a238 sports camp Child's Name * Please submit a new form for every child. First Name Last Name Child's Age * Select Child's T-Shirt Size Youth Small Youth Medium Youth Large Adult Small Parent/Guardian's Name First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact Cell Phone# * (###) ### #### Secondary (Alternative) Emergency Contact Phone #: * (###) ### #### Please list below any allergies that your child may have: By submitting this form electronically I agree to the following: AUTHORIZATION TO TREAT- I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies in the event that a parent/guardian can be reached in the case of an emergency or a critical decision needs to be made and parents can’t be reached in a timely manner. RELEASE FROM LIABILITY- I give permission for my child to attend events on and off New Life Church premises. I therefore, RELEASE New Life Church of Jesus Christ and its volunteers/employees from liability in case of accident /or injury whether resulting in minor injury or loss of life from activities related to New Life Church of Jesus Christ either on site or during travel off-site. * Thank you!
