Monarch Summer Youth Camp Registration
Please utilize this form to register for Monarch Summer Break Youth Camp

Spring Break Youth Space Camp
June 17th - June 28th
9:00 AM - 1:00 PM
St. Paul A.M.E. Church
1554 Gears Road
Houston, Texas 77067


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Email *
Student Name *
Grade *
Guardian Full Name *
Guardian E-mail Address *
Guardian Phone Number *
Emergency Person Name *
Emergency Person Phone *
Does your child have a food allergy? *
Please describe.  If no, write N/A. *
PHOTO and VIDEO RELEASE:
I grant permission to Monarch Academy and invested parties to photograph and or video my child(ren) during activities and use them in video and/or printed materials. Videos may be posted on social media platforms, all invested parties' organizations website to utilize for the organizations educational marketing purposes. 
Below type: Yes. I,(Name of Guardian) grant permission or No, I, ( Name of Guardian) do not grant permission.
*
VOLUNTARY WAIVER and RELEASE:
There are risks connected with my child's participation in this event and its related activities Injury to their person or damage or loss of their personal property is a possibility.  Further, I VOLUNTARILY RELEASE AND DISCHARGE, Monarch Academy and interested parties i.e.  Donald Burgs Ministries, Inc., Tabernacle Baptist Church, Studio 15 and all other directors, workers, and volunteers from all actions, lawsuits, demands, and claims of whatever nature in law, or equity from all injuries suffered by me while participating in this event of its related activities  and further from the loss of damage of personal property by theft, negligence, or otherwise. 

Below Type: I, (Guardian Name) acknowledge the possibility of all risks and voluntarily release and discharge all invested parties listed above in this statement.
*
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