Spark Session 2023 Camper Application
June 25th-30th @ Camp Rock Creek.
This is for students going into 4th Grade through 2023 High School Graduates
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Email *
Student's Name *
Student's Age *
Student's Grade (the grade they will enter into next school year) *
Emergency Contact - Name, Number, and Email *
What Church Do You Attend? *
Are you a baptized Christian? *
If not baptized, do you permit your child to be baptized at camp if they desire to do so? *
Required
Shirt Size? *
Does Student take daily meds? If yes, list all medications and instructions (For our Nurse) *
Is participant covered by personal/family medical insurance? *
If yes, Please add Insurance Company, Policy Number, Policy holder's name, and date of birth *
Is sponsor (Southwest) authorized to approve medical treatment? *
Required
Dietary restrictions *
How will you be paying? *
Required
Insurance Disclaimer:
By submitting this form, the participant (or parent/guardian) acknowledges and accepts the risks of physical injury associated with participation in the activity described above, except for gross negligence on the part of the sponsor. The participant (or parent/guardian) accepts personal financial responsibility for any bodily or personal injury sustained during the activity. Further, the participant (or parent/guardian) promises to hold harmless the sponsoring organization and its representatives for any injury related to the activity. I relieve Camp Rock Creek and the Southwest Church of Christ from any liabilities due to sickness, accidents, and/or injuries  while attending the camp or while coming to or from the camp grounds. If I cannot be reached by phone, I give my consent to the director or nurse to authorize physicians to administer medical help.
I understand and accept that I release Southwest church of Christ and Camp Rock Creek from any accident or incident that occurs to my child during Spark Session. *
Required
*New rule in place*
I understand and accept that phones are NOT ALLOWED during Spark Session for campers. If needed, you can talk to counselors or directors for specific usage, but will not be allowed to keep phone in cabin unless specified directly by directors. 
 *
Required
Every year, Spark Session produces a video from the week that goes on YouTube. No names or any sort of identification of children will be posted. I understand and accept that I permit Southwest church of Christ and Camp Rock Creek to publish photos and or videos of my child taken during Spark Session. *
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