Summer Camp Registration Form

WHICH CAMP ARE YOU REGISTERING FOR?

Quest Week

Rock at the Point

Camper's Name *

First Name

Last Name

Parent's Name *

First Name

Last Name

Parent's Cell Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Camper's Date of Birth *

MM

DD

YYYY

Liability Release Form *

I, in consideration of the benefits derived from my participation, or the participation of my minor child in Musical Theater Camp administratively organized by Grace First Presbyterian Church, do hereby voluntarily release, quit and forever discharge Grace First Presbyterian Church and its officers, employees, and agents, from all manners of suits, actions, claims, demands and liabilities which may arise from my participation in this event. I recognize that the conditions in some of the place to which I will travel are not of the same standards as the conditions to which I am accustomed. I realize further that there are certain health risks as well as other risks to me and my property, and I enter into participation in the trip with the knowledge of those risks. I understand that this document constitutes a full and complete waiver of all possible claims, including claims for negligence in personal and property damages arising out of my participation of this event. No Provision of this document shall, in any way, limit my right to make claims against persons other than Grace First Presbyterian Church, its officers, employees, and agents.

I Agree

Consent for Medical Care *

By checking this box, (I/We), the undersigned , parent/guardian of (If under 18), a minor, do hereby authorize the persons presenting this form to call a physician and to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable for (my/our) child. It is understood that a conscientious effort must be made to notify (me/us) before such action is taken. It is further understood that we release the person presenting this form from all liabilities connected with the transportation, diagnosis treatment, hospital care, and expenses necessary for the treatment of (my/our) child. This authorization is given pursuant to the provisions of section 25.8 of the Civil Code of California.

I Agree

Emergency Contact If Parent Cannot Be Reached *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

T-shirt Size *

Child S

Child M

Child L

Adult S

Adult M

Adult L

Adult XL

Adult XXL