UED ( ) Summer Camp 2015
|
|
- Esmond McDonald
- 6 years ago
- Views:
Transcription
1 UED ( ) Summer Camp 2015 Registration Form UED Summer Camp 2015 Student Information who current 4th and 5th graders when 7/2 (thurs) - 7/4 (sat) where Pinecrest Christian Conference Center 1140 Pine Crest Road Twin Peaks, CA cost Early Registration - $100 (5/17-6/7) *first come first serve Late Registration - $120 (6/8-6/21) *upon availability CASH or CHECK (Please make checks BLANK) Office Use Only Name (English) (Korean) I am currently in 4th grade 5th grade Small Group # Teacher I attend 2nd service 3rd service Check if you do not attend Sa-Rang Community Church Parent Information Parent s Name Parent s Contact (Cell) (Work) Parent s Scholarship Available UED is very excited and grateful to announce that scholarships are available for this year s summer camp. UED has limited number of scholarships on first come first serve basis with priority given to Sa-Rang Community Church members. We want your child to attend this year s camp regardless of your financial circumstances so that he or she can be truly blessed and touched by our Lord. If you would like your child to receive scholarship, please do not hesitate to sign below. If however, you would like to pass this opportunity to another child who would better benefit from this offer, please disregard the signature section below. 초등부학부모님들께금년여름캠프장학금에대해알려드립니다. 하나님의축복으로한정된양의장학급이제공됩니다. 각가정의재정상황을떠나이번캠프를통해우리학생들이하나님의사랑과은혜를마음껏체험하기원합니다. 장학금이필요하신가정은밑에싸인을해주시기바랍니다. 만약장학금이더필요한학생 / 가정에이번기회가더적합하다생각하신다면밑에칸을비워주시기바랍니다. 장학금은선착순이며남가주사랑의교회교인에게먼저적용됩니다. Scholarship Request Date We Welcome Donations! 도네이션받습니다! $$ $ To make a donation to this camp, you can include in the registration fee or pay separately in cash or check (please make checks BLANK) Thank you for your support! :) Read & Fill Out Next Few Pages Questions? P Hanna
2 UED/ 초등부 Summer Camp 2015 MEDICAL CONSENT / WAIVER AND RELEASE FORM Child s/minor s Name: ( Participant ). In consideration for permitting Participant to participate in Sa-Rang Community Church summer retreat activities, I acknowledge and agree to the following provisions. Acknowledgment of Risks. I understand that there are certain risks associated with participation in camping, hiking or any other outdoor activities ("Activities"). I recognize and am aware that there is always the potential for accidents to occur, including but not limited to mild or severe bodily injury, including illness and fatalities. For this and other reasons, some risk cannot be eliminated, altered or controlled, such as: Activities often take place in a natural environment where unexpected and unmarked objects and conditions potentially create a risk of injury from tripping and falling, insect or animal contact, and potentially harmful vegetation; Weather conditions, which may change rapidly and unpredictably, potentially causing injury directly ( i.e. sunburn, hot/cold temperature extremes) or by affecting other factors ( i.e. performance of equipment may be impaired). Activities in or near water potentially involve risks of injury, illness and drowning. Lakes, ponds, rivers and other bodies of water present risks of water movement, subsurface conditions, cold water temperatures, water impurities and the like. There is also the risk of falling from or being struck by a water craft. Motor vehicle accidents may occur in the course of transporting Participant from location to location. A complete listing of all risks is not possible. These are just some but not all of the risks inherent in the Activities. There are also some risks that cannot be reasonably anticipated. Church staff and volunteers shall use their best judgment in determining how to react to circumstances. Obligations of Participant. Each Participant is expected to: Obey all posted rules and regulations of the camp facilities, especially those designed to limit injury to the Participant or others and follow the instructions of group leaders and supervisors assigned to Participant; and Assist by informing/alerting the group leaders or supervisors to situations that may cause injury to Participant or others. Waiver and Release. I understand that Sa-Rang Community Church, its employees, officers, directors, agents, staff and volunteers ( Sa-Rang ) assumes no responsibility for personal injuries (including loss of life) resulting from Participant s participation in any and all Activities. For valuable consideration, a receipt of which is acknowledged, I hereby release Sa-Rang from any and all rights, claims, demands, causes of action, and damages of any kind, known or unknown, existing or arising in the