DayCamp 2018/VBS

I would like to help with Day Camp! *

Yes! No

Volunteer Address *

Line 1

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City

State

Zip Code

Country

Volunteer Phone Number *

I hereby give informed and expressed consent for my child to take part in all camp activities under supervision, and agree that the Day Camp or Day Camp personnel will not be held responsible for accidents arising there from. I authorize the Day Camp Healthcare Provider and/or designated Day Camp staff/volunteer to provide appropriate treatment to my child for injuries and/or illness. I understand that the information on this form may be released to the appropriate medical personnel in case of medical emergency. I also understand the failure to disclose medical or emotional problems in advance may lead to serious consequences while at Day Camp. Lastly, I verify that everything contained on this form is complete and accurate, to the best of my knowledge. *

I consent.

I also consent to the use of any photograph of my child or family in future Lutherwood publications. * A copy of this form will be shared with Camp Lutherwood Ministries at the end of the Day Camp week. *

I consent.

ON-LINE 2018 REGISTRATION IS OPEN!

OPTION 1 : FILL OUT ONLINE