Form Test

Camp Sonrise Camper Registration Form

Camper Information

Camper's First Name (Put preferred name in " after legal name)
Camper’s First Name (Put your preferred name in ” after your legal name.)
Camper's Last Name
Date of Birth
Age (At the Time of Camp)
Gender
Name of School Enrolled In
Grade Your Child Will Be Going To
Name of Church Presently Attending
T-Shirt Size - $10.00
Canteen Card ?
Canteen Card Value

Parent/Guardian/Primary Contact

First Name of Parent/Guardian/Primary Contact
Last Name of Parent/Guardian/Primary Contact
Father's Name
Mother's Name
Street
City
Select State
Zip Code
Email Address (Don't have one, enter none@none.com)
Home Phone
Cell Phone
Work Phone
If you select "Yes " you will receive information about our future events and more information about camp. If you select "No" you will only receive an email with more information about camp. (Ex.) Rules, Where & what time to meet, what to pack, etc.

Emergency Contact Information

Please provide two additional people, different from the parent/guardian listed above, who would automatically be the first person we contact.
First Contact's Name
Relationship To Camper Listed Above
Home Phone
Work/Cell Phone
Second Contact's Name
Relationship To Camper Listed Above
Home Phone
Work/Cell Phone

Medical Information

The information below is not required.
Policy Number/Member ID
Health Insurance Provider
Primary Care Physician
Primary Care Physician Address
Phone Number
Hospital Preference

Medical Conditions

Please List All Known Medical Conditions, Including Any Requiring Maintenance Medication (i.e. Diabetes, Asthma, Seizures) Below So We Can Accommodate Your Camper’s Needs. (Add As Many Lines As You Need By Clicking The Add Button Below)

Continued..

Emergency Authorization

I, the undersigned, parent or guardian of the above named individual, acknowledge that staff of Camp Son Rise take every precaution to provide for the safety of all students, however participation in camp activities necessarily involves risk of physical injury. I further acknowledge that the programs of Sonrise family camp are administered by adults, who volunteer their time, rather than by paid, trained professionals. In consideration for accepting the registration of the above named individual and permitting the voluntary participation of said individual in its programs, I (for myself as well as for my child, his/her heirs and assigns) hereby release, discharge and hold harmless Forest Park Church of Christ and its employees, camp director, volunteers and other representatives or affiliates (including without limitation the facilities and volunteers) from and against any and all claims arising out of or relating to illness, physical injury, death or other damages that may result to said individual while participating in a Forest Park Church of Christ sponsored event, including any physical injury by negligence of any volunteer while performing his/her duties during any practices or games. I attest that my child is physically capable to participate in this event. However should camp director/volunteers/pastoral staff (Jason Corder or Bob Blanshan) determine in their sole discretion that completion or participation in any events would be injurious to my child’s health or should my child become ill or injured, I consent to his or her removal and treatment by any physician or medical care provider at the direction of the volunteers, camp director and staff.

Signature

By signing below you agree that you have read and understand the above form, the camp rules, and you and your child agree to their conditions.
Your Legal Signature
Today's Date
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