future, resulting from or related to personal injuries and/or property damage, arising from Participant's participation in the Activities. Furthermore, I agree to hold harmless, defend and indemnify Sa-Rang from and against any and all claims (except those caused entirely by the gross negligence or intentional conduct of Sa-Rang) that may arise as a result of Participant's participation in the Activities. If any part of this agreement is found to be null and void such action shall not void any other part of this agreement. Consent and Acknowledgments. I authorize Sa-Rang to administer first aid, CPR or other treatment by a qualified staff member to Participant. I further grant Sa-Rang the authority to release Participant, for the purpose of providing medical treatment, to the care of medical personnel or physicians as reasonably appropriate. I consent to a licensed physician to administer drugs or medicine or to perform such medical procedures as that physician determines necessary for the relief of pain and to preserve the Participant s life or health. I understand that in the event that Participant is not covered by his/her own medical insurance or if such policy does not fully cover all incurred expenses, I, as the parent or guardian, shall assume and be deemed financially responsible for all such costs and expenses incurred by Participant. I have read and fully understand the terms of this agreement. I give my fully informed consent and permission for Participant to participate in all camp activities. Print Parent s/legal Guardian s Name: Signature: Date: Rev
3
4
5
6
TULANE UNIVERSITY ATHLETICS CAMPS Physical Examination Information. Date / / Name of Camp: Name of Participant: Age: Birth date: / /
Physical Examination Information Date / / Name of Camp: Name of Participant: Age: Birth date: / / Each participant must EITHER attach a copy of a physician conducted sports examination applicable to this
More informationVACATION BIBLE CAMP PARTICIPANT REGISTRATION FORM We are headed to a new camp location this year!
Need Help? Have Questions? Email: vacationbiblecamp@thenbcf.org 425.282.6220 VACATION BIBLE CAMP PARTICIPANT REGISTRATION FORM We are headed to a new camp location this year! Crista Camps- Miracle Ranch
More informationPARENT/GUARDIAN NAME: PARENT/GUARDIAN DOB: (Person responsible for account) CAMPER NAME: CAMPER DOB: GRADE: SHIRT SIZE:
Spring Break Camp PARENT/GUARDIAN NAME: PARENT/GUARDIAN DOB: (Person responsible for account) CAMPER NAME: CAMPER DOB: GRADE: SHIRT SIZE: Have you attended Camp C-Woo before? Yes No CWU ID Number Spring
More informationBlue Sky Adventure Camp - Registration Form
Blue Sky Adventure Camp - Registration Form Please complete this registration form, sign it and return it with a $100 per week deposit owed for camp registration. Please note that a single registration
More informationGrosse Pointe Memorial Church 2019 Registration Form 4 th /5 th grade Winter Retreat Camp Michindoh FRIDAY, MARCH 1 - SUNDAY, MARCH 3, 2019
2019 Registration Form 4 th /5 th grade Winter Retreat Camp Michindoh FRIDAY, MARCH 1 - SUNDAY, MARCH 3, 2019 Use the checklist to make sure Registration is complete 2019 Winter Retreat Registration form
More informationPersonal Medical Record
Personal Medical Record Personal details Age: Height (in meters): Weight (in kgs): BMI (kgs/metres 2 ): *Online BMI calculation tools are easily available 1. Any previous illness - past 3 months (mention
More informationD.M.G. Athletics. The Official Indoor/Outdoor Summer Basketball League. Team Registration Packet
D.M.G. Athletics Presents The Official Indoor/Outdoor Summer Basketball League Team Registration Packet Questions: Contact Coach Dawne Gittens at 860-929-7692 or via email at dgittens@bgchartford.org Team
More informationYouth Services Programs Application Please complete and return application to Nome Eskimo Community at 200 W. 5 th Avenue or Fax
P.O. Box 1090 Nome, Alaska 99762 Phone: (907) 443-2246 Fax: (907) 443-3539 www.necalaska.org Programs Application Please complete and return application to Nome Eskimo Community at 200 W. 5 th Avenue or
More informationApproved OLA: 05/08/18
2018 DAWG CAMP DISCOVERY RELEASE, WAIVER OF LIABILITY, AND COVENANT NOT TO SUE (READ CAREFULLY BEFORE SIGNING) I, _, hereby acknowledge my awareness that my participation in the Dawg Camp Discovery program,
More informationUniversity of Maryland-Campus Recreation Services MAP Trip Registration Packet
University of Maryland-Campus Recreation Services MAP Trip Registration Packet Trip Name: Trip Please read the following trip information carefully. Please initial and sign where requested to acknowledge
