Elements of Faith Spring Escape Registration
We are so excited to have you join us May 17-19, 2024 for Spring Escape at Camp Lawroweld!
Full Name of Adventurer
First Name
Last Name
Full Name of Pathfinder
First Name
Last Name
Full Name of Parent/Guardian
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Lodging at Camp Lawroweld
*
I need lodging while at Spring Escape
I plan on bringing a camper to Spring Escape
I plan on bringing a tent to Spring Escape
I plan on camping in the Pathfinder Campground at Spring Escape (Pathfinder Volunteers Only)
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Adventurer Club - Photo Release Form
The Northern New England Conference and the leaders of its Adventurer Club have my permission to use my or my child’s photograph publicly to promote Adventurers. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.
If you choose not to let the conference use your photos you will need to ensure that your child is not in any Adventurer group photos and they/you will need to wear a red band though out the weekend to alert photographers not to photograph them. Please ask for your red band at the registration booth.
*
You MAY use our Photos
You May NOT use our photos
Other
Signature
*
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Emergency Medical Information
Date of last Tetanus booster
Medication allergies
Do you carry an Epi-Pen in case of an anaphylactic reaction
Yes
No
Other
Medication currently taken
Physician's Name
Physician's Phone Number
-
Area Code
Phone Number
Insurance?
Yes
No
Insurance Company Name/ID
Consent to Treat and Hold Harmless
I (we) the undersigned parent, parents, or legal guardian of the above named child, understand that I am expected to be at ALL Adventure meetings and events. However, if I am unable to be located and emergency treatment is needed, I (we) give permission for adult leaders or volunteers to administer emergency treatment, contact emergency personnel, and act in my stead in approving necessary medical care until I can reasonably be contacted. I understand that should any medical bills be incurred, our family’s insurance(s) will be primary. I further, on behalf of myself, my spouse, next of kin, executors, heirs, assigns, or anyone else who might claim or sue on my or my child’s behalf, fully release and agree to hold harmless the Northern New England Conference of Seventh-day Adventists its affiliated entities, and any of its agents, employees, and /or volunteers from any and all liability, including but not limited to any claims, losses, or liabilities due to death, personal injury, disability, property damage, medical expenses, and/or theft, that may arise from or relate to my child’s participation in the Adventure Club and any and all activities.
Signature
*
Name of your club
*
Special Dietary Restrictions/Allergies - Please note that all food will be Vegetarian. Portions for diet restrictions will be based on these numbers, so please be accurate. No changes will be able to be made once we are at camp.
*
No Dietary Restrictions
Vegan
Gluten Free
Other
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