VBS Camper Registration | The Freedom Center Church

Camp Choice*

Cheer (Girls only 1st - 6th Grade)
Soccer (Boys/Girls 1st - 6th Grade)
Basketball (Boys/Girls ages 3rd - 6th Grade)

Shirt Size*

Child Name*

First Last

Age*

Bring Your Own Ball?*

Yes
No

Gender*

Male
Female

Grade*

Birth Date*

Parent/Guardian Name*

First Last

Relationship to Child*

Email*

Authorized Adult Pickup (other than Parent/Guardian)*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Emergency Name*

First Last

Emergency Phone*

Allergies / Health Issues: (If none, list NA)*

Special Requests: (If none, list NA)*

Consent*

I agree to the: Medical and Liability Release

(PLEASE READ CAREFULLY)

We realize that no activity is without the possibility of unforeseen hazards which could result in injury or sickness to an individual.
As a parent or guardian, you are to be aware of your responsibility to instruct your child of the importance of conduct that will ensure safety and an enjoyable time while participating in this activity.
Although we are coming out of the COVID-19 pandemic, we are taking to sanitation steps to ensure a clean playing environment, but there is always the chance that in a group of people, COVID-19 exposure may happen. You also acknowledge the contagious nature of COVID-19 and that your child(ren) may be exposed to or infected by COVID-19 by participating in our Mega Sports Camp and that such exposure or infection may result in personal injury, illness, permanent disability, and death.
By signing this form, you, as a parent/guardian or other responsible party, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss or injuries to the child for whom you sign.

I further give my permission for the use of any photo or likeness of my child to be used by the sponsoring organizations for their use in promotional materials.

I give my child permission to participate in this activity, and give my permission to the leaders of this function to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity.

Signature*

Glad you can join us!