More informationRelease and Assumption of Risk Agreement
Release and Agreement Rationale & Purpose Safety is a fundamental concern of The Mountain Institute (TMI). Despite operating activities and programs to the best of our capabilities, TMI s course activities
More informationST. CLOUD AREA FAMILY YMCA SUMMER CAMP WAIVERS
ST. CLOUD AREA FAMILY YMCA SUMMER CAMP WAIVERS Parent Statement of Understanding The following information is important for the safety and protection of your child. Please read this information and sign
More informationA Journey through Pueblo History and Tradition. Registration Packet
A Journey through Pueblo History and Tradition Registration Packet Monday Friday June 5 June 16, 2017 9am 4pm Thank you for your interest in our Traditional Teachings Camp! Here s some information to review
More information% Important%Information%for%The%Difference%2016%
WhatisTheDifference? The$Difference$is$a$unique$Student$Ministry$event$in$which$several$youth$ groups$in$the$nacogdoches$area$come$together$at$pineywoods$camp$(near$ Corrigan)$to$study$the$truth$and$worship$with$one$another.$$Our$goal$is$that$
More informationCHAMPAIGN COMMUNITY UNIT SCHOOL DISTRICT NO. 4 Champaign, Illinois FIELD TRIP PERMIT
FIELD TRIP PERMIT (School) (Student s Name) (Teacher/Sponsor) (Telephone Number) PARENTS/GUARDIANS: A field trip to is planned for (class or group) on. The trip will begin at a.m./p.m. and return at a.m./p.m.
More informationYoga Retreat Terms and Conditions
SUNDARA DESTINATIONS, LLC Yoga Retreat Terms and Conditions Sundara Destinations, LLC ( Sundara ) is committed to providing the highest quality yoga experience for all of our guests. To help make that
More informationWELCOME TO YMCA SUMMER CAMP 2018!
WELCOME TO YMCA SUMMER CAMP 2018! The following pages are the registration materials required to complete your registration. Read your Parent Handbook carefully, as it contains important information, policies
More informationCape Cod Community College Summer of Science Program REGISTRATION APPLICATION Page 1 of 6
REGISTRATION APPLICATION Page 1 of 6 INSTRUCTIONS Complete ALL Registration Application Pages (1 6), please make checks payable to:. Mail to: The Center for Corporate and Professional Education, Hyannis
More informationAFCC CAMPER REGISTRATION FORM
AFCC CAMPER REGISTRATION FORM Camper s Name Gender: M F Phone Number Email Address Address City/State/Zip Sponsor or Student Grade Completed (if student): Age Birthdate Church City T-Shirt Size: YM YL
More informationRegistration for Information Technology Summer Camp for rising 7 th, 8 th, and 9 th grade girls
Registration for Information Technology Summer Camp for rising 7 th, 8 th, and 9 th grade girls Student Name: Date of Birth: If you are a returning camper, indicate what year you attended: School Name:
More informationStark Museum of Art Application for Summer 2018 Art Quest Program, Health Form/Consent, and Liability Waiver
Stark Museum of Art Application for Summer 2018 Art Quest Program, Health Form/Consent, and Liability Waiver Camp Sessions Listed on Page 2 Application Due June 22, 2018 Application must be complete in
More informationLVC SPORTS CENTER ACTIVITIES CAMP JUNE 11 14, 2018
LVC SPORTS CENTER ACTIVITIES CAMP JUNE 11 14, 2018 All campers will receive a 2018 camp T-shirt Lunch is served each day All campers must be dropped off and picked up at the LVC Sports Center each day
More informationSHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2017 EcoRangers Application, Health Form/Consent, and Liability Waiver
SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2017 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 23, 2017 Application
More informationMEDICAL INFORMATION AND MEDICAL TREATMENT RELEASE AND AUTHORIZATION FORM
MEDICAL INFORMATION AND MEDICAL TREATMENT RELEASE AND AUTHORIZATION FORM Camp Information Address: City, State, Zip Code: Gender: Medical Information The decision whether to permit the participant identified
More informationSchedule: When: Saturday, December Time: 9:00-4:00pm Where: Garrett s Sports Complex/Fieldhouse Cost: $60/ per athlete
When: Saturday, December 9. 2017 Time: 9:00-4:00pm Where: Garrett s Sports Complex/Fieldhouse Cost: $60/ per athlete Instructors: SU Coaches & current SU Athletes Schedule: 9:00-9:45 Registration 9:45
More informationPerforming Arts Academy
Please complete this form and bring it to auditions Performing Arts Academy 4400 Lewis St. Middletown, OH 45044 513-594-7242 MUSICAL THEATRE REGISTRATION FORM ENROLLMENT FOR SUMMER 2018 STUDENT NAME BIRTH
More informationSHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2018 EcoRangers Application, Health Form/Consent, and Liability Waiver
SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2018 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 22, 2018 Application
More informationBefore and After School Care
Before and After School Care BLAIR FAMILY YMCA 2016-2017 School Year Registration Forms To put Christian principles into practice through programs that build a health spirit, mind and body for all. -YMCA
More informationRELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS
RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS Activity: CSU, Chico Recreational Sports Youth Camps Activity Date(s) and Time(s): Summer 2018 (June 11 August 10,
More informationOVERNIGHT PERMISSION FORMS
INSTRUCTIONS: OVERNIGHT PERMISSION FORMS (TRANSPORTATION BY BUS, LEASED VEHICLES, OR PRIVATE VEHICLES) (revised 9/1/11) NOTE: All forms are interactive, so you can type in the information needed. Items
More information7 ACTIVITIES INVOLVING MINORS. 7 ACTIVITIES INVOLVING MINORS Overview. 701 Youth Programs & Field Trips. 702 Steps to Safe Youth Activities
7 ACTIVITIES INVOLVING MINORS 7 ACTIVITIES INVOLVING MINORS Overview Adults working with youth must be familiar and comply with The Code of Ethics for Youth Ministry Leaders and Liability Concerns found
More informationMountain Venture Guiding (MGV) -- MVGuides.com 2460 State Route 48, Fulton, NY (315) YOUR ACKNOWLEDGMENT OF THE RISKS
Mountain Venture Guiding (MGV) -- MVGuides.com 2460 State Route 48, Fulton, NY 13069-4139 (315) 529-0283 Before you arrive at your outdoor event, YOU MUST thoroughly read all program materials and call
More informationYouth Camp REGISTRATION
Youth Camp REGISTRATION Parent #1 Name Home Phone Work Phone E-mail Address City State / ZIP Parent #2 Name Home Phone Work Phone E-mail Address City State / Zip 1. Camper s Name Age Gender Green and Gold
More informationParker Bounds Johnson Foundation Wilderness4Life & Wild Hearts Participant Waiver, Medical Info, & Consent Forms
INSTRUCTIONS: Please answer ALL portions of the documents to the best of your knowledge (check or write None if not applicable). Make sure to sign and date ALL documents, using blue or black pen ink only.
More informationSHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2019 EcoRangers Application, Health Form/Consent, and Liability Waiver
SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2019 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 21, 2019 Application
More informationSession I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church
th Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church Session II: June 12th - June 16th, Performance June 13th; Music On Wheels Academy Music Camp
More informationWAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT This document affects your legal rights. You should read and understand it before signing it.
WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT This document affects your legal rights. You should read and understand it before signing it. In consideration for receiving permission to participate in
More informationConstruction Site Guidelines. Under 18 requires a signed parental permission form (found on
Construction Site Guidelines Under 18 requires a signed parental permission form (found on www.hfhcc.org). Please contact Eliza (610-384-7993, ext. 17 or eliza@hfhcc.org) one (1) week before your scheduled
More informationUniversity Health Services Health and Safety
Advisory 21.1 Guidelines On Minors In Potentially Hazardous Locations Other Than Laboratories Persons under 18 years of age are not allowed in potentially hazardous locations (shops, utility plants) at
More informationNON-EMPLOYEE ACTIVITY RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
NON-EMPLOYEE ACTIVITY RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT Albright allows Participants to participate in Participant activities that may involve or require overnight
More informationSTREET ADDRESS CITY STATE ZIP / / / /
Please fill out the registration for completely and return to : YMCA of Northern Michigan 434 East Lake Street, Petoskey, MI 49770 231-348-8393 Fax 231-348-8402 Camper Information CHILD S NAME GENDER Male
More informationMail application to: Wendy Weaver 250 E. Orchard St. Delton, MI 49046
This form needs to be filled out on-line and then printed, signed and mailed to Wendy Weaver at address to the right. Mail application to: Wendy Weaver 250 E. Orchard St. Delton, MI 49046 There are six
More information4 ARROWS RANCH & WASSER QUARTER HORSES present 2018 SUMMER HORSE CAMP!!! Treat your child to a summer camp experience that they will never forget!
