Faith Quest Summer Camp 2024

Contact Information of Parent or Legal Guardian

Name

This address will receive a confirmation email

Phone

Address

Relationship to child (parent, grandparent, etc.)

Insurance Information (for emergency purposes)

Insurance Company

Insurance ID Number

Name of primary Insurance holder

Emergency Contacts

Please provide two people that we can contact in case of an emergency.

Name of First Contact

Phone

Relationship to child

Name of Second Contact

Phone

Relationship to child

Child 1 Information

Name of Child 1 (please include last name if different from above)

Date of Birth

Gender

Male Female

Grade entering in the Fall

Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

T-Shirt Size

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large

Allergies, Special Needs, or Concerns: Please let us know how we can best minister to your child. Include any food allergies, calming strategies, or other suggestions.

Child 2 Information

Name of Child 2

Date of Birth

Gender Male Female

Grade entering in the Fall Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

T-Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large

Please list any Allergies, Special Needs or Concerns.

Child 3 Information

Name of Child 3

Date of Birth

Gender Male Female

Grade entering in Fall Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade

T-Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large

Please list any Allergies, Special Needs or Concerns

If you have more than 3 children you are registering, please check this box and complete a second form for the additional children. More than 3 children

Authorization

By registering my child(ren) for Faith Quest Summer Camp, I hereby release Wintonbury Church, their officers, staff, volunteers, and membership from responsibility and liability for an injury or illness that my child may sustain while participating in any activities at Faith Quest Kids Camp. In the event of a medical emergency, I authorize an adult leader of Faith Quest Kids Camp to seek emergency medical services. I expect to be contacted as soon as possible.

I agree

PARTICPATION & PHOTO RELEASE AGREEMENT: By registering my child(ren) for this event I am agreeing to allow them to participate in all Faith Quest Summer Camp activities, including being photographed. I acknowledge that those photographs may be used by Wintonbury Church for future promotions.

I agree My child has restrictions to this agreement (see below)

Please list any participation or photography restrictions

Faith Quest Summer Camp 2024

Description

Please Fix the Following