2024 TCBA Camper Registration
June 3-6, 2024 at Baptist Hill Campground, Mt. Vernon, Missouri
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Email *
CAMPER INFORMATION
Registering for: *
Camper's First Name: *
Camper's Last Name: *
Gender: *
Date of birth: *
MM
/
DD
/
YYYY
Name of church attending with: *
T shirt size: *
Grade just completed: *
PARENT/GUARDIAN INFORMATION
Parent or Guardian  Name: *
Relationship to Camper: *
Email address: *
1st Contact Phone: *
2nd Contact Phone:
Once at camp,  your child will not be allowed to leave without written permission of a parent or guardian (ID will be required). Individuals other than the parent/guardian listed above who may pick up my child from camp:
Name:
Relationship to Camper:
Phone Number:
Name:
Relationship to Camper:
Phone Number:
RELEASE FOR ACTIVITIES: *
Please check the following activities that your child IS NOT ALLOWED TO participate in.  If a box is not marked, we will assume your child can participate in that activity.
Required
RELEASE FOR IMAGES: *
TCBA camp leader may take photographs or make audio/video recordings of campers and leaders while at camp.  In addition, images may be used in advertising, promoting and publications for TCBA Camp.
MEDICAL INFORMATION
My child has permission to be given the following over-the-counter medications by the Camp Nurse. *
Required
Will your child be taking prescription medications at camp?   *
Is your child currently under a doctor's care: *
Required
If yes, what is your child being treated for?
List any other health concerns, allergies, or special instructions:
List of prescription medication your child will be taking at camp (BRING IN ORIGINAL BOTTLE*) (If not taking any medication, type "NONE") *
* All medications MUST be sent in the ORIGINAL prescription bottle(s) inside a Ziplock Bag with the the child's name and church written in permanent ink on the bag. Please send only enough medication for the 4 days of camp. All medication will be checked in with the camp medic upon the arrival to camp. 
Permission to treat in an Emergency *
Your selection gives permission for camp staff to seek emergency medical treatment if needed.  Furthermore, your selection acts as consent for your child to participate in the activities listed above.
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