4 ARROWS RANCH & WASSER QUARTER HORSES present 2018 SUMMER HORSE CAMP!!! Treat your child to a summer camp experience that they will never forget! Our summer camps run June-August offering opportunities
More informationWAIVER AND ASSUMPTION OF RISK AGREEMENT
WAIVER AND ASSUMPTION OF RISK AGREEMENT Information Note This Note does not form part of the Waiver and Assumption of Risk Agreement. It is intended to give guidance about what you are agreeing to by signing
More informationCamp Copass th Graders ONLY. Camper Name (print) Camper Grade (print)
Camp Copass 2018 5 th Graders ONLY Camper Name (print) Camper Grade (print) Camp Copass 2018 Forms & Information Love Your # Selfie I praise you, for I am fearfully and wonderfully made. Ps: 139:14 Love
More informationStark Museum of Art Application for Summer 2016 Art Quest Program, Health Form/Consent, and Liability Waiver
Stark Museum of Art Application for Summer 2016 Art Quest Program, Health Form/Consent, and Liability Waiver Camp Sessions and Costs Listed on Page 2 Application Due June 9, 2016 Application must be complete
More informationManHood Camp LA 2017 Registration Paperwork Instructions
ManHood Camp LA 2017 Registration Paperwork Instructions 1) Please print out the following paperwork for your group. 2) You will need a liability release signed for every person in your group, both youth
More informationCOUCH TO 5K RUN. A FOCUS 4 WOMEN CRC FALL 2017 Saturday, November 4, 2017, 9:00 a.m. to 4:00 p.m. Space is limited, so sign up soon!
COUCH TO 5K RUN A FOCUS 4 WOMEN CRC FALL 2017 Saturday, November 4, 2017, 9:00 a.m. to 4:00 p.m. Space is limited, so sign up soon! Applications will be available starting Tuesday, August 1, 2017, in the
More informationPhysical Examination Form
Physical Examination Form Physical Examination must be completed by a licensed medical physician or nurse practitioner within twelve (12) months of camper attending camp. All campers must have this form
More informationUGA Livestock Judging Camp Athens, Georgia June 26-28, Participant Name: Parent/Guardian: Phone: Address: City: State: Zip: School:
PLEASE PRINT UGA Livestock Judging Camp Athens, Georgia June 26-28, 2018 Participant Name: Parent/Guardian: Phone: Address: City: State: Zip: School: Email: Grade: Shirt Size: YS YM YL YXL AS AM AL AXL
More informationThe College of Engineering & Computer Science Webelos Engineering Pin Day Saturday, October 28, 2017
The College of Engineering & Computer Science 2017 Webelos Engineering Pin Day Saturday, October 28, 2017 Registration at 7:30 a.m. - Event runs from 8:00 to 11:15 a.m. University of Evansville Koch Center
More informationSummer Camp Application INTERNATIONAL DEVELOPMENT 101
INTERNATIONAL DEVELOPMENT 101 Student Information Student Name: Sex : Male / Female Student Preferred/Nickname: Mailing Address: Home Phone Number: Cell Phone Number: School: Grade (Entering): Date of
More informationOutdoor Adventures. Insurance Company: Policy/Certificate # Group # Allergy List Below Reaction Medication Required
Outdoor Adventures Participant Information Medical and Waiver Form PART 1 GENERAL INFORMATION PARTICIPANT Address: Legal Name: APT# Gender: Male Female City State Zip Cell Phone #: Z number: E-mail: EMERGENCY
More information** Important Notice to Summer Camp Program Parents ** Kiddie, Day, and Youth In Action ** Leaders Club
** Important Notice to Summer Camp Program Parents ** Kiddie, Day, and Youth In Action ** Leaders Club As a new year of Kent County Parks and Recreation Summer Camp fun is quickly approaching, we want
More informationThere are just a few points I would like to go over before you start filling out the forms. This will not take long.
