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English (US)
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Guest/Camper Name*
*
First Name
Last Name
Activity Waiver
Camp activities include strenuous outdoor activities and out of camp travel in camp vehicles. As with most activities in life, there is an inherent risk in participating in these activities. By signing below you are indicating that you understand the risk involved in camp activities and you are willing to participate in all activities. All activities are well supervised with an emphasis on safety. IT IS MANDATORY THAT THIS FORM IS FILLED OUT, SIGNED, DATED, AND RETURNED BY YOU. A copy of this form will be emailed to you upon completion.
Email
*
example@example.com
Event Start Date*
*
-
Month
-
Day
Year
Date of Arrival
End Date of Event*
*
-
Month
-
Day
Year
Date
Name of Group*
*
What is the name of the church, school, or organization with whom you are coming
Group Name
Please Select
Calvary BC Red Bank
LifePoint
Other
Which Waiver is this for?
*
Adult (aged 21 or older)
Minor (aged 20 or younger)
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Activity Waiver - Adult
Contact Information
For Adults aged 21 or older
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Emergency Contact
*
First Name
Last Name
Emergency Phone
*
-
Area Code
Phone Number
Name of Group
*
What is the name of church, organization, or school group with whom you are coming?
Start Date of Event
*
-
Month
-
Day
Year
Date
Legal Name
*
First Name
Last Name
Signature
*
Date of Signature
*
-
Month
-
Day
Year
Date
Submit
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Next
Activity Waiver - Camper
Contact Information
Camper Birthdate
*
-
Month
-
Day
Year
Date
Camper Age
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Phone
*
-
Area Code
Phone Number
Camper Health Information
To be completed by Parent or Guardian
Activity Restrictions
List, if any, activity restrictions.
Emergency Contact 1
*
First Name
Last Name
Emergency Phone 1
*
-
Area Code
Phone Number
Name of Group
*
What is the name of church, organization, or school group with whom camper is coming?
Start Date of Event
*
-
Month
-
Day
Year
Date
End Date of Event
*
-
Month
-
Day
Year
Date
Parent/Legal Guardian Name 1
*
First Name
Last Name
Signature 1
*
Parent/Legal Guardian Name 2
*
First Name
Last Name
Signature 2
*
Submit
Should be Empty: