Camp of Champions Registration

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Kid's of Grace, a ministry of Grace Fellowship of Amador, is excited to announce its 2019 Camp of Champions Soccer Camp!!

Are you ready to get in the game?!

Name and information *

First and last name of child attending:

Grade entering: *

1st

2nd

3rd

4th

5th

6th

7th

Birthday: *

Please include month, day and year.

YYYY

Age as of June 17: *

Address: *

Please include city & zip

Does child attend Sunday School? *

Yes

Name of Home Church

If applicable

Soccer Player's shirt size *

Y XS

Y S

Y M

Y L

Y XL

Medical information *

Please include any food allergies. Simply put N/A if none.

Name of Health Insurance. *

Policy Number of Health Insurance. *

Policy Holder of Health Insurance. *

WAIVER OF RESPONSIBILITY *

I/we release Grace Fellowship Church and any volunteers or associates of liability for any and all injuries during June 17-20, 2019 for Soccer Camp 2019. I hereby consent to any medical or dental treatment deemed necessary in the event of an emergency during any activity sponsored by Grace Fellowship Church. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my child.

I have read and agree to this waiver.

Type name and date as an electronic signature to this waiver. *

Parent information *

Parent/guardian name

Home phone *

Cell/Work Phone *

E-Mail Address *

Address: *

Please include street, city and zip.

Same as child's

Different than child's

Address if different than child's *

Please include street, city and zip.

Emergency Contact Name: *

Relation to child: *

Home Phone: *

Cell/Work Phone: *

Authorized Person(s) to Pick Up Child *

I would like to volunteer to help in any way I can!

Yes, please contact me with areas I can help out

No, thank you

Clear selection

All our volunteers must be Livescan fingerprinted with Grace Fellowship Church. If you would like to help with Camp of Champions, please plan on joining us for Livescan Fingerprinting on Sunday, June 2 at 12 noon in the Grace Library.

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