A NON-PROFIT ORGANIZATION Anaheim Hills Costa Mesa Encinitas Glendale Las Vegas Long Beach Mission Viejo Northridge San Diego Santa Monica South Bay Temple City Tucson Ventura Dear Parents, Thank you for
More informationSustainable Agriculture Internship Application
P.O. Box 437462 Kamuela, Hawai i 96743 +1 808 887-6411 Fax +1 808 885-6707 kohalacenter.org 2015 2016 Sustainable Agriculture Internship Application Please complete the application information below and
More information2018 CENTRAL WASHINGTON UNIVERSITY MEN S RUGBY ELITE PROSPECT CAMP
2018 CENTRAL WASHINGTON UNIVERSITY MEN S RUGBY ELITE PROSPECT CAMP SAT., MAY 26 8 a.m. 4 p.m. Todd Thornley CONTACT PHONE: 509-963-2312 E-MAIL: todd.thornley@cwu.edu REGISTRATION DUE FRIDAY, MAY 18, 2018
More informationChild: L M S XS. Session I - June Overnight Camper (9-18 years) or Day Camper (7-18 years)
THIS APPLICATION IS FOR MANUAL REGISTRATIONS ONLY Print and mail with $100 Non Refundable deposit or full amount to: Box 870393 Tuscaloosa, AL 35487 Full Name: Preferred Name: Address: City: State: Zip:
More informationPARTICIPANT AGREEMENT (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
EXHIBIT D PLEASE READ CAREFULLY (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I,, a person being over the age of eighteen, hereby enter this RELEASE
More informationCatholic Mutual..."CARES"
Catholic Mutual..."CARES" Camping Guidelines Many of today s activities for our youth ministry programs involve activities away from the church setting. Camping trips provide a fun way to keep kids involved
More information2018 Registration Form
2018 Registration Form Camper s Name: Birth Date: Grade (completed in 2017) School: T-shirt Size: YS YM YL AS AM AL AXL Billing Name: Address: STREET CITY STATE ZIP Email Address: Note: Camp statements
More informationEKU Educational Talent Search Program Student Leadership Team
EKU Educational Talent Search Program Student Leadership Team 2018-19 Dear ETS Participant, You have indicated an interest in being on the ETS Student Leadership Team. It will be necessary for us to meet
More informationAfter School Program Registration Form
2018-19 After School Program Registration Form Office Use Only Date registered: _ Staff: Please fill out this form entirely. If there are blanks it may slow down your child s enrollment process. If a line
More information2019 SUMMER DAY CAMP REGISTRATION
2019 SUMMER DAY CAMP REGISTRATION Child: First Name MI Last Name [ ] YMCA Member [ ] Non Member Email Enrollment Date SUMMER DAY CAMPS CHOOSE YOUR CAMPS & LOCATION: [ ] Ages 5-12 (must have attended kindergarten)
More informationCHINESE CULTURE CAMP REGISTRATION FORM
CHINESE CULTURE CAMP REGISTRATION FORM Child s Information: Last Name: First Name: MI: Nickname: Gender: M F Birth Date: Age: Primary Phone #: School Attending: Grade: Parent(s)/Guardian(s) Information:
More informationEast High Rugby Sooner State Tour II Friday April 6 Monday April 9
East High Rugby Sooner State Tour II Friday April 6 Monday April 9 All East High Rugby players are encouraged to travel with the team to matches in Tulsa, Oklahoma. The 22 nd annual tour is a great team
More informationExplorathon 2018: A STEM Event
Explorathon 2018: A STEM Event Expanding Horizons for Girls in Science, Technology, Engineering, and Mathematics A joint project of the American Association of University Women Birmingham Branch, Ford
More informationSHORT-TERM MISSIONS APPLICATION
GENERAL INFORMATION Date Last Name First Name Middle Name Please print your name clearly EXACTLY AS IT APPEARS ON YOUR PASSPORT Present address: City State Zip DOB / / Age Gender: M F Grade Email Home
More informationSUMMER CAMP ACKNOWLEDGEMENT OF RISK FORM
SUMMER CAMP ACKNOWLEDGEMENT OF RISK FORM I,, am the parent and/or legal guardian of, a minor child under the age of 18 years. I would like to have my child participate in the following CAMP/PROGRAM at
More informationCatholic Mutual CARES
Catholic Mutual CARES Field Trip Risk Management Information The purpose of the enclosed information is to provide sample forms and procedures to minimize the exposures created by participation in field
More informationCharter Oak Gymnastics Winter Camp 2016
Charter Oak Gymnastics Winter Camp 2016 Week 1: December 26th-30th We may host 2nd week of Camp if enough families are interested January 2nd-6th Prices: Half Day $108 per week Full Day $178 per week Extended
More informationAre You Willing to Work For It?
