Summer Camp Registration
January 11th-15th 2027
CAMPER INFORMATION:
Camper's Name
*
First Name
Last Name
Parent's / Guardian's Name
First Name
Last Name
Contact Number
*
E-mail
*
Male/ Female
*
Male
Female
Camper's Age
*
Church that you will be attending camp with
*
Please Select
Clarence Valley Baptist Church
Lismore Bible Church
Coffs Harbour Bible Church
Harvest Bible Church
Goondiwindi Family Church
Bethshan Bible Church
Condell Park Bible Church
Springwood Baptist Church
Bonville Bible Church
Southern Cross Baptist Church
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Medical Release Indemity Statement
I the undersigned, being (Age 18 or over/parent or guardian of ________________________ hereby authorise the camp leaders and authorities, or any person delegated by them, to obtain in the case of accident or illness, any medical aid, authorise medical treatment, and/or authorise the doctor so engaged to prescribe any drugs, anaesthetic, or medication considered necessary. I will assume all responsibility for all costs and expenses with such treatment. I release the organising churches, camp leaders and authorities, or any person delegated by them from all liability arising from any such illness or injury, and I hereby indemnify such organising churches, leaders and authorities against all claims which may be made against them in exercising this authority.”
Medical Information
Allergies
Signed
*
I agree to the terms of the above medical realease
Please note all registrations are subject to the approval of your local church.
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