ELEVATE MINISTRIES
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Registration Form
*
Indicates required field
Parent/Guardian Name
*
First
Last
Primary Parent or Guardian
Primary Phone Number
*
Secondary Phone Number
*
Parent/Guardian Email
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Camper #1 Name
*
First
Last
[object Object]
Camper Grade (Completed)
*
K5
1st
2nd
3rd
4th
5th
Sport Options
*
Basketball
Soccer
Cheerleading
Does Your Child Have Any Allergies or Medical Conditions?
*
If you have additional campers, please fill out the following form for each child. If you only have one camper registering, please skip to the Liability Release form.
Camper #2 Name
*
First
Last
[object Object]
Camper Grade (Completed)
*
K5
1st
2nd
3rd
4th
5th
Does Your Child Have Any Allergies or Medical Conditions?
*
Sport Options
*
Basketball
Soccer
Cheerleading
Camper #3 Name
*
First
Last
[object Object]
Camper Grade (Completed)
*
K5
1st
2nd
3rd
4th
5th
Does Your Child Have Any Allergies or Medical Conditions?
*
Sport Options
*
Basketball
Soccer
Cheerleading
Camper #4 Name
*
First
Last
Camper Grade (Completed)
*
K5
1st
2nd
3rd
4th
5th
Does Your Child Have Any Allergies or Medical Conditions?
*
Sport Options
*
Basketball
Soccer
Cheerleading
Camper #5 Name
*
First
Last
Camper Grade (Completed)
*
K5
1st
2nd
3rd
4th
5th
Does Your Camper Have Any Allergies or Medical Conditions?
*
Sport Options
*
Basketball
Soccer
Cheerleader
Liability Release Form
PLEASE READ CAREFULLY AND SIGN BELOW TO INDICATE YOUR AGREEMENT.
I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, named above, to attend Elevate Sports Camp at
Emmanuel Baptist Church in Hebron, Indiana
. I also give
Emmanuel Baptist Church
and its representatives permission to take and use photographs and/or videos made during this activity for promotional materials in the future. This includes, but is not limited to, flyers, website, posters, brochures, social networking sites and other print and digital communications.
In order that my child may receive the proper medical treatment in the event that he/she may sustain injury or illness during Elevate Sports Camp, I hereby authorize the camp staff to obtain or provide medical treatment for my child for such injury or illness during the camp, and I hereby hold the camp staff and
Emmanuel Baptist Church
, as well as its representatives, harmless in the exercise of this authority.
I further understand that there is always a possibility that my child may sustain physical illness or injury while at the camp. If this occurs, I hereby authorize the camp staff and representatives to refer my child to a medical treatment center (hospital, etc.). I further acknowledge and understand that I will be responsible for any medical bills that may be incurred on behalf of my son/daughter for physical illness or injury that he/she may sustain during the camp. Understanding that there is always a possibility that my child may sustain physical illness or injury, I acknowledge and understand that my child is assuming the risk of such physical illness or injury by his/her participation, and I further release
Emmanuel Baptist Church
and its representatives from any claims for personal illness or injury that my child may sustain during the camp.
I further acknowledge and understand that my child will be responsible for his/her failure to abide by the rules and regulations of the camp.
I Have Read And Agree To The Liability Release Form
*
Yes
Parent/Guardian Signature
*
First
Last
Please Let Us Know How You Heard About Us.
*
Facebook
Instagram
E-mail
Sign Out Front
Invitation From Friend
Church
Date
*
Submit
If you have not already done so, please sign up for KidCheck. This will be used for registration at Elevate Sports Camp.
KidCheck Information
KidCheck Registration
Home
Philosophy of Ministry
Elevate Ministries
Nursery
Elevate Kids (2 yrs - 5th Grade)
>
Elevate Kids Parents Page
E-Team Members
Director Resources
Elevate Youth (6th-12th Grades))
>
Yearly Theme
Event Calendar
KidCheck Information
Basketball League
>
Coaching Resources
Events
Yearly Youth Calendar
Sports Camp
Connect With Us