Camper Registration Form(ONE FORM PER CAMPER) Camper First Name * Camper Last Name * Age * As of July 2024 Grade (Fall 2024) * PreK (3's, 4's & young 5's/potty trained) Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Name Of buddy/buddies your child would like to be placed with. Maximum of 2 Names. First and last name, please. Youth T Shirt Size * Please select from the menu below XS S M L Are There Any Allergies We Should Know About? Parent / Guardian Name * First Name Last Name Email * Parent / Guardian Phone * Must be reachable during camp hours (###) ### #### Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Any Additional Comments To The Director WAIVER In consideration for being accepted by Creekside Community Church for participation in Camp Creekside VBS 2022 I/we, being the parent(s) or legal guardian(s) of said child on reverse side do release and agree to hold harmless Creekside Community Church and the director thereof from any and all liability, claims, or demands for personal injury, as well as damage and expenses, of any nature that may be incurred by the parent/guardian and child-participant that occur while the child is participating in the above described trip or activity. We, on behalf of our child-participant, assume all risk of personal injury, damage and expense as the result of participation in recreational activities involved. Authorization and permission are given to said church to furnish any necessary transportation, food and lodging for our child-participant. We, as parents/legal guardians of the child-participant, give our permission fpr him/her to participate fully in the trip/activity. We give our permission to take said participant to a doctor or a hospital and authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any. We understand that we will be contacted if at all possible and that our family physician will be contacted if possible, but in the event that he/she cannot be reached, the trip leader may choose a reputable physician. Should it be necessary for the participant to return home due to medical reasons, disciplinary action, or otherwise, we assume all transportation costs. By Checking This Box, you confirm that you have read and agree to the waiver. * I Agree Thank you!If you have multiple campers to register please do that prior to paying.Click HERE for payment page.VBS can always use the help, check our Amazon Wish List HERE.
