Kids Camp 2025: August 4th-7th

Parent/Guardian Name

This address will receive a confirmation email

Phone

Address

Please List All Children Attending Camp (Age, grade, gender):

Please List Any Medical Needs, allergies, etc:

You have my persmission to administer: benadryl, anti itch cream, medications, etc. while my child is at camp. Please Select Yes or No

YES NO

You have my permission to take and use photos/videos of my child and use them without identification.

YES NO

I understand and acknowledge the possibility of injury during events at CLF. I fully accept this risk and hold harmless from any legal liability, Christian Life Fellowship church and persons involved in this ministry. In the case of an emergency that requires medical treatment for my child/children, I understand every effort will be made to contact me. If I cannot be reached I give my permission to the CLF staff and volunteers to secure the services of medical professionals to provide the care necessary for my child's well being. I assume all responsibility of costs connected to treatment of my child. *Please submit a (YES) in the box below confirming your agreement to these terms.

Insurance Provider & Policy Number

Payment Options:

Sign and Date

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Kids Camp 2025: August 4th-7th

Description

Please Fix the Following