Day Camp 2018 Registration Form

 
 

AUGUST 13-17

from 8:45am to 4:30pm

Early drop off and late pick up is available.

Printable Registration form here.

Information
Name of Child *
Name of Child
Date of Birth *
Date of Birth
Address *
Address
Home
Home
Parent or Guardian 1 *
Parent or Guardian 1
Cell 1
Cell 1
Parent of Guardian 2
Parent of Guardian 2
Cell 2
Cell 2
Please add the name(s) of adults authorized by the parent/guardian to pickup child.
Emergency Contact *
Emergency Contact
Emergency Contact *
Emergency Contact
Do you have a church home? *
Please be specific and request a form if medications are being left onsite with the child. If none, please say NONE.
T-shirt size
Please select one
PHOTO RELEASE *
I give permission for me and my child's picture or any photographic/video footage to be used for identification for security or in other Evangel promotional materials. By checking "YES" I acknowledge that these photographs will be stored on Evangel hard drives for these purposes.
WAIVER *
While every precaution is taken for safety and good health for our children by ensuring good ratios of leaders to campers and carefully planning games and activities, some sports and activities carry with them the inherent risk of personal injury (beyond the risk associated with many of the recreational activities at Evangel). I understand and accept these risks and agree that by allowing my child to participate in camp, my child may be taking part in a recreational activity that presents the potential for personal injury. I undertake and agree to indemnify and hold blameless Evangel, its personnel, its leaders and Board of Directors from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Evangel, as well as any medical treatments authorized by the supervising individuals representing Evangel. By checking "YES" I understand and agree with the above information.
Fees are $50 for the first child, and $40 for each subsequent child. Payment can be made at the church office at your earliest convenience.