Rainbow Trail Bible Day Camp 2025

*This form needs to be completely filled out by a parent/guardian. It will be kept by the Church staff
* The cost is $10 per camper. This covers a T- shirt, snacks, and craft supplies.
Pay here $10 fee

Camper Information

First name

This address will receive a confirmation email

Phone

Address

Birthdate

Parent/Guardian

Phone

Parent/Guardian

Phone

Emergency Contact

Relationship with camper

Medical info/Insurance

Do you carry medical/hospital insurance?

Yes No

If so, please indicate:

Carrier

Group/Policy Number

Name of physician

Phone

Date of last immunizations for:

TPD

Tetanus

Measles (MMR)

Polio

Please check and date any of the following, which have occurred to the camper or in the camper's family:

Please explain any of the above

Operations/serious injuries. Please explain.

Suggestions, activity restrictions, or other health related information for camp personnel

Will your child need to take any medications during day camp?

Yes No

If so, please list medications

Select your preferred T-shirt size (Everyone will get a t-shirt. We will do our best to ensure you get your preferred size, but cannot guarantee if you register after May 1st).

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large

My child has permission to participate in all camp activities, except as noted. I hereby give permission to the medical personnel selected by the camp director to order X-rays, routine tests and treatment for the health of my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp director to hospitalize or secure proper treatment (including surgery, injection, and/or anesthesia) for my child as named above. I hereby autorize the capture of photos and/or video of my child during the camp, for the purpose of their potencial use on our website and social media plataforms.

Parent/Guardian concent

Rainbow Trail Bible Day Camp 2025

Description

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