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Kids Summer Camp Registration

Terms and Conditions

I hereby give permission for my child to participate in the Kids Summer Camp at Cloverdale Baptist Church from July 8 – July 12, 2019. I hereby give Church employees or Camp volunteers the authority to act on my behalf and authorize treatment for my child in the case of an emergency when I cannot be immediately reached for such authorization. I understand that I am financially responsible for such treatment. I hereby waive any rights, and release the Church, its members, directors, employees and camp volunteers from all actions, suits, claims and damages arising from any accident or injury during my child’s participation in camp activities.

I understand that my child may be videoed or photographed for the purposes of camp highlights and/or promotional DVD and give permission to the church to use my child’s photograph in the camp highlight video or camp promotional material.

*Denotes Required Field
  • Yes
  • No
  • Yes
  • No
 ) -
 ) -
  • Male
  • Female
  • Grade Primary or Kindergarten (ages 56)
  • Grade 1 (ages 67)
  • Grade 2 (ages 78)
  • Grade 3 (ages 89)
  • Grade 4 (ages 910)
  • Grade 5 (ages 1011)
  • Grade 6 (ages 1112)

Note: Within 1 year age difference, we will do our best to accommodate as many requests as possible