Baking Adventures (July 13-17)
summer camp registration
Email address *
Student Name *
Your answer
Student Age *
Your answer
Parent/Guardian #1 Name *
Your answer
Telephone #1 *
Your answer
Parent/Guardian #2 Name *
Your answer
Telephone #2 *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
zip code *
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special needs/requests
Your answer
I am aware that while participating in activities and functions offered by Lisa Smith’s Summer Camp certain risks and dangers may occur. In consideration of this, I have and do hereby assume all risks and hold harmless Lisa Smith, the counselors and the Land of the Sky Church from any and all liability, actions, causes of actions, debts, claims and demand of every kind and nature whatsoever which I now have, or which may arise from my participation in functions offered by Lisa Smith. I have read the above release and agree to the above release and assumptions of risk. *
Required
I give permission for public media (e.g. radio, newspaper, local TV) to photograph, video tape or talk with my child (with the possible use of the photo, video or quote). I give Lisa Smith and the camp counselors permission to photograph, video tape or quote my child for any external publication or website use. I agree to allow Lisa Smith to show or upload a movie made by or including my child. *
Required
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