: Peanuts - shortness of breath and rash) If no medical problems or allergies, list NONE
6
Medical Conditions* This field is required.Select All That Apply
Asthma
Eczema
Constipation
Urinary Incontinence
Allergic Rhinitis (Seasonal Allergies)
Anxiety
Diabetes
Seizure Disorder
Hypertension
NONE
Other
7
Does the camper take any emergency medications (i.e. Albuterol, EpiPen, Diazepam) or meal time insulin?* This field is required.EX: Albuterol inhaler - every 4 hours as needed for shortness of breath
Huge
Large
Normal
Small
Ok
Ok
8
Medication Authorization* This field is required.No medication will be administered unless this section is completed. I authorize designated camp personnel, trained volunteers, or staff (as permitted by camp policy and applicable law) to assist with or administer the previously listed medication(s) to my child as directed. I understand medications must be provided in the original labeled container.
My child will NOT need medication administered during camp
I authorize camp personnel to administer medication as listed
9
Behavior and Mental Health* This field is required.Check All That Apply
NONE
My child has a tendency to disrespect or defy authoritative figures
My child has been prescribed a medication to manage a mental/psychological condition
My child has Autism
My child has a learning disability
My child has a tendency to run/run away when upset or triggered
My child has a tendency to be violent or destructive when upset or triggered
Other
10
BEHAVIOR AND MENTAL HEALTHPlease provide a brief description
11
Dietary Restrictions* This field is required.
NONE
Low Carbohydrate
Vegetarian
Vegan
Gluten Free
Dairy Free
12
Is there anything else we should know about the camper that would make this day camp easier for them?
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Large
Normal
Small
Ok
Ok
13
Parent or Guardian* This field is required.
First Name
Last Name
14
Mobile Phone* This field is required.
15
Home Phone
16
E-mail* This field is required.
example@example.com
17
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
18
Emergency Contact* This field is required.
First Name
Last Name
19
Emergency Contact Mobile Phone* This field is required.
20
Emergency Contact Relationship to Camper* This field is required.
21
Additional Authorized Pick Up PersonPlease list any additional individual (OTHER than the parent or legal guardian listed above) who is authorized to pick up your child from camp. I understand camp personnel may require photo identification before releasing my child to an authorized person.
22
NOT Authorized to Pick-Up (OPTIONAL)If any person is NOT authorized for pick-up, please list here
Name
Relationship to Child
Brief description of why person is NOT authorized to pick up child
23
Upload a copy of Parent/Guardian ID for Pick UpRedaction of ID number, date of birth and address are acceptable. Do not redact name and picture.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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Emergency Medical Authorization* This field is required.
I, the undersigned parent or legal guardian of the above-named participant (“Participant”), authorize Lamb of God Christian Church and Character Camp, including their pastors, directors, employees, volunteers, and agents, to obtain emergency medical treatment for my child in the event of illness or injury if I cannot be reached promptly. I authorize competent adult volunteers and/or medical personnel to provide treatment deemed reasonably necessary for my child’s health and safety. I understand reasonable efforts will be made to contact me or my emergency contact before treatment is authorized. I accept responsibility for costs associated with such treatment not covered by insurance.
25
Assumption of Risk and Release of Liability* This field is required.
I understand participation in camp activities, including but not limited to recreation, games, crafts, sports, and other supervised activities involves inherent risks of injury. I knowingly and voluntarily assume all risks associated with my child’s participation. To the fullest extent permitted by law, I release, waive, and hold harmless Lamb of God Christian Church and Character Camp and their pastors, officers, directors, employees, volunteers, and agents from claims, demands, damages, or causes of action arising from my child’s participation, except to the extent caused by gross negligence or willful misconduct.
26
Abuse Prevention and Mandated Reporting Acknowledgment* This field is required.
I acknowledge that Lamb of God Christian Church and Character Camp are committed to providing a safe environment for all children and maintaining policies and procedures designed to prevent abuse and protect participants. I understand the organization may implement child safety measures, including supervision standards, volunteer screening, background checks, check-in/check-out procedures, and other protective protocols. I understand certain staff members and volunteers may be mandated reporters under applicable law and may be required to report suspected child abuse, neglect, or threats to a child’s safety to appropriate authorities, as required by law. I acknowledge and support compliance with these safety policies and legal reporting obligations.
27
Indemnification* This field is required.
I agree to indemnify and hold harmless Lamb of God Christian Church and Character Camp from claims brought by or on behalf of my child arising out of participation in camp activities, except where prohibited by law.
28
Photo, Video & Media Release* This field is required.I grant permission to Lamb of God Christian Church, Character Camp, and their representatives, to photograph, videotape, or otherwise record my child’s participation in camp activities, and to use my child’s image, likeness, voice, artwork, or statements for lawful nonprofit purposes, including ministry communications, newsletters, brochures, fundraising materials, social media, websites, and promotional materials, without compensation. I understand these materials may be used in print, digital, and online formats. I release and hold harmless Lamb of God Christian Church and Character Camp from claims arising out of the use of such photographs, videos, or recordings as authorized in this release.
I grant permission for my child to be photographed/recorded and for these materials to be used as described above.
I do NOT grant permission for my child to be photographed/recorded or for these materials to be used.
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By signing and submitting this registraiton form, you understand and agree to all policies.
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Parent/Guardian Name* This field is required.
First Name
Last Name
31
Parent/Guardian Signature* This field is required.
32
Date & Time of Submission
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