Christ Bible Camp Registration Form
Participant Name
First Name
Last Name
Participant Age
Grade Entering
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Please list any allergies or medical conditions
Who is authorized to pick up this child from camp?
I authorize Christ Lutheran Church to take and use photographs to highlight the ministries of the congregation. Photographs will not be used or distributed for any other purpose other than to promote activities for Christ Lutheran Church.
Yes
No
I consent to my child's participation in the Christ Bible Camp program.
Yes
No
I authorize the Christ Bible Camp staff to seek emergency medical treatment for my child if necessary.
Yes
No
By signing this form, I agree to release and hold harmless the Christ Bible Camp program, staff, and volunteers from any claims or liability arising from my child's participation.
Date of Signature
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: