Registration and Release Form
Teen Camp | June 18-22, 2018

This form must be completed by the camper's parent or legal guardian. One form should be completed for each camper.

Payments can be made at www.lbcignite.com/teencamp.

Email address *
Camper Registration Information
Teen's First & Last Name *
Your answer
Grade (in the fall) *
Roommate Request (We will do our best to accommodate requests submitted by May 27 for friends in the same grade.)
Your answer
Who Can We Contact if We Have Questions about Your Registration?
Name *
Your answer
Phone *
Your answer
Phone Type *
Release of Liability
In case of an emergency, I hereby give permission to the physician selected by the Lancaster Baptist Church Youth Leader to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child as named above. It is understood that the church and doctor will make every effort to contact the parent/guardian of the child before treatment. I hereby release Lancaster Baptist Church of all liability.
Parent or Guardian "Signature" *
Your answer
Date *
MM
/
DD
/
YYYY
Thousand Pines Registration & Health Form Required
Please take a moment to complete the online registration and health form for Thousand Pines at app.campdoc.com/register/tpcc/lb618. Please note your registration is not complete until both LBC and Thousand Pines forms have been submitted. (IMPORTANT: If you click the link above, don't forget to return to this form and hit submit before you close your browser!)
Have you complete the Thousand Pines health form? *
A copy of your responses will be emailed to the address you provided.
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