Grade Completed
*
Select Option
12th
11th
10th
9th
8th
7th
T-shirt Size (Adult)
*
Select Option
S
M
L
XL
XXL
XXXL
PARENT/GUARDIAN INFORMATION
Relationship to Student
*
Select Option
Mother
Father
Guardian
REQUIRED FIELDS - ENTER NONE IF NOT APPLICABLE
APPOINTMENT OF MEDICAL AUTHORITY I hereby give permission to the medical personnel selected by the Student Pastor or his designees to order x-rays, routine tests, and treatment for the student(s) to which I am registering for in the event I cannot be reached. I hereby give permission to the physician selected by the Student Pastor or his designees to hospitalize, secure proper treatment for, and to order injection, anesthesia, and/or surgery for my child(ren) as named above. I will not hold the Student Pastor, his designees, or Hillcrest Baptist Church liable for anything that may happen to my child, including death.
REQUIRED FIELDS - ENTER NONE IF NO INSURANCE
I hereby give Hillcrest Baptist Church and parties designated by them, including clients, licenses, purchasers, agents, publishers, and periodicals, the irrevocable right to use my child’s name and/or photograph for sale and reproduction in any print or electronic medium for purposes of advertising, trade, display, exhibition, competition, or editorial use pertaining to ministries, activities, or events of Hillcrest Baptist Church . This includes use on websites and all social media. I have read this release and understand and agree to its terms.
STATEMENT OF UNDERSTANDING & AGREEMENT OF REGISTRATION FORM
I understand that this Medical/Release Form is valid and that by signing this, my child has my express permission to participate in all activities, of any, nature, sponsored by the Church for the given school year as stated above. If I desire to limit my child’s participation in any event, I will submit my wishes in writing to the Student Pastor prior to that event. I understand that there are inherent risks involved in any ministry or athletic event and knowing that the church will always try to act responsibly, I fully release the church, its pastors, employees, and volunteer/ workers/chaperones/sponsors from any and all liability for any claim, including, but not limited to injury, loss, or damage to person or property that may occur during the course of my child’s involvement. Students may sign for themselves if they are 18+.
FUGE CAMP INFORMATION PACKET
After you register , Pastor Benji will reach out to you personally to give you an informational packet that has all the details of travel, logistics, packing, and expectations!
If you would like to have a physical packet, please reach out to Pastor Benji to set up an appointment to come by the church!
PAYMENT OPTIONSTHIS IS NONREFUNDABLE . The cost will include payment for lodging, food, and a t-shirt. Please read below for our available payment options:Choose the link below to pay. PAYMENT IS DUE 1 WEEK PRIOR TO CAMP (June 22) PLEASE NOTE: If, for any reason, this cost is a hardship for you, please choose the Cash option and reach out to Pastor Benji. We can't express enough how we don't want finances to be a reason why your student(s) can't come to this retreat.
Once you have completed the payment form, be sure to return to this window and click SUBMIT.
