Register for Backpack Weekend
Ready to register? Fill out the form below! (wwbc v2)
Sign in to Google to save your progress. Learn more
Which event(s) would you like to register for?
 *
Required
Camper's Full Name
 *
Camper's Gender
 *
Camper's date of birth
 *
MM
/
DD
/
YYYY
Age as of Event *
Email Address
 *
Street Address
 *
Apartment/Suite/etc.
City
 *
State/Province
 *
ZIP/Postal Code
 *
Phone
 *
Parent/Guardian Name
 *
Emergency Contact Name
 *
Emergency Contact Phone
 *
Relationship of Emergency Contact
 *
Pickup Person
 *
Church
 *
Date of Last Tetanus Shot
 *
MM
/
DD
/
YYYY
Do you have insurance?
 *
Are you current on immunizations?
 *
Please list any dietary needs you have
 *
Please list any allergies you have
 *
Please list any medications you take
 *
Do you have or experience any of the following: Sleepwalking, fainting, epilepsy, diabetes or asthma *
Please list any other pre-existing medical conditions that you have below
 *
Do you have any other important information to share?
*
How do you plan to pay?
 *
Permission Statement - By completing and submitting this form, I GIVE PERMISSION for Whispering Winds Bible Camp (WWBC) to secure medical treatment for the participant in case of illness or accident. I GIVE PERMISSION for my child to participate in all activities, at WWBC's Super Saturday Event. I ACKNOWLEDGE AND ACCEPT the risks involved in camp activities. I ACCEPT personal financial responsibility for any bodily injury sustained while my child is at WWBC's Super Saturday Event. Furthermore, I PROMISE to hold harmless WWBC and its representatives for any injury related to Super Saturday. I GIVE PERMSSION for my child to attend Super Saturday and receive the Bible-based instruction provided. I GIVE PERMISSION to use pictures including the participant in organizational publicity. * *
Type name as your signature - have a parent or guardian sign if you are under 18
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms