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Student fall retreat 2023

At green country camp

For Students who
are in 6th-12th Grades

October 20-22

$60


$65 after october 14

 

Parent-Camper meeting October 18 @ 6:30 p.m.

FOr more info on student camp, download the camp packeT here.
Register below!

After completing this form, please follow the link to finalize payment and registration (please select 'Students Camp' fund on payment page). Thank you!

CAMPER INFORMATION

PARENT/Guardian INFORMATION

Primary EMERGENCY CONTACT

Secondary EMERGENCY CONTACT

I understand and agree to the following: If you are sick, have been sick in the last 2 weeks, or have been around someone who was sick over the last 2 weeks, please stay home. At camp, we will encourage hand washing after completing activities and before and after eating. 

INSURANCE INFORMATION

CURRENT MEDICATIONS

Camper Medical History (If camper is subject to any of these please check them to let us know.)

Are you sending medication to camp? If so, please send in the original bottle with the printed label.*

I would like to be contacted before any medication is given to my child (e.g., Tylenol, Ibuprofen, Pepcid, Tums, or Benadryl).

I hereby give this church permission to give over-the-counter medication to my child. These may include, but is not limited to, Tylenol, Ibuprofen, Pepcid, Tums, or Benadryl.

Does the camper have CDIB?

As the participant, parent and/or guardian (if under 18 years of age) of said member, I hereby acknowledge that he/she is presently under my care, custody and control. In the event there arises any emergency needing medical attention, I hereby consent and give my permission to Foundation Church, or its representatives, or any attending physicians, to make such decisions and to perform such medical treatment, which may in their sole discretion be necessary and proper under the circumstances. As the participant, parent and/or guardian of said member, I hereby do release, acquit, discharge to hold harmless Foundation Church or its representatives or any attending physician from any and all actions, damages, or liabilities arising out of the treatment of any sickness or accident incurred by above said participant during time away while on any church activities. *

Primary Care Physician

MEDIA RIGHTS

I expressly understand and acknowledge that during the course of the camp photographs and/or video footage of my child may be taken, and I hereby give permission for such photographs or videos to be used on the church website, in service, and/or Facebook Page.

I understand that by typing in my full legal name and date, I am signing this form for Foundation Church and registering my child for camp.

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