CAMPS 2018
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| Title
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| Pick a fun title to be listed as!
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| First Name
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| Last Name
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| Address
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| City
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| State
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| Zip Code
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| Parent Email
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| Confirm
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| Camper Email
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| Confirm
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| Phone Number
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| Grade Just Completed
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| 8th 9th 10th 11th 12th As of June 2018
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| Gender
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| Male Female
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| Do you need bus tranportation?
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| Yes No Note: Busses are first come, first serve so please indicate 1st/2nd choice for bus locations.
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| 1st choice
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| 2nd choice
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| Do you have any dietary restrictions?
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| No Yes
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| If yes, please explain
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Consent and release form
(sign below)
I hereby give permission to my son/daughter _____________________________(sign below) to join in and participate in the events and activities that will be sponsored by CAMPS. I further agree that the sponsoring churches and Lakeside, their servants, agents, and employees shall be held harmless from and indemnified against any liability, costs, claims, loss or damage which it or they may incur as a result of any accident or injury to my child. Permission is also hereby given for any medical treatment which may be necessary or reasonable in the event such an accident or injury occurs or in the event that any illness manifests itself.
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| Son/Daughter Name
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| Parent/Guardian Signature
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Image Policy
Your attendance at CAMPS 2019 implies permission for CAMPS to reproduce your image,likeness and voice during the week of CAMPS and post CAMPS publicity.
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| Name of Insurance
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| Address of Insurance Company
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| Tel#
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| Policy Holder's Name
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| Policy Number
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| Emergency Contact Name
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| Phone Number
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Refund Policy
CAMPS will not issue refunds after July 10th for any reason or circumstance. As parent/guardian and/or camper I accept the terms of the refund policy and sign below. Payment in full is due by July 10th.
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| I agree to the terms
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| I agree
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Image Verification
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