Are You Willing to Work For It? NTCC Work Scholarship Program ~ A Groundbreaking Opportunity available in the summer of 2014 at NTCC s Eagle Ranch NTCC Wants You? NTCC is looking for a select group of
More information$35/Stall/Night Stabling/ Haul in Fee Haul in fee will be charged to those who do not have a Galway Downs
Entries will not be accepted without payment. Close date is the second Friday before the event. Late entries accepted until the Wednesday before the event. Scratches must be in writing to DelMarEventing@gmail.com.
More informationCUNY INTERNATIONAL TRAVEL PARTICIPATION, WAIVER,
CUNY INTERNATIONAL TRAVEL PARTICIPATION, WAIVER, AND EMERGENCY CONTACT FORM CUNY INTERNATIONAL TRAVEL PARTICIPATION, WAIVER, AND EMERGENCY CONTACT FORM This form (the Release Form ) has been developed
More informationWe are excited to offer Camp Good Grief for free. This day camp is filled with fun and adventurous camp activities combined with grief support.
Dear Parent/Guardian, Thank you for interest in Hospice of Michigan's Camp Good Grief hosted at Camp Newaygo 5333 S. Centerline Rd, Newaygo, MI 49337 on Friday June 16, 2017 from 8am-4pm. We are excited
More informationCITY OF PALM COAST YOUTH PARKS & RECREATION DEPARTMENT ADULT REGISTRATION FORM SENIOR
CITY OF PALM COAST YOUTH PARKS & RECREATION DEPARTMENT ADULT REGISTRATION FORM SENIOR Please print clearly. Completion of the registration process is required for each participant prior to program start
More informationKids R.O.C.K. Summer 2019 Registration Packet
City of Inver Grove Heights Parks and Recreation Department Kids R.O.C.K. Summer 2019 Registration Packet Please carefully complete all of the following pages. Your child s registration will not be processed
More informationSUMMER CAMP REGISTRATION
SUMMER CAMP REGISTRATION 2019 Please return completed registration to: YMCA of Northern Michigan, 523 W. Jefferson Street, Petoskey, MI 49770. CAMPER INFORMATION Child s First Name: Last Name: (One form
More informationALBION COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS
ALBION COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I, (or hereinafter on behalf of my minor child) ( Participant ), hereby acknowledge
More information2019 WEST ST. TAMMANY YMCA Summer Camp Registration
Child s Name: _ Grade Entering 2019: Please Select One: Member Non-Member I will be signing my camper up for Pre-K Camp Youth Camp Leaders Camp Pre-K Camp (ages 3-5, must be 3 by start of session, must
More informationCommunity Advocacy and Mentorship Program s (CAMP) Life Skills Retreat
Community Advocacy and Mentorship Program s (CAMP) Life Skills Retreat WHAT IS THIS? The Pediatric AIDS Coalition (PAC) at UCLA puts on a Life Skills Retreat for students around the country to participate
More informationCovington Catholic Summer Mission Trip Application Form
Covington Catholic Summer Mission Trip Application Form Name Adult Student STUDENT MISSIONARY: Grade Level: Parent Name(s) Address: Parent(s) Cell Phone Number: Student cell phone Number: Parent(s) email
More informationCamp Medical Information & Release Form
Global Youth Ministry Global Youth Camps 40 Blackhawk Trail Chatsworth, GA 30705 877-251-1800 www.globalyouthministry.org Camp Medical Information & Release Form Name Gender Age Birthdate / / Church/Org
More informationACADEMY DISTRICT 20 HIGH TRAILS PERMISSION FORM
ACADEMY DISTRICT 20 HIGH TRAILS PERMISSION FORM Student Name: Purpose of Activity: Leadership Day Destination: High Trails Date of Trip: Departure Time: Return Time: Mode of Transportation: ASD20 Bus Departure
More informationACADEMY DISTRICT 20 HIGH TRAILS PERMISSION FORM
ACADEMY DISTRICT 20 HIGH TRAILS PERMISSION FORM Team Name: Middle School: Student Name: Destination: High Trails Date of Trip: Departure Time: Return Time: Mode of Transportation: ASD20 Bus Departure Location:
More informationCAMPER INFORMATION SHEET RIVERS EDGE. Camper Name: Camper Birth Date: Group Attending With: Parent Name(s): Contact Address: Contact Phone:
CAMPER INFORMATION SHEET RIVERS EDGE Camper Name: Camper Birth Date: Camper Gender: M or F Group Attending With: Parent Name(s): Contact Address: Contact Phone: Contact Email: Camp Eagle 6424 Hackberry
More informationMissional Living Mission Trip - Missionary Participant Information STUDENT INFORMATION (If you are 17 yrs. Old and under)
Missional Living Mission Trip - Missionary Participant Information STUDENT INFORMATION (If you are 17 yrs. Old and under) This information form is to designed to fulfill several purposes: it will help
More informationFOR THE LOVE OF LEARNING 3110 SE Aster Lane, Stuart, FL
FOR THE LOVE OF LEARNING 3110 SE Aster Lane, Stuart, FL 34994 772-924-1070 ForTheLoveOfLearningFL@GMail.com 2019/2020 REGISTRATION Student Name: D.O.B.: Age on Sept 2019: Address City State Zip Home Phone#
More informationI. Appendix B - Summer Camp Release and NCAA Compliance Attestation
I. Appendix B - Summer Camp Release and NCAA Compliance Attestation For Participation in Activity in University Department of Athletics Facilities For the purposes of this document, herein after referred
More informationNSU PREVIEW DAY. Wednesday, March 28, :00 a.m. 6:00 p.m.
