Middle School Summer Camp 2022 Registration (Full: Waitlist Available

Parent's Name

Student's Name

Age

Grade

Address

This address will receive a confirmation email

Parent Phone

Additional Parent/Guardian

Additional Phone

Date

I give permission for my child to be transported in a vehicle rented/driven by an adult representative of Expedition Church and to obtain any medical care necessary for my child’s health and welfare including emergency treatment and to do so without having to wait until I have been contacted. I further understand that I will be held liable for the expense of that treatment. I agree to hold harmless and release any liability or suit for damage Expedition Church and any of its agents, employees and/or volunteers for any illness or injury to my child arising out of their participation in this trip. I understand that if my child violates rules or expectations, they may be sent home at my expense.

Agree

Payment Agreement: I understand that I am responsible for the full payment of $350 if my child drops out of camp AFTER 5/24/2022. I understand that I am responsible for the full payment of the $50 deposit if my child drops out BEFORE 5/24/2022.

I agree

Electronic Signature Agreement. By selecting the

I accept

Electronic signature of Parent or Guardian

Description

May 31 - June 4, 2022

Middle School Summer Camp
May 31 - June 4
UCYC - Prescott, AZ
$350
Please fill out this form and click submit.

Middle School Summer Camp 2022 Registration (Full: Waitlist Available

Description

Please Fix the Following