Bible Day Camp 2025 – Registration and Waiver

Name of Parent/Guardian

Phone Number

Emergency Contact (Name and Phone Number)

Name of Child #1

Birthday of Child #1 (YYYY-MM-DD)

Name of Child #2

Birthday of Child #2 (YYYY-MM-DD)

Name of Child #3

Birthday of Child #3 (YYYY-MM-DD)

Name of Child #4

Birthday of Child #4 (YYYY-MM-DD)

Does your child have any allergies?(required)

Yes No

If yes, please list (make sure to specify which child if registering more than one):

Is your child bringing any medication with them?(required)

Yes No

If yes, please list (make sure to specify which child if registering more than one):

If yes, please read and check the following box:

We do not administer any medication without the consent and specifically written instructions from a parents/guardian. The parent/guardian is expected to bring the medication to the appropriate staff/volunteer each day of the program, along with detailed written instructions for time, dosage, and any other information concerning the use of medication. Any medication left over will be taken home each day and brought back the following days as needed (once again with detailed written instructions).

Does your child have any physical, emotional, mental, behavioural concerns or limitations that our staff and volunteers should be aware of?(required)

Yes No

If yes, please explain (make sure to specify which child if registering more than one):

Do we have permission to take photos/videos of your child(ren)?(required)

Yes No

We at Life Centre may, from time to time, take photos and videos of the program. in this regard, we seek your consent for the publishing or use of photos in which your child may be included. the photos will be used for social media, Life Centre’s website, advertising, and promo. should you decide to take back your authorization later, you may do so in writing to us. for the protection of the privacy of the child, we guarantee that names will not be included.

Please read and check off the following:(required)

The safety of your child is our primary concern. Precautions will be taken for their well-being and protection. I/we, the parents or guardians named above, authorize Life Centre to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment, or procedures for the participant(s) named above. I/we, the parents or guardians named above, undertake and agree to indemnify and hold blameless Life Centre, its pastors, ministry personnel, representatives, leadership, and denomination from and against any loss, damage, or injury suffered by the participant as a result of being part of the activities of Life Centre, as well as any medical treatment authorized by the supervising individuals representing Life Centre. This consent and authorization is effective only when participating in or travelling to events sponsored by Life Centre. Life Centre is collecting and retaining this personal information for the purpose of enrolling your child(ren) in our programs, to assign the child(ren) to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at our organization. This information will be maintained indefinitely. If you wish Life Centre to view your child's information, please contact us. I/we have read, understood, and agree with above, and sign it to cover all program activities for the program on August 11-15, 2025 as stated above.

Thank you for your response. ✨