PREVIEW DAY NSU Multimedia Camp Wednesday, March 28, 2018 8:00 a.m. 6:00 p.m. Parent/Guardian Contact Information Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement Photo Release
More informationBeyond the Hour WHAT IS HOUR OF CODE? GATEWAY SCIENCE MUSEUM & SPONSORS Present... for grades 5-8 TH
GATEWAY SCIENCE MUSEUM & 201 7 SPONSORS Present... Beyond the Hour F R I D A Y, AP R IL 14 T H, for grades 5-8 TH 20 17 3:3 0-5PM This workshop is independently paced and picks up at your skill level.
More informationFor summer 2019, the key verse we hope every camper and adult will memorize is John 17:3.
WHAT KIDS WILL LEARN AT CAMP: For summer 2019, the key verse we hope every camper and adult will memorize is John 17:3. This is eternal life: that they may know You, the only true God, and the One You
More informationENROLLMENT PACKAGE: RETURNING STUDENT
ENROLLMENT PACKAGE: RETURNING STUDENT Dear Parents, Included in this packet are the necessary documents for a returning student to BVM Academy. Please read and fill out each form carefully. Some documents
More information2016 5K Reindeer Run/Walk Team Registration
2016 5K Reindeer Run/Walk Team Registration Team Registration Forms and Waiver must be fully completed and received by December 2 nd in order to receive the $20/person group rate; Minimum of 3 people per
More informationYouth Camp Waiver RELEASE, WAIVER OF LIABILITY, COVENANT NOT TO SUE AND LIKENESS RELEASE
Youth Camp Waiver RELEASE, WAIVER OF LIABILITY, COVENANT NOT TO SUE AND LIKENESS RELEASE (READ CAREFULLY BEFORE SIGNING) I,, hereby acknowledge my awareness that my child s participation in the University
More informationTentative Schedule UGA Livestock Judging Camp Athens, Ga :00 am- 12:00pm Registration Double Bridges. 12:00 Orientation Double Bridges
Tentative Schedule UGA Livestock Judging Camp Athens, Ga 30605 Tuesday, June 26 10:00 am- 12:00pm Registration Double Bridges 12:00 Orientation Double Bridges 1:00pm Note Taking/Reasons Outline Indoor
More informationWELCOME TO Y CAMP 2018!
WELCOME TO Y CAMP 2018! The following pages are the registration materials required to complete your registration. In addition to these forms, some jurisdictions require additional forms as outlined below
More informationPLEASE DO NOT MAIL TO STREET ADDRESS. POST OFFICE WILL RETURN YOUR MAIL
SOTA Conference 2018 Dear SOTA Families and Students, Tacoma School of the Arts is a learning community. Whatever else we may be or try to accomplish, this is where we begin. We take the task of building
More informationCITY KIDS DAY CAMP REGISTRATION FORM
RETURN CAMP ENTRY FORM WITH PAYMENT TO: M.C. PARKS 100 E. MICHIGAN BLVD. SUITE 2 MICHIGAN CITY, IN 46360 (219) 873-1506 www.michigancityparks.com CITY KIDS DAY CAMP REGISTRATION FORM 1. HOUSEHOLD INFORMATION
More informationKingston debate camp
Kingston debate camp improve your skills AND prepare FOR THE winter debate SEASON. Students From beginners to experienced are encouraged to attend. Dates: July 31 st - August 4 th, 2017 Time: 10am 3pm
More information