Friendship VBS Sports Camp 2016
Camper registration and release form. Please fill out a form for each child attending camp.
Thank you. Camp shirt reserved for on-line registrations prior to 7/19/16.
Camper Last Name *
Your answer
Camper First Name *
Your answer
Camper Age *
Your answer
Camper Date of Birth *
MM
/
DD
/
YYYY
Camper Gender *
Required
Camper T-Shirt Size *
Camper's school next year
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Home Address (ex. 111 Noname st.) *
Your answer
City *
Your answer
Zip Code *
Your answer
Parent/Guardian Phone (xxx-xxx-xxxx) *
Your answer
Parent/Guardian Email *
Your answer
Church (optional)
if regularly attending
Your answer
Liability Release: I, the undersigned parent or guardian, do hereby grant my permission for my child to attend the Friendship Creekside VBS Sports Camp and fully participate in all activities thereof. In order that my child may receive the necessary medical treatment in the event of an injury or illness, I hereby authorize Friendship Creekside VBS Sports Camp to obtain medical treatment for my child for such an injury or illness during camp, and I hereby release and agree to hold harmless Friendship Creekside VBS Sports Camp, its agents, employees, and representatives from any and all claims and liability arising in anyway out of their exercise of this authority. I understand and agree that all bill for medical care and treatment will be forwarded to me or my insurance company, and that it will be my responsibility to see that such bills are paid. I further acknowledge, understand and agree that in participating in this camp, there is a possibility of physical illness or injury and that my child is assuming the risk of such injury by his/her participation. Parent/Guardian signature is required. *
Your answer
Photography/Media release: I consent to the use of my child's image in print, online, video and other media-related materials. No names of individual children will be released with photos or images. (example is highlight video shared at sports camp) *
Required
General Health: Please select any medical conditions concerning your child. *
Required
Yes to above question? Please describe. Be specific.
Your answer
Volunteer opportunities and service hours are available. Let us know if you or a middle or high school student would like to volunteer and receive service hours.
List names (first and last). If student, please provide age.
Your answer
Are you interested in giving toward our VBS Sports Camp? If so, select the amount you are willing to give.
Your gift helps with t-shirts, prizes and awards for our campers. Thank you!
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