Sports Fun Camp 2019 Registration
Thank you for your interest in Sports Fun Camp presented by The Church at Pecan Creek, June 10-13, 2019. For information about the church please visit our website www.TheChurchAtPecanCreek.com.

Please note that you MUST complete a form for EACH child that will attend.

Medical & Activity Release
My child has my permission to engage in prescribed activities, except as noted by me. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by an adult leader in charge, to medical treatment that may be deemed necessary by a physician to ensure the well being of the above-named participant, due to sickness or accident while attending activities of The Church At Pecan Creek. I also authorize adult sponsors to transport my child at their discretion in the case of an emergency.

We represent to you that we and the participant hold The Church At Pecan Creek, its agents, employees, and representative harmless from all liability arising from the conduct of the participant and agree to defend and indemnify The Church At Pecan Creek, its agents, employees, and representatives against any claim or liability arising as a result of such conduct.

Media Consent: I give my consent and permission for the taking of photographs and/or video of me (or my child) during the described event and waive and/or assign any and all rights (including copyright) in such media to The Church At Pecan Creek, as the sole owner of such media, shall have the exclusive right to control and determine the use, display, performance, reproduction, and dissemination of any such photographs and/or videos. Photos will be used daily to recap the day in a video for the kids to watch.

Parent/Legal Guardian Authorization *
Parent/Legal Guardian Name *
Your answer
Today's Date *
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Child's Name *
Your answer
Child's Date of Birth *
Double check the year!
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Child's sex *
Child's shirt size *
2018-2019 School Grade *
Select the grade your that your child COMPLETED in the 2018-2019 school year
School Attended *
Your answer
Home Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parent/Guardian's Contact Phone Number 1 *
Your answer
Parent/Guardian's Contact Phone Number 2
Only needed if you have a second phone number we should attempt to reach you at, such as a work number.
Your answer
Parent/Guardian's Name *
Your answer
Relationship to Child *
Your answer
Parent/Guardian's Email Address *
Your answer
Emergency Contact Name *
Please provide an emergency contact other than yourself.
Your answer
Emergency Contact Phone Number *
Please provide the best phone number to reach the emergency contact.
Your answer
Any medical concerns we need to know about?
Your answer
Any severe food allergies we need to know about?
While we do our best to be allergy friendly, if your child has a severe allergy it might be best to provide a snack for them.
Your answer
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