Camp EPIC 2026 Registration Form

Camper Information:
CAMP EPIC 2026 Registration Form

Gettysburg Seventh-Day Adventist Church
First NameLast Name
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Age
Gender
Parent Guardian Information:
First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Second Contact Person

First NameLast Name
Phone Number
Format: (000) 000-0000.
Person Authorized to pickup:
First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
PERSONS AUTHORIZED TO PICKUP (option 2)

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
If necessary, please specify individuals who are not permitted to pick up your child:
First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
FIELD TRIP INFORMATION

I give my son/daughter permission to attend the Camp Epic activities that will take place off the Gettysburg Adventist Church property (i.e. Pool, Theatre, etc.). I here with release and hold harmless Camp Epic 2026 of any claims of personal injury.
Signature
Date

MonthDayYear
Date
MEDICAL INFORMATION
Does my son/daughtter have any allergies, chronic illness, or medical conditions? If yes, please describe.
Medications / Dosage / Frequency
Diabetic:
Asthma:
Does camper know how to swim?
Please elaborate on other chronic condition or major illnesses of child. If necessary, state proper care for child as well as procedures to follow:
PERMISSIONS FOR MEDICAL TREATMENT

In the event of an emergency occurring while my son/daughter is at Camp Epic 2026, a program of the Hanover Seventh-day Adventist church on the grounds of the Gettysburg Seventh-day Adventist Church and public facilities used bythe camp, I hereby grant permission to the camp and to its volunteers to take whatever action deemed necessary. In the event that I cannot be reached, I hereby authorize the camp and/or its employees to give consent for myson/daughter to receive medical treatment.
Parent/Guardian Signature
Date

MonthDayYear
Date
Medical contact information:
Family DoctorPhone
Hospital/Medical Facility Preference:
Additional Comments:
EPIC CAMP 2026 WAIVERS
1. Insurance

I fully understand Camp Epic 2026 is a program of the Gettysburg Seventh-day Adventist Church, does not provide any accident or health insurance coverage for my son/daughter. I fully understand that it is my responsibility to provide accident and or health insurance coverage for my child.
Please specify the following for which your child is covered:

Insurance CompanyPolicy/Group Number
Member ID Number:Policy Holder’s Name
Policy Holder’s Date of Birth
2. Liability

As the parent of guardian of a minor child participating in activities of Camp Epic 2026, a program of the Gettysburg Seventh-day Adventist Church, I hereby waive and release any claims I, or my child may have against Camp Epic, and it’s volunteers, arising from injuries to my child or damages to my child’s property, under the care of Camp Epic 2026. I further understand that Camp Epic is neither certified nor licensed as a day care provider. In the event of any injury to my child, I give permission for emergency treatment or first aid. I understand that Epic Camp does not assume any unstated written responsibilities to take care of any emergencies beyond the scope of Camp Epic 2026.
3.Technology

MP3 players, cell phone, etc. are not permitted. We ask that each camper leave these items at home. Under the circumstances that these items are brought to camp, Camp Epic 2026 and/or its employees will not be held responsible for any loss or damage. When a child is seen using such technology without permission they will be asked to put it away on first offense and confiscated to be returned at the end of the day on second offense. If you need to contact your child during the day, please contact Camp Epic 2026 Director or Assistant Director.
4. Emergency

In case of accident or serious illness the adult in charge will try to contact me at the number given on this form. If the adult in charge is unable to contact me, I hereby authorize the camp director or staff member to take my child to the Physician indicated or the nearest medical facility.
These waivers and releases shall be valid for the duration of the session in which my child is enrolled. I have carefully read this waiver and release and agree to the terms stated. I certify that I am the parent or legal guardian of First Name Last Name

I verify that the information I have provided is correct and current.
Parent/Guardian Signature
Date

MonthDayYear
Date
Image Release Form 2026
The undersigned enters into this agreement with the Pennsylvania Conference of Seventh-day Adventists, 720 Museum Road, Reading, PA.

I hereby consent and authorize the Pennsylvania Conference or its assigns, to use my name, likeness, image, voice, appearance, video and audio recordings, and performance for the purpose of news releases, advertising, publicity, publication or distribution in any manner whatsoever, in composite or edited forms.

I warrant and represent that all material furnished by me is my own or that I have full authority to use it for such purposes. I expressly release and indemnify the Pennsylvania Conference and its assigns from all liability in connection with such uses.

I have read this release and am fully familiar with its contents.
Consent (if applicable): I am the parent and/or guardian of the minor(s) named below and have the legal authority to execute the above release. I approve the foregoing and waive any rights in the premises.
Date

MonthDayYear
Date
Signature
Name

First NameLast Name
Should be Empty:

Camper Information:

CAMP EPIC 2026 Registration Form

Parent Guardian Information:

Person Authorized to pickup:

If necessary, please specify individuals who are not permitted to pick up your child:

FIELD TRIP INFORMATION

MEDICAL INFORMATION

PERMISSIONS FOR MEDICAL TREATMENT

Medical contact information:

EPIC CAMP 2026 WAIVERS

1. Insurance

2. Liability

3.Technology

4. Emergency

Image Release Form 2026