GracePoint Student Camp '18
WHEN: July 8th-12th, 2018
How Much: $350 (includes $95 deposit, due 3/1)
CONTACT: Phillip Whitfield -
Student Name *
Your answer
Student Grade *
Shirt Size (all adult sizes) *
Parent/Legal Guardian Name *
Your answer
Parent/Legal Guardian Phone *
Your answer
Parent/Legal Guardian Email *
Your answer
I would like my phone number/email to be added to the Camp 2018 Remind 101 Notification Account *
Address (mailing) *
Your answer
Insurance Provider *
Your answer
Insurance Policy Number *
Your answer
I give permission for my child to attend the GracePoint Church Portland Student Ministry Events.I understand that personal injury can and may occur to my child, and I hereby authorize Phillip Whitfield, or another appointed youth advisor, to seek and consent to emergency medical attention for my child as needed; and I further agree to be liable for and to pay all costs incurred in connection with such medical attention. I hereby release GracePoint Church Portland, its employees, agents and volunteers, from any and all liability, claims, demands, causes of action and possible causes of action whatsoever arising out of or related to any loss, damage or injury (including death) that may be sustained by my child while participating in or traveling to and from events. *
I give permission for my child to ride in any vehicle designated by GracePoint Church Portland, its employees and adult volunteers, while participating in and traveling to and from any events.I agree to accept full responsibility, financially or otherwise, for any damage my child may do to the property of GracePoint Church Portland, properties visited on outing, other’s personal property, or vehicles used for transportation.I agree and consent to all of the above stated. *
Community Standards - In accordance with the GracePoint Church behavioral policy, the following behavior will not be tolerated at any GracePoint Church Portland youth gathering. Violation of these standards, or being knowingly in the presence of others violating these standards, can and will result in consequences deemed appropriate by the student pastor, staff, and advisors of GracePoint Church Portland, including, but not limited to, being sent home immediately at the participant’s expense. *Possession or use of alcohol, tobacco, or illegal drugs, possession or use of weapons, including pocket knives, firearms, and fireworks, and egregious and repetitive disrespect to fellow students and/or adult sponsors, and inappropriate sexual behavior. *
Dietary restrictions *
I understand that I will have to pay a $95 by May 6th, 2018 *
Parent Signature (type name if online) *
Your answer
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