Sports Camp 2018

Please fill out this form and click submit. Please fill out one per child.

Menomonie Alliance Church
July 16-20, 2018, 5:00pm-8:00pm
Child's Information

 
 
 
 
 
 
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*Outdoor Recreation - Fishing:
By signing in the textbox below, I agree to give my permission for my child, who is signed up for Outdoor Recreation - Fishing, to go with a group of volunteers and other children to Bullfrog Fish Farm on Thursday, July 19th. I understand that my child will be driven by a screened, approved volunteer of Menomonie Alliance Church.
 
Household Information

 
 
 
 
 
 
 
 
Emergency Contact Information

 
 
 
Parental Consent

I/We, the undersigned, parent(s) or legal guardian of the minor listed above, do hereby give permission for Menomonie Alliance Church to take and/or use photographs, voice, video, or digital tapes of my child for promotional/informational materials.
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Medical and Liability Release

We realize that no activity is without the possibility of unforeseen hazards which could result in injury to an individual. As a parent or guardian, you are to be aware of your responsibility to instruct your child of the importance of conduct which will ensure safety and enjoyable time while participating in this activity. By signing this form, you, as a parent, guardian or other responsible party, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss, or injuries to the child for whom you sign.

I give my child permission to participate in this activity. If said minor becomes ill or injured while in the care or under the supervision of Menomonie Alliance Church, I authorize said minor to receive first aid by any of its staff or volunteers. I give my permission to the leaders of this function to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity.
 
 
Payment

$15.00
 
 
 
 
 
 

Description

Please fill out this form and click submit. Please fill out one per child.

Menomonie Alliance Church
July 16-20, 2018, 5:00pm-8:00pm