Camp 2019 Registration/Waiver Form

Address *

Parent/Guardian Name #1 *

First Name Last Name
Parent/Guardian E-mail #1 *
Parent/Guardian Phone Number #1 *

Area Code Phone Number
Parent/Guardian Name #2

First Name Last Name
Parent/Guardian E-mail #2
example@example.com
Parent/Guardian Phone Number #2

Area Code Phone Number
Signed Release/Waiver

As the parent/legal guardian of above mentioned minor, I give permission for my son/daughter to participate in above mentioned camp. In the event of an emergency where medical treatment is required, I give permission to the YFC Camp staff or CIYFC staff to obtain the services of a licensed physician. Please attempt to notify me immediately. In consideration of the minor's participation in the YFC Camp event, I agree to release, indemnify and hold harmless Youth for Christ/Campus Life/City Life, its employees and agents, contracted or otherwise, from any liability, diseases, or damages resulting from said participation.
Signature (hold down cursor to sign) *

Clear
Signed Picture Release

I give persmission for any pictures involving my above mentioned child taken at above mentioned camp for possible use on the YFC website and/or other promotional publications.
Signature (hold down cursor to sign)

Clear

Student Registration Form