Glorify Sports & Arts Camp 2019
Please fill out this form and click submit.
Name of Child registering
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Child's Age
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Child's last completed grade
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Which track would your child like to participate in? (choose one)
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Please select one option.
Sports
Arts
Name of Parent/gardian
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Address
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Email
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This address will receive a confirmation email
Phone Number where we can contact a parent in case of emergency
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Allergies/other helpful information
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Video/Photography and Liability Release:
If you are in agreement with the statement below, please type your name into the field provided.
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 Glorify Sports & Arts Camp at Westminster Presbyterian Church. I acknowledge that participation in Glorify Sports & Arts 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 Glorify Sports & Arts Camp. I, the undersigned, also acknowledge that any child registered on this form, as a participant in Glorify Sports & Arts Camp at Westminster Presbyterian Church, may be photographed or captured on video during the Glorify Sports & Arts 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.
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