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Registration for Kids Camp Agape 2018
***If you are registering more than one child, please submit SEPARATE for each of them.***

Please input your email address below to receive a copy of this registration.
How many kids are you registering for this camp (from the same household?) *
Required
Campers First name *
Campers' Last Name *
Age of Camper *
01.01.2011 *
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T-shirt size for camper *
Name of the Parent or Legal Guardian *
Home Address (full, with zip code) *
Cell Phone Number *
Email address *
Emergency Contact Name (Other than parent/legal guardian) *
Emergency Contact's relationship to child *
Emergency contact's phone number *
Is your child allergic to any types of medicine? If yes, please specify *
Is your child allergic to any types of food or plants? If yes, please specify *
Does your child have any type of disease or illness? If yes, please specify *
If your child gets a headache or a stomachache, which medicine should be given? Tylenol, ibuprofen etc. Please specify. *
Did your child have any type of surgery that would prohibit him/her from physical activities? If yes, please specify the type of surgery and the date. *
Has your child broken any bones in the past? If yes, please specify, and add month/year. *
Any additional information about the health of your child that we may need to know
Parent/Guardian who, when picking up the child, will sign off on the check out from each day (full name) *
Phone number of the parent/guardian responsible for dropping off/picking up camper. *
If a different parent/guardian also has permission to sign off camper (please give name and number)
Felicita County Park Address: 742 Clarence Lane, Escondido, CA. 92029                                                                
Name of the person filling out this form (has to be one of the parents). *
Camper’s behavior and discipline: *
Please make sure your child is aware of the following aspects on how he/she needs to behave at Camp AGAPE: - respect and obey all camp staff - respect all other campers - be present at all camp meetings, games, and activities - keep the park grounds clean - never go anywhere without asking for permission from staff and receiving that permission. The following disciplinary steps will be implemented: 1)Warning. 2)Meeting with Camp Director  3) Phone call to the parents of the camper & sending the camper home.
Required
Disclaimer about clothes *
No flip-flops, please have sneakers (running shoes, close toed, with a strap on back). As for boys and girls appropriate clothe to be knee high (shorts or skirts to be knee high). Have a hat and put sunscreen on before camp, extra sunscreen will be provided. Please write the child's name on the tag of any jacket.
Required
Disclaimer about electronic devices *
Cell phones and other electronics are discouraged from all use at Camp AGAPE to help each person to: •focus on the themes from the Bible •build stronger friendships with other campers. Slavic Evangelical Church and all participating staff at Camp Agape are hereby released from any damage or loss that any of the children’s or participant’s devices might have.
Required
General Disclaimer *
I on behalf of myself and my child I do hereby release the Slavic Evangelical Church of San Diego and its staff from all claims and causes of action by reason of any injury which may be sustained as a result of these church activities on the campground premises. I agree to direct my child to cooperate and to conform to directions and instructions of personnel of the Camp Agape organization who are in charge of these activities. Should my child not do so, and should those leading an activity believe it necessary, the child will be released from the activity as soon as possible after being called by a staff representative for that purpose. I hereby give my permission to the physician, nurse, selected by Slavic Evangelical Church of San Diego to give medical aid as required for illness or injury. Parents are not required to attend but are encouraged to attend to help. This is a registration form only (please fill out one registration for per EACH child). Please make your payments for this child and if you are signing up any additional children at https://www.eventbrite.com/e/christian-english-russian-childrens-summer-day-camp-2018-tickets-36247596537
Required
Is this your child's first year visiting Agape Kids Camp? *
How did you find out about this camp? *
Are you inviting your friend to join this camp for the first time? IF YES, what is their first and last name?
You will receive a special prize from the camp staff when you and your friend will arrive to camp on the first day.
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