Parker UMC Camp
Name of Participant *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Which session are you attending? *
Camp T-shirt Size *
Does your child have any allergies or medical conditions that staff should be aware of? *
If yes, please list information regarding allergies and/or medical conditions about your daughter of which staff/volunteers should be aware.
Your answer
Mailing Address *
Your answer
Email Address *
Your answer
Parent/Guardian Name *
Your answer
Phone Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Insurance Company *
Your answer
Policy Number *
Your answer
In an emergency, I grant permission for emergency medical treatment to be administered.
I give permission for my child to be photographed and for such photographs to be released for publicity purposes.
Electronic Signature of Parent/Guardian *
My child has permission to participate in the V4C volleyball camp. I release Volley for Christ and its staff and volunteers from responsibility for any bills resulting from injuries incurred in this program. While no sports physical is required for my child to participate, I understand that my child should be in good physical condition and that current medical exam is strongly recommended. I have listed information regarding allergies and/or medical conditions about my child of which staff/volunteers should be aware.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service