Camp Creekside VBS 2018 Registration Form

Gender*

We do our best to honor friend requests, but no guarantees.

Parent/Guardian Information

Do you have a Home Church?*

Health/Medical Information

(Must be reachable during the hours of camp)

Are there any conditions that might hinder your student from participating in any activities?

Parent/Guardian Permission

The Medical Release and Parent/Guardian Permission slip is good for the period of July 1, 2018 until July 1, 2019.

has my permission to participate at Camp Creekside VBS being held at Creekside Community Church in Alamo.  I/we being the parent(s) or legal guardian(s) of child named above 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 activity.  We, on behalf of our child-participant, assume all risk of personal injury, damage, and expense as a 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 for him/her to participate fully in the activity.  We give our permission to take said participant to a doctor or a hospital and authorize medical treatment, including but not 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 camp 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 filling out the below fields and checking off the box that you accept these terms, you are hereby giving your "signature" and parent/guardian permission.

 

I agree to the terms listed above in this medical release form.*

Please check here to indicate your approval for your child's photo to be used in future Creekside publications.