Music Camp 2025: Camp Counselors Form

Camp Counselor Name

Email (or a Parent's Email)

This address will receive a confirmation email

Phone

Current Grade

In case of Emergency, contact (include first and last name & phone number):

Parent's contact information, if different from Emergency contact (Include first and last name & phone number)

Voice Part

Additional music experience (instruments played, music ensembles, can harmonize vocally, can sing multiple voice parts, etc.)

Clearances

Yes, I understand that Kerri Rogers from the WPC office will contact me regarding volunteer clearance forms if these have not already been filled out. If she contacts me or my parent, I will make every attempt to fill out any and all paperwork required a

Allergies/medical conditions/special needs/activity restrictions, etc.

Please describe your child’s reactions to the food allergen you have listed. (i.e anaphylaxis, nausea, vomiting, difficulty breathing, hives, etc.) Food Allergy Policy: The church cannot responsibly promise an environment that is 100% free from food allergens. We will take precautions by providing a “safe” snack for children with a medically diagnosed food allergy based on the allergy information you provide below. The snack will be different from the snack provided for the rest of the class.

Liability Release

In the event of an emergency, I, the undersigned parent/guardian, understand that all will be done to contact me or the emergency contact named above. However, if neither can be reached, we give full permission to a representative of Westminster Presbyterian Church to seek medical attention in my absence for any child registered on this form. I, the undersigned parent/guardian, hereby assume all risk, known or unknown, for any child registered on this form, in connection with their attendance and participation in Music Camp at Westminster Presbyterian Church. I acknowledge that participation in Music Camp at Westminster Presbyterian Church is voluntary and therefore FULLY RELEASE and discharge Westminster Presbyterian Church, its pastors, employees, directors, and volunteer workers, from any and all liability in connection with any activities carried on at Westminster Presbyterian Church in the Music Camp program.

Parent/Guardian Signature (by typing your name in this space, you agree with the statement above.)

Photography/Video Authorization Release

I, the undersigned, also acknowledge that any child registered on this form, as a participant in Music Camp at Westminster Presbyterian Church, may be photographed or captured on video during the Music Camp program and activities. I hereby grant full permission to Westminster Presbyterian Church to use photographs or videos—in print, electronic, online, or other public media—of any child registered on this form and further release Westminster Presbyterian Church from any and all liability connected with the authorized use of words and image of any child registered on this form.

Parent/Guardian Signature (by typing your name in this space, you agree with the statement above.)

Description

Music Camp 2025
June 24–27, 9 am–Noon
and June 29, 11 am service (report time TBA)

Theme: Music Through the Ages
See website for more information at westpca.com/music-camp

Students in grades 8–12 are invited to be Camp Counselors for Music Camp. As a Camp Counselor, you will help out with children and be involved in the Youth Choir led by director Floyd Rawleigh. Camp Counselor registration is FREE!

Please fill out this form and click submit.

Music Camp 2025: Camp Counselors Form

Description

Please Fix the Following