KB Christian Summer Camp 2019
Campers Registration form
Email address *
Name: Parent or Guardian *
Your answer
Address: *
Your answer
Phone: *
Your answer
No. Children *
Your answer
List the children Full Name, age, shirt & shoe size: *
Your answer
DOB of each child *
Your answer
Primary Emergency Contact *
Your answer
Can your child swim *
List any allergies or medical conditions *
Your answer
Liability Release Statement: I do not hold anyone connected with this activity, responsible if any misfortune should occur. I understand and support the fact that my son/daughter must comply with all directions and instructions given, by the camp staff to the group involved in this activity. I acknowledge that participation in this activity involves inherent risks of injury to my child including risks associated with transportation by motor vehicle. I release, Kingdom Builders/ KB Ranch staff from all claims and liability for any injury or damage that the child may have due to participation in the various events throughout the duration of the camp, including foreseen and unseen risks.
Type your name below, to represent your signature *
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A copy of your responses will be emailed to the address